We would like to express our sincere gratitude to Wu and Zhang1 for the insightful comments and questions on our study.2 Our study focused on the baseline Fibrosis-4 index (FIB-4) and liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) to assess for the risk of hepatocellular carcinoma (HCC) during the follow-up, and recommendations on the threshold to initiate HCC surveillance were made based on the current guidelines’ suggestion on the cost-effectiveness threshold.3 While we agree that further studies are required to confirm whether serial changes in FIB-4 and/or LSM should alter the strategy for subsequent HCC surveillance, it is understood that changes in FIB-4 and LSM over time carry prognostic value in terms of risk of liver-related events (LREs), including HCC.4 5 As metabolic dysfunction-associated steatotic liver disease (MASLD) is a dynamic disease, it is advocated that non-invasive fibrosis…