ArticleGut2025
Non-invasive risk-based surveillance of hepatocellular carcinoma in patients with metabolic dysfunction-associated steatotic liver disease.
Article in Gut, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Are there true and false classifications in noninvasive liver disease assessment for metabolic dysfunction-associated steatotic liver disease?Hepatobiliary surgery and nutrition · 2026Article
- Toward more practical hepatocellular carcinoma surveillance in metabolic dysfunction-associated steatotic liver disease: clinical implications of fibrosis-based risk stratification.Hepatobiliary surgery and nutrition · 2026Article
- Cardiovascular and hepatic outcomes: prognostic differences across MASLD-MetALD-ALD continuum.Clinical and molecular hepatology · 2026Review
- Risk assessment in metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction and alcohol-related liver disease: current approaches and future directions.Clinical and molecular hepatology · 2026Review
- Risk of HCC in Elderly Patients With MASLD: Proposal of an Effective Surveillance Strategy.Journal of gastroenterology and hepatology · 2026Article
- The Malaysian Society of Gastroenterology and Hepatology Consensus Statements on Prevention and Early Detection of Hepatocellular Carcinoma in Malaysia.Journal of gastroenterology and hepatology · 2026Review
- Liver stiffness at baseline as a marker of hepatocellular carcinoma in cirrhosis: A matched analysis.World journal of gastrointestinal pathophysiology · 2026Article
- Risk Assessment and Prediction of Hepatocellular Carcinoma in Noncirrhotic Metabolic Dysfunction-Associated Steatotic Liver Disease.International journal of molecular sciences · 2026Review
- Non-invasive tests to guide hepatocellular carcinoma surveillance.JHEP reports : innovation in hepatology · 2026Article
- Machine learning-based prediction models for liver-related events in patients with hepatitis B-related cirrhosis and clinically significant portal hypertension.World journal of gastroenterology · 2026Article
- Current management strategies for sarcopenia and frailty in cirrhosis: Missing link in transplant candidacy.World journal of hepatology · 2026Review
- Risk Scores for Stratifying Hepatocellular Carcinoma and Optimizing Surveillance Strategies.Cancers · 2026Review
- Association between the aMAP risk score and mortality in the MASLD/MetALD/ALD patient population: a cohort study.Frontiers in medicine · 2026Article
- Histological severity and hepatic outcomes in patients with metabolic dysfunction-associated steatotic liver disease and discrepant FIB-4 and liver stiffness measurement.Clinical and molecular hepatology · 2026Article
- HCC Is the Predominant Liver-Related Event in MASLD: 2-Step Non-Invasive Algorithms to Stratify Risk in Non-Cirrhotic Patients.Journal of hepatocellular carcinoma · 2026Article
- Personalized Mortality Risk Stratification in ALD- and MASLD-Related Hepatocellular Carcinoma Using a Machine Learning Approach.Metabolites · 2025Article
- Review
- Machine learning-based hepatocellular carcinoma risk prediction model for patients with HBV-related compensated advanced chronic liver disease.Journal of cancer research and clinical oncology · 2025Article
- Austrian multisociety consensus on metabolic dysfunction-associated steatotic liver disease : Austrian Society of Gastroenterology and Hepatology (ÖGGH), Austrian Society of Diabetology (ÖDG), Austrian Society of Obesity (ÖAG).Wiener klinische Wochenschrift · 2025Article
- Role of non-invasive tests in the management of resectable hepatocellular carcinoma: future directions.Hepatobiliary surgery and nutrition · 2025Article
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40 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) affects over 30% of the general population and is the fastest growing cause of hepatocellular carcinoma (HCC). Current guidelines recommend HCC surveillance in patients with cirrhosis when annual HCC incidence exceeds 1% without specifying the role of non-invasive tests in patient selection.
objectiveTo define non-invasive test thresholds to select patients with MASLD for HCC surveillance.
designA multicentre longitudinal study of adults with MASLD from 16 tertiary centres in the USA, Europe and Asia between February 2004 and January 2023. Primary outcome was incident HCC.
results12 950 patients had Fibrosis-4 index (FIB-4) and liver stiffness measurement (LSM) (mean age 51.7 years; 41.1% male). At a median follow-up of 47.7 (IQR 23.3-72.3) months, 109 (0.8%) developed HCC. FIB-4 was below the low cut-off (<1.3 if aged <65 years and <2.0 if aged ≥65 years), between the low cut-off and <2.67, 2.67 to <3.25, and ≥3.25 in 66.3%, 23.9%, 3.4% and 6.4% of patients; the corresponding annual HCC incidence was 0.07%, 0.17%, 0.77% and 1.18%. As a stand-alone test, the annual HCC incidence exceeded 0.2% for LSM ≥10 kPa and 1% for LSM ≥20 kPa. If LSM was performed as a second step only among patients with FIB-4 above the low cut-off, the annual HCC incidence exceeded 0.2% for LSM ≥10 kPa and 1% for LSM ≥15 kPa.
conclusionHCC surveillance should be offered to patients with MASLD with FIB-4 ≥3.25 or LSM ≥20 kPa. When a two-step approach is adopted, LSM ≥15 kPa in patients with increased FIB-4 predicts a high HCC risk.
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