Clinical Utility of a 30% Reduction in VCTE-Derived Liver Stiffness Measurement for Identifying Histologic Improvement in Metabolic Dysfunction-Associated Steatohepatitis

Highlights

• A ≥30% relative decline in VCTE-derived liver stiffness measurement (LSM) is modestly predictive of histologic fibrosis regression in MASH patients.
• This non-invasive marker aligns with regulatory recommendations but shows only moderate diagnostic accuracy (AUC ~0.65), underscoring the need for complementary biomarkers.
• Multivariable-adjusted analyses confirm the independent association between ≥30% LSM reduction and fibrosis improvement without worsening steatohepatitis.
• Validation across diverse cohorts reveals consistent but limited performance, indicating population heterogeneity and measurement variability.