Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of liver-related morbidity and mortality worldwide. As the disease progresses, liver fibrosis and liver-related events (LREs), including hepatocellular carcinoma and other complications, become important indicators of clinical risk. However, accurately assessing fibrosis severity and predicting future LREs remains challenging. Liver biopsy is invasive and costly, while existing noninvasive biomarkers and imaging approaches have limitations.