MASLD: What We Have Learned and Where We Need to Go-A Call to Action

Area of Science:

• Radiology and Hepatology
• Medical Imaging
• Gastroenterology

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly fatty liver disease, has seen a significant rise in prevalence globally.
• Increasing obesity rates correlate with the growing incidence of MASLD, highlighting a significant public health concern.
• Despite extensive research, substantial knowledge gaps persist regarding MASLD pathophysiology and progression.

Purpose of the Study:

• To provide the latest insights into metabolic dysfunction-associated steatotic liver disease (MASLD), including its nomenclature, disease spectrum, epidemiology, and clinical impact.
• To review current qualitative and quantitative imaging modalities for assessing and monitoring MASLD.
• To identify and discuss six key challenges in MASLD assessment, presenting opportunities for the radiology community.

Main Methods:

• Pictorial review synthesizing current knowledge on MASLD.
• Discussion of epidemiological data, morbidity, and mortality associated with MASLD.
• Evaluation of existing imaging techniques for MASLD assessment and monitoring.

Main Results:

• The review details the updated nomenclature and the broad spectrum of MASLD.
• Current imaging methods for MASLD assessment are discussed, highlighting their capabilities and limitations.
• Six critical challenges in MASLD assessment are proposed: proliferation, reproducibility, reporting, needle-in-the-haystack, availability, and knowledge gaps.

Conclusions:

• The identified challenges in MASLD assessment present opportunities for proactive contributions from the radiology community.
• A collaborative effort is needed among radiologists and other societies to advance imaging technologies for MASLD.
• There is a call to action for the radiology community to develop, validate, disseminate, and improve accessibility of imaging technologies to address the MASLD health crisis.