Keywords: Liver, Liver, Obesity, Metabolic dysfunction-associated steatohepatitis (MASH), Metabolic dysfunction-associated steatotic liver disease (MASLD), vibration-controlled transient elastography (VCTE)
Motivation: Metabolic dysfunction-associated steatohepatitis (MASH) represents a growing pandemic with obese patients at higher risk. However, obesity limits vibration-controlled transient elastography (VCTE) in frontline screening.
Goal(s): We aimed to compare the effect of body mass index (BMI) on diagnostic performance of VCTE and abbreviated MRI.
Approach: Patients (N=229) were enrolled into a prospective study with VCTE and a subset (N=59) underwent same-day abbreviated MRI.
Results: Patients with BMI > 32 had a higher failure rate of VCTE at 33%, but MRI was diagnostic in all patients. Obese patients with BMI > 32 benefit from proceeding directly to MRI for hepatic evaluation.
Impact: Obesity correlates with higher liver fibrosis in metabolic dysfunction-associated steatohepatitis (MASH), but also increases failure of vibration-controlled transient elastography (VCTE) in frontline screening. Abbreviated MRI should be considered a frontline screening modality in obese patients with BMI >32.
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