Current Evidence on MR Elastography in Metabolic Dysfunction-Associated Steatohepatitis: A Scoping Review

Area of Science:

• Hepatology and Gastroenterology
• Medical Imaging and Diagnostics
• Non-invasive Liver Disease Assessment

Background:

• Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disease linked to fibrosis, cirrhosis, and liver cancer.
• Magnetic resonance elastography (MRE) is a non-invasive imaging technique for assessing liver fibrosis and inflammation.
• Recent pharmaceutical approvals for MASH increase the demand for accurate diagnostic tools like MRE.

Purpose of the Study:

• To conduct a scoping review on the current research of MRE in MASH for assessing fibrosis and inflammation.
• To evaluate the diagnostic performance of MRE in MASH based on existing literature.

Main Methods:

• A structured literature search was performed in MEDLINE and Embase + Embase Classic databases.
• Eleven studies published within the last five years, meeting predefined criteria (e.g., prospective design, histopathological validation), were included.
• Data on MRE's performance for fibrosis and inflammation assessment in MASH were extracted and analyzed.

Main Results:

• MRE demonstrated excellent diagnostic performance for liver fibrosis in MASH, with AUCs up to 0.97, surpassing many other non-invasive tests.
• Preliminary studies indicate good performance of MRE for assessing hepatic inflammation, with AUCs up to 0.83.
• Multiparametric MRI approaches combining MRE with PDFF and cT1 show potential to enhance diagnostic accuracy for steatosis, fibrosis, and inflammation in MASH.

Conclusions:

• MRE is a reliable non-invasive tool for assessing hepatic fibrosis in MASH.
• MRE shows significant promise for evaluating hepatic inflammation in MASH.
• Further research is needed to establish MRE as a biopsy alternative for MASH diagnosis and management.