Scholarlink

Purpose <p>Elastography is central to fibrosis risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD). While vibration-controlled transient elastography (VCTE) is most widely used, magnetic resonance elastography (MRE) is more accurate. A discordance between them has been reported, and body mass index (BMI) has been proposed as a determinant. We investigated the impact of BMI on VCTE–MRE discordance in a real-world cohort.</p> Methods <p>This retrospective study included 268 adults with MASLD who underwent VCTE and MRE within 30 days. The primary endpoint was high-grade cross-threshold discordance, defined as VCTE ≥ F3 with MRE &lt; F2 or MRE ≥ F3 with VCTE &lt; F2. Secondary endpoints included discordance at ≥F2,≥F3, and ≥ 2-stage disagreement. Predictors of high-grade discordance were evaluated using logistic regression adjusted for age, sex, and diabetes. BMI-stratified calibration models were developed to harmonize TE values into MRE-equivalent scores.</p> Results <p>VCTE and MRE showed moderate correlation (Spearman ρ = 0.54; log-Pearson <i>r</i> = 0.70) and moderate staged agreement (κ = 0.50). High-grade discordance occurred in 19.0% overall and increased sharply with BMI: 7.7% (&lt; 25), 10.3% (25–29.9), 21.4% (30–34.9), and 64.7% (≥ 35). Discordance was predominantly TE-high/MRE-low. Multivariable analysis showed that every 5&#xa0;kg/m<sup>2</sup> increase in BMI nearly tripled the odds of high-grade discordance (OR 2.70; 95% CI 1.93–3.93). Calibration modelling revealed that advanced VCTE values in patients with BMI ≥ 35 corresponded to MRE values well below the threshold for advanced fibrosis.</p> Conclusion <p>In MASLD, VCTE–MRE discordance is strongly BMI-dependent and clinically consequential in severe obesity, supporting BMI-aware fibrosis triage and modality harmonization.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

BMI-dependent discordance between transient and MR elastography: risk of fibrosis overestimation in severe obesity

  • 期刊论文

  • 发表日期：

    2026年5月15日

查看全文
  • Akash Roy,
  • Surabhi Jajodia,
  • Shardhya Chakraborty,
  • Shruti Keyal,
  • Awanish Tewari,
  • Nikhil Sonthalia,
  • Sarthak Chakrabarti,
  • Sourish Roy,
  • Rajat Khandelwal,
  • Uday Chand Ghoshal,
  • Mahesh Kumar Goenka

摘要

Purpose

Elastography is central to fibrosis risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD). While vibration-controlled transient elastography (VCTE) is most widely used, magnetic resonance elastography (MRE) is more accurate. A discordance between them has been reported, and body mass index (BMI) has been proposed as a determinant. We investigated the impact of BMI on VCTE–MRE discordance in a real-world cohort.

Methods

This retrospective study included 268 adults with MASLD who underwent VCTE and MRE within 30 days. The primary endpoint was high-grade cross-threshold discordance, defined as VCTE ≥ F3 with MRE < F2 or MRE ≥ F3 with VCTE < F2. Secondary endpoints included discordance at ≥F2,≥F3, and ≥ 2-stage disagreement. Predictors of high-grade discordance were evaluated using logistic regression adjusted for age, sex, and diabetes. BMI-stratified calibration models were developed to harmonize TE values into MRE-equivalent scores.

Results

VCTE and MRE showed moderate correlation (Spearman ρ = 0.54; log-Pearson r = 0.70) and moderate staged agreement (κ = 0.50). High-grade discordance occurred in 19.0% overall and increased sharply with BMI: 7.7% (< 25), 10.3% (25–29.9), 21.4% (30–34.9), and 64.7% (≥ 35). Discordance was predominantly TE-high/MRE-low. Multivariable analysis showed that every 5 kg/m2 increase in BMI nearly tripled the odds of high-grade discordance (OR 2.70; 95% CI 1.93–3.93). Calibration modelling revealed that advanced VCTE values in patients with BMI ≥ 35 corresponded to MRE values well below the threshold for advanced fibrosis.

Conclusion

In MASLD, VCTE–MRE discordance is strongly BMI-dependent and clinically consequential in severe obesity, supporting BMI-aware fibrosis triage and modality harmonization.

Graphical abstract