ASSESSMENT OF FIBROSIS AND STEATOSIS IN PATIENTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE USING TWO TRANSIENT ELASTOGRAPHY TECHNIQUES

Abstract

Introduction and Objectives

Metabolic associated steatotic liver disease (MASLD) is one of the leading causes of chronic liver disease worldwide. Accurate non-invasive assessment of hepatic fibrosis and steatosis is critical for cirrhosis progression risk stratification and clinical decision-making. While FibroScan® is a well-validated transient elastography technique, Hepatus® has emerged as a comparable technological alternative. There are few studies directly comparing the two modalities. This study aimed to compare the performance of FibroScan® and Hepatus® in evaluating hepatic fibrosis and fat deposition degree in patients with hepatic steatosis.

Materials and Methods

A prospective, blinded validation study was conducted in 122 adult patients with hepatic steatosis diagnosis. Liver stiffness (kPa) and steatosis (dB/m) were assessed on the same day using both devices by independent expert operators, ensuring optimal examination quality (IQR/M <0.3). Correlation, agreement and differences were analyzed using appropriate statistical tests and post-hoc analysis.

Results

For liver fibrosis, both devices showed strong correlation (r=0.85, p<0.05) and substantial agreement (Kappa=0.77), with greater concordance in advanced stages and no significant differences in mean values. Regarding hepatic steatosis, although Hepatus® reported higher absolute values (p<0.05), it showed an almost perfect positive linear correlation with FibroScan® (r≈1). Agreement for steatosis staging was moderate (Kappa=0.39), with discrepancies mainly observed in extreme categories (S0 vs S3).

Conclusions

FibroScan® and Hepatus® show high concordance and strong correlation in assessing liver fibrosis and steatosis quantification. Hepatus® may serve as a viable clinical alternative for non-invasive evaluation of MASLD in diverse healthcare settings.