Gut Liver.  2024 Nov;18(6):1048-1059. 10.5009/gnl240198.

Combi-Elastography versus Transient Elastography for Assessing the Histological Severity of Metabolic Dysfunction-Associated Steatotic Liver Disease

• Lee YK
• Lee DH
• Joo SK
• Jang H
• So YH
• Jang S
• Lee DH
• Park JH
• Chang MS
• Kim W
• On behalf of Innovative Target Exploration of NAFLD (ITEN) Consortium

• KMID: 2561534
• DOI: http://doi.org/10.5009/gnl240198

Abstract

Background/Aims
Combi-elastography is a B-mode ultrasound-based method in which two elastography modalities are utilized simultaneously to assess metabolic dysfunction-associated steatotic liver disease (MASLD). However, the performance of combi-elastography for diagnosing metabolic dysfunction-associated steatohepatitis (MASH) and determining fibrosis severity is unclear. This study compared the diagnostic performances of combi-elastography and vibrationcontrolled transient elastography (VCTE) for identifying hepatic steatosis, fibrosis, and high-risk MASH.
Methods
Participants who underwent combi-elastography, VCTE, and liver biopsy were selected from a prospective cohort of patients with clinically suspected MASLD. Combi-elastographyrelated parameters were acquired, and their performances were evaluated using area under the receiver-operating characteristic curve (AUROC) analysis.
Results
A total of 212 participants were included. The diagnostic performance for hepatic steatosis of the attenuation coefficient adjusted by covariates from combi-elastography was comparable to that of the controlled attenuation parameter measured by VCTE (AUROC, 0.85 vs 0.85; p=0.925). The performance of the combi-elastography-derived fibrosis index adjusted by covariates for diagnosing significant fibrosis was comparable to that of liver stiffness measured by VCTE (AUROC, 0.77 vs 0.80; p=0.573). The activity index from combi-elastography adjusted by covariates was equivalent to the FibroScan-aspartate aminotransferase score in diagnosing high-risk MASH among participants with MASLD (AUROC, 0.72 vs 0.74; p=0.792).
Conclusions
The performance of combi-elastography is similar to that of VCTE when evaluating histology of MASLD.

Keyword

Metabolic dysfunction-associated steatotic liver disease; Metabolic dysfunctionassociated steatohepatitis; Elasticity imaging techniques; Ultrasonography