Welcome to a new insightful episode of “Ask the Author”. Today, we’re honored to have Professor Vincent Wong with us, discussing his groundbreaking work titled “Vibration-Controlled Transient Elastography Scores to Predict Liver-Related Events in Steatotic Liver Disease,” recently published in JAMA.

In this enlightening discussion, Professor Wong delves into the background and context of their study. He highlights the prevalence of Metabolic Associated Fatty Liver Disease (MAFLD), affecting over 30% of the global population, necessitating the use of noninvasive tests (NITs) for disease assessment. Unlike previous studies focused solely on the correlation between NITs and liver histology, Professor Wong’s team aimed to demonstrate the prognostic value of NITs in monitoring disease progression and treatment response.

Their study, a multicenter cohort involving over 16,000 patients with MAFLD, showcased impressive numbers. Prospective data collection across 16 tertiary referral centers allowed for longitudinal analysis, with more than 10,000 patients undergoing multiple examinations. This comprehensive approach provided insights into the prognostic significance of changes in NITs over time.

The results are nothing short of revolutionary. Many existing NITs exhibited prognostic performance comparable to, if not superior to, liver histology. Notably, the Vibration-Controlled Transient Elastography (VCTE)-based Agile 3+ and Agile 4 scores stood out, boasting time-dependent area under the curve values nearing 90%. Furthermore, a 20% or greater change in liver status measurement translated into significant alterations in the incidence of liver-related events, validating NITs as effective monitoring tools.

Professor Wong emphasizes the transformative impact of these findings on the field. With growing evidence supporting the efficacy of NITs in predicting liver-related events and monitoring disease progression, the need for liver biopsy for prognostication diminishes. As regulatory bodies consider NITs as surrogate endpoints, patients stand to benefit from reduced reliance on invasive procedures, both in research and routine clinical care.

In conclusion, Professor Wong’s study heralds a new era in liver disease management, where noninvasive tests serve as reliable indicators of prognosis. With these insights, medical practitioners can navigate the complexities of MAFLD with greater confidence and precision, ultimately improving patient outcomes.

We extend our heartfelt congratulations to Professor Wong and his team for their remarkable contribution to the field. Stay tuned for more enlightening discussions on cutting-edge medical research.

Prof. Vincent Wong answering to the questions of Professor Jean-Fran├žois Dufour.