Role of Vibration-Controlled Transient Elastography in the Evaluation and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease

The increasing global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) underscores the urgent need for a reliable non-invasive test (NIT) to phenotype and stratify risk in affected individuals. This narrative review aims to provide clinicians with an understanding of vibration-controlled transient elastography (VCTE). We focus on the clinical significance of key VCTE-derived parameters: the controlled attenuation parameter (CAP), liver stiffness measurement (LSM), and spleen stiffness measurement (SSM).

VCTE enables simultaneous assessment of hepatic steatosis, fibrosis, and the severity of portal hypertension by measuring CAP, LSM, and SSM, respectively. Furthermore, combination scores improve diagnostic accuracy by reducing values in the indeterminate range. Changes in CAP, LSM, or SSM over time may serve as biomarkers of disease activity.

CAP, LSM, and SSM, as NITs obtained through VCTE, play pivotal roles in disease phenotyping risk prognostication and monitoring disease progression or treatment response. It is hoped that VCTE-based parameters will minimize or obviate the need for invasive liver biopsy.