ArticleUltrasonography (Seoul, Korea)2026
LAD-NASH score using multiparametric ultrasound for identification of at-risk MASH: head-to-head comparison with the FAST score.
Article in Ultrasonography (Seoul, Korea), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeNoninvasive scores have been proposed to identify patients with at-risk metabolic dysfunction-associated steatohepatitis (MASH) who may benefit from pharmacologic therapy. The LAD-NASH (model combining attenuation coefficient, dispersion slope, and liver stiffness for identification of nonalcoholic steatohepatitis) score, a multiparametric ultrasound (US)-based model that combines the attenuation coefficient, dispersion slope, and liver stiffness to identify nonalcoholic steatohepatitis, was recently developed for this purpose. This study aimed to validate the LAD-NASH score for identifying at-risk MASH in patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) and to compare its diagnostic performance with that of the FibroScan-aspartate aminotransferase (FAST) score.
methodsThis study enrolled consecutive patients who underwent multiparametric US and liver biopsy on the same day between February 2023 and April 2024. At-risk MASH was defined as biopsy-confirmed MASH with a MASLD activity score of ≥4 and fibrosis stage of ≥F2. The diagnostic performance of the LAD-NASH and FAST scores was evaluated using the areas under the receiver-operating characteristic curves (AUROCs).
resultsA total of 70 patients with biopsy-proven MASLD were included (median age, 44 years; 34 men; median body mass index, 28.7 kg/m²; at-risk MASH, 27.1%). The LAD-NASH and FAST scores demonstrated comparable diagnostic performance for identifying at-risk MASH (AUROCs, 0.740; 95% confidence intervals [CI], 0.621 to 0.838 vs. 0.739; 95% CI, 0.621 to 0.837; P=0.995). Using the rule-out cutoff of ≤0.264, the LAD-NASH score demonstrated 100% sensitivity and 100% negative predictive value for at-risk MASH.
conclusionThe LAD-NASH and FAST scores showed comparable diagnostic performance for identifying at-risk MASH. Because it is based solely on multiparametric US, the LAD-NASH score may be a useful noninvasive rule-out tool for at-risk MASH.
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