In MASLD, One-Year FibroScan Change Predicts Future Decompensation: CGH | September 2026

Introduction:

FibroScan liver stiffness measurement (LSM) is widely used to stage fibrosis in MASLD, but its value as a dynamic prognostic marker is less established. This study examined whether one-year changes in LSM predict subsequent liver-related outcomes.

Why was this study needed?

Baseline LSM predicts advanced fibrosis and clinical outcomes.

It is unclear whether serial changes in stiffness provide additional prognostic information.

Dynamic biomarkers are increasingly important as disease-modifying MASH therapies enter practice.

Key Findings:

The cohort included 1,744 patients with MASLD and baseline LSM ≥8 kPa.

One-year change in LSM independently predicted subsequent liver-related events and hepatic decompensation.

Patients with the greatest LSM reductions had the lowest subsequent risk.

Progressive increases in LSM identified patients at increasingly higher risk.

Changes in ALT, CAP, and FIB-4 did not independently predict these outcomes.

LSM change did not independently predict HCC.

Importantly, the study does not prove that treatment-induced LSM reduction itself improves clinical outcomes.

Bottom Line:

FibroScan may be more than a baseline fibrosis tool in MASLD: its trajectory over time carries prognostic information. Whether treatment-induced reductions in stiffness can serve as a surrogate for improved outcomes requires prospective validation.