MRI-PDFF-based score using fat homogeneity identifies MASH in obese adults

An MRI-PDFF score combining right-lobe fat fraction mean, standard deviation, ALT, and waist circumference identified metabolic dysfunction-associated steatohepatitis (MASH) with AUROC 0.90 (95%CI 0.84–0.95) in 107 obese adults, outperforming other noninvasive models.

• MASH livers showed higher fat content and more homogeneous fat distribution in the right lobe.
• The raw-MASH score outperformed HAIR, ION, and acNASH (all p<0.05) and had higher AUROC than MR-MASH (0.90 vs 0.85, p=0.066).
• A dual threshold strategy further improved sensitivity and specificity.

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