Noninvasive Detection of MASH and Fibrotic Burden Using Ultrasound-Derived LIID and LSM in MASLD: A Multicenter Study

Area of Science:

• Hepatology
• Medical Imaging
• Diagnostic Tools

Background:

• Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disease linked to adverse health outcomes.
• Accurate diagnosis and staging of MASH and its associated fibrosis are crucial for patient management.

Purpose of the Study:

• To validate a novel quantitative ultrasound (QUS)-derived LIID score for noninvasive MASH diagnosis.
• To evaluate liver stiffness measurement (LSM) performance for fibrosis detection in metabolic dysfunction-associated steatotic liver disease (MASLD).

Main Methods:

• A multicenter study included 410 patients with biopsy-proven MASLD.
• Quantitative ultrasound (QUS) and liver stiffness measurement (LSM) were performed using the iLivTouch platform.
• Performance was assessed by comparing LIID score and LSM with liver biopsy results.

Main Results:

• The LIID score showed an AUROC of 0.71 for MASH detection, with thresholds for ruling out (6.0) and ruling in (7.8) MASH.
• LSM demonstrated excellent diagnostic performance for advanced fibrosis (AUROC: 0.86) and acceptable accuracy for significant fibrosis and cirrhosis.
• The LIID score achieved 89.6% sensitivity for ruling out MASH and 88.4% specificity for ruling in MASH.

Conclusions:

• The LIID score provides a noninvasive, ultrasound-based method for identifying MASH.
• Combining LIID score with LSM enables comprehensive, noninvasive assessment of liver inflammation and fibrosis in MASLD.
• This ultrasound-based strategy may decrease the clinical reliance on liver biopsy.