The data were retrospectively collected. We included patients with chronic liver disease who underwent liver biopsy, VCTE, and unenhanced abdominal CT within a 3-month period between 2019 and 2023.

Liver steatosis was assessed using VCTE-CAP values (db/m) (Method 1) and CT-based methods: liver attenuation (Method 2) or the difference between liver and spleen attenuation(Method 3), both measured in Hounsfield Units (HU). Histological steatosis was categorised as none S0(<5%), mild S1(5–32%), moderate S2(33–65%) and severe S3(≥66%).

The diagnostic performance of CAP, respectively  CT scan methods as well as their cuttoff values for predicting the steatosis grade were assessed using receiver operating characteristic curves (AUROC) and Youden Index. DeLong test of difference between AUROCs was used for pairwise comparisons.