ArticleAbdominal radiology (New York)2026
BMI-dependent discordance between transient and MR elastography: risk of fibrosis overestimation in severe obesity.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeElastography is central to fibrosis risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD). While vibration-controlled transient elastography (VCTE) is most widely used, magnetic resonance elastography (MRE) is more accurate. A discordance between them has been reported, and body mass index (BMI) has been proposed as a determinant. We investigated the impact of BMI on VCTE-MRE discordance in a real-world cohort.
methodsThis retrospective study included 268 adults with MASLD who underwent VCTE and MRE within 30 days. The primary endpoint was high-grade cross-threshold discordance, defined as VCTE ≥ F3 with MRE < F2 or MRE ≥ F3 with VCTE < F2. Secondary endpoints included discordance at ≥F2,≥F3, and ≥ 2-stage disagreement. Predictors of high-grade discordance were evaluated using logistic regression adjusted for age, sex, and diabetes. BMI-stratified calibration models were developed to harmonize TE values into MRE-equivalent scores.
resultsVCTE and MRE showed moderate correlation (Spearman ρ = 0.54; log-Pearson r = 0.70) and moderate staged agreement (κ = 0.50). High-grade discordance occurred in 19.0% overall and increased sharply with BMI: 7.7% (< 25), 10.3% (25-29.9), 21.4% (30-34.9), and 64.7% (≥ 35). Discordance was predominantly TE-high/MRE-low. Multivariable analysis showed that every 5 kg/m
conclusionIn MASLD, VCTE-MRE discordance is strongly BMI-dependent and clinically consequential in severe obesity, supporting BMI-aware fibrosis triage and modality harmonization.
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