Multifrequency MR elastography for grading inflammation in metabolic dysfunction-associated steatotic liver disease:...

Area of Science:

• Hepatology
• Medical Imaging
• Biophysics

Background:

• Noninvasive grading of liver inflammation in metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant clinical challenge.
• Accurate assessment of inflammation is crucial for managing MASLD and preventing progression to metabolic dysfunction-associated steatohepatitis (MASH).

Purpose of the Study:

• To assess the diagnostic capabilities of multifrequency MR elastography (MMRE) for grading liver inflammation.
• To determine the efficacy of MMRE in diagnosing MASH.

Main Methods:

• Prospective study involving participants undergoing MMRE at 30, 40, and 60 Hz on a 3T MRI system.
• Calculation of multifrequency dispersion coefficient (α), storage modulus (G'), loss modulus (G''), and shear modulus magnitude (|G*|).
• Histopathological analysis of liver biopsy specimens served as the reference standard for grading inflammation, ballooning, and fibrosis to determine MASH status.

Main Results:

• The multifrequency dispersion coefficient (α) demonstrated significant correlations with lobular inflammation (ρ = -0.62, P < .001) and ballooning (ρ = -0.42, P < .001).
• The correlation between α and lobular inflammation remained significant after adjusting for steatosis, ballooning, and fibrosis (β = -0.06, P < .001).
• Areas under the receiver operating characteristic curve (AUCs) for α ranged from 0.81 to 0.96 for differentiating inflammation and ballooning grades and diagnosing MASH.

Conclusions:

• The multifrequency dispersion coefficient (α) derived from MMRE is significantly associated with histologic liver inflammation and ballooning in MASLD patients.
• MMRE, particularly the α parameter, shows potential as a noninvasive tool for assessing liver disease severity.
• Further external validation is recommended to establish α as a reliable clinical marker for MASLD and MASH.