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Background <p>Liver biopsy is the gold standard for diagnosing metabolic dysfunction associated steatohepatitis (MASH). There is an unmet need for non-invasive tests to differentiate uncomplicated hepatic steatosis from steatohepatitis and fibrotic MASH.</p> Objectives <p>We aimed to evaluate the role of T1 relaxation time, MRI-PDFF (Proton density fat fraction), and IVIM (Intravoxel Incoherent motion) in detecting and differentiating MASH from non-MASH group of patients and fibrotic MASH from low-risk/absent MASH group.</p> Material &amp; methods <p>We prospectively conducted a cross-sectional study of 64 patients with Metabolic dysfunction associated steatotic liver disease (MASLD) and reviewed MRI data from 46 patients who underwent liver biopsy. Dedicated sequences were performed using a 1.5 T MR scanner to derive liver MRI-PDFF, T1, and IVIM values (D-True diffusion coefficient, D*- pseudo diffusion coefficient, and f - perfusion fraction). The NASH CRN (Clinical Research Network) scoring system was used to categorize patients based on biopsy results. MR-derived data were compared with the biopsy results.</p> Results <p>Median T1 values were significantly higher in patients with MASH than the non-MASH group (884.97 ms versus 698.59 ms; <i>p</i> = 0.0002, AUROC (95% CI) 0.828 (0.709–0.947)) and in fibrotic MASH versus low-risk/absent MASH group (870.48 ms versus 695.10 ms; <i>p</i> &lt; 0.0001, AUROC (95% CI) 0.851 (0.742–0.961)). Median MRI-PDFF values were significantly higher in MASH patients compared to non-MASH patients (19.38% vs. 9.46%, <i>p</i> = 0.0004, AUROC (95% CI) 0.808 (0.657–0.937)) and in fibrotic MASH compared to low-risk/absent MASH (20.45% vs. 8.58%, <i>p</i> = 0.0001, AUROC (95% CI) 0.847 (0.730–0.963)). MASH patients showed significantly lower D* (<i>p</i> = 0.0167) and f (<i>p</i> = 0.0382) than the non-MASH group; fibrotic MASH patients had lower D (<i>p</i> = 0.042) and D* (<i>p</i> = 0.025) than the low-risk/absent MASH group.</p> Summary and conclusion <p>MRI T1 mapping and MRI-PDFF demonstrate good diagnostic accuracy for detecting biopsy-defined MASH and fibrotic MASH. Further large-scale, multicenter studies are required to establish their role in clinical practice and potentially help reduce reliance on liver biopsy.</p>

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Quantitative MR biomarkers in identifying steatohepatitis and fibrosis associated with metabolic dysfunction associated liver disease—a single center cross-sectional study

  • 期刊论文

  • 发表日期：

    2026年7月10日

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  • Srinivas Meharwade,
  • Sanchita Gupta,
  • Ankur Goyal,
  • Devasenathipathy Kandasamy,
  • Shalimar,
  • Shivanand Gamanagatti,
  • Prasenjit Das,
  • Amit Mehndiratta,
  • Mani Kalaivani,
  • Raju Sharma

摘要

Background

Liver biopsy is the gold standard for diagnosing metabolic dysfunction associated steatohepatitis (MASH). There is an unmet need for non-invasive tests to differentiate uncomplicated hepatic steatosis from steatohepatitis and fibrotic MASH.

Objectives

We aimed to evaluate the role of T1 relaxation time, MRI-PDFF (Proton density fat fraction), and IVIM (Intravoxel Incoherent motion) in detecting and differentiating MASH from non-MASH group of patients and fibrotic MASH from low-risk/absent MASH group.

Material & methods

We prospectively conducted a cross-sectional study of 64 patients with Metabolic dysfunction associated steatotic liver disease (MASLD) and reviewed MRI data from 46 patients who underwent liver biopsy. Dedicated sequences were performed using a 1.5 T MR scanner to derive liver MRI-PDFF, T1, and IVIM values (D-True diffusion coefficient, D*- pseudo diffusion coefficient, and f - perfusion fraction). The NASH CRN (Clinical Research Network) scoring system was used to categorize patients based on biopsy results. MR-derived data were compared with the biopsy results.

Results

Median T1 values were significantly higher in patients with MASH than the non-MASH group (884.97 ms versus 698.59 ms; p = 0.0002, AUROC (95% CI) 0.828 (0.709–0.947)) and in fibrotic MASH versus low-risk/absent MASH group (870.48 ms versus 695.10 ms; p < 0.0001, AUROC (95% CI) 0.851 (0.742–0.961)). Median MRI-PDFF values were significantly higher in MASH patients compared to non-MASH patients (19.38% vs. 9.46%, p = 0.0004, AUROC (95% CI) 0.808 (0.657–0.937)) and in fibrotic MASH compared to low-risk/absent MASH (20.45% vs. 8.58%, p = 0.0001, AUROC (95% CI) 0.847 (0.730–0.963)). MASH patients showed significantly lower D* (p = 0.0167) and f (p = 0.0382) than the non-MASH group; fibrotic MASH patients had lower D (p = 0.042) and D* (p = 0.025) than the low-risk/absent MASH group.

Summary and conclusion

MRI T1 mapping and MRI-PDFF demonstrate good diagnostic accuracy for detecting biopsy-defined MASH and fibrotic MASH. Further large-scale, multicenter studies are required to establish their role in clinical practice and potentially help reduce reliance on liver biopsy.