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This conversation centers around the different kinds of impact that in-office scanning can have on MASLD therapy, both in terms of improved prognostics and better overall outcomes. 

Roger Green starts by suggesting that the recent commercialization of a second VCTE in the U.S. (specifically, Hepatoscope from e-Scopics), coupled with increased promotion of the scanning device Velacur from Sonic Incytes, will increase education and promotion dramatically and lead to significant increases in patients scanned and scan frequency. I then note the downside to this issue: increased presence of scanning devices, coupled with the fact that FDA approved Rezdiffra without requiring biopsy, might make it more difficult to recruit patients to biopsy-based clinical trials.

The group demurs whether this might motivate the FDA or EMA to move toward NITs sooner but is highly confident that it will lead to improved liver health coupled with increased access to training for prescribers and advanced providers and, separately, sensible reimbursement structures.

Jörn Schattenberg shifts to discuss LiverAIM, a new EU consortium with the goal of demonstrating that testing affects outcomes by comparing matched cohorts of 50,000 patients each. If this demonstrates the cost-effectiveness of screening, it will address reimbursement and the speed of device purchase. Louise asks whether LiverAIM will include a brief interventional therapy and conversation, two elements she finds vital in treating liver patients.  Jörn states this is not the primary study objective but might occur. She asks how the study will address cultural and governmental differences between countries. Jörn expresses hope that these can fall out in analysis.