Non-Invasive Tests for the Detection of MASLD: Biomarkers and Imaging for Staging Steatosis, MASH, and Fibrosis

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has become the predominant cause of liver diseases, with a rising incidence globally, has gained considerable attention. As a heterogeneous disease, it imposes a significant economic burden on society and can progress to severe outcomes like cirrhosis, hepatocellular carcinoma (HCC) and even death. However, awareness, attention, and early intervention for MASLD are lacking, as the disease often starts insidiously and remains asymptomatic in its initial stages. The traditional diagnostic approaches, including liver biopsy and routine laboratory tests, are limited by their invasiveness, acceptance, and specificity. Similarly, imaging methods struggle with high costs and insufficient sensitivity. Early diagnosis and management of MASLD are critical to preventing the onset and decelerating the progression of liver fibrosis, thereby improving liver health. These challenges have prompted considerable efforts to develop non-invasive tests for diagnosing and managing MASLD. Using serum alone or in combination with imaging technology has the potential to improve early diagnostic accuracy, allowing clinicians to better assess and classify the disease. This article offers a comprehensive overview of the current state of non-invasive assessments for MASLD, discussing their applicability and exploring their potential in diagnosing and staging steatosis, MASH, and fibrosis, thereby enhancing patient management and care.