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Updated: Sep 12, 2025

Author Spotlight: Establishing MASLD Cell Models for Investigating Disease Mechanisms and the Lipid-Lowering Effects of Koumiss

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Part 2: CAR Metabolic Dysfunction-Associated Steatotic Liver Disease Working Group Recommendations for Risk

Mitchell P Wilson¹, Gavin Low¹, Abdel-Aziz Shaheen²

¹University of Alberta, Edmonton, AB, Canada.

Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes

|August 6, 2025

Summary

This guideline offers a pathway for assessing metabolic dysfunction-associated steatotic liver disease (MASLD) risk. It recommends using the FIB-4 score followed by imaging to identify patients with advanced hepatic fibrosis.

Keywords:

biomarkers elastography liver cirrhosis liver fibrosis magnetic resonance elastography metabolic-associated steatotic liver disease noninvasive diagnostic techniques practice guidelines risk assessment ultrasonography

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Optimized Analysis of In Vivo and In Vitro Hepatic Steatosis

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Published on: March 11, 2017

Area of Science:

Hepatology
Radiology
Medical Guidelines

Background:

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously nonalcoholic fatty liver disease (NAFLD), is a growing health concern.
Accurate risk stratification is crucial for managing patients with MASLD and preventing advanced hepatic fibrosis.
Multidisciplinary collaboration is essential for developing comprehensive clinical guidelines.

Purpose of the Study:

To provide Delphi consensus-based guidance for the risk stratification of patients with known or suspected MASLD.
To establish a patient pathway integrating serological and imaging investigations for fibrosis assessment.
To offer recommendations for quality assurance in elastography programs for MASLD.

Main Methods:

Development of 14 recommendations through a Delphi consensus process by the Canadian Association of Radiologists (CAR) MASLD Working Group.
Integration of clinical, serological (FIB-4), and imaging investigations for risk stratification.
Discussion of clinical, technical, and grading recommendations for point shear wave elastography (pSWE), 2-dimensional SWE (2D-SWE), and magnetic resonance elastography (MRE).

Main Results:

A recommended pathway for population screening and risk stratification of MASLD patients.
Identification of a combination of serological and imaging investigations to stratify patients into low and high risk for advanced hepatic fibrosis (F ≥ 3).
Detailed recommendations for the application and quality assurance of elastography techniques in MASLD assessment.

Conclusions:

The guidelines provide a structured approach for risk stratifying MASLD patients, prioritizing those at higher risk for advanced fibrosis.
The recommended pathway facilitates efficient patient management by combining non-invasive serological and imaging tools.
Implementation of these recommendations can improve the quality of care and diagnostic accuracy for MASLD.