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World J Gastroenterol. Jul 7, 2025; 31(25): 105518
Published online Jul 7, 2025. doi: 10.3748/wjg.v31.i25.105518
Multiparametric ultrasound for non-invasive assessment of liver steatosis, fibrosis, and inflammation in metabolic dysfunction-associated steatotic liver disease
Antonio Liguori, Maria E Ainora, Luca Di Gialleonardo, Nicholas Viceconti, Lucrezia Petrucci, Giorgio Esposto, Maria C Giustiniani, Irene Mignini, Raffaele Borriello, Linda Galasso, Mattia Paratore, Matteo Garcovich, Laura Riccardi, Maurizio Pompili, Antonio Grieco, Antonio Gasbarrini, Luca Miele, Maria A Zocco
Antonio Liguori, Nicholas Viceconti, Lucrezia Petrucci, Maurizio Pompili, Antonio Grieco, Luca Miele, Unità di Medicina Interna e Trapianto di Fegato, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy
Maria E Ainora, Luca Di Gialleonardo, Giorgio Esposto, Irene Mignini, Raffaele Borriello, Linda Galasso, Mattia Paratore, Matteo Garcovich, Laura Riccardi, Antonio Gasbarrini, Maria A Zocco, CEMAD, Centro Malattie Apparato Digerente, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy
Maria C Giustiniani, Dipartimento di Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy
Author contributions: Zocco MA and Miele L contributed to conceptualization; Liguori A, Ainora ME, Miele L, and Zocco MA contributed to methodology; Liguori A contributed to formal analysis; Liguori A, Ainora ME, Di Gialleonardo L, Petrucci L, Viceconti N, Mignini I, Borriello R, Galasso L, Garcovich M, Giustiniani MC, and Paratore M contributed to the investigation; Liguori A, Di Gialleonardo L, Viceconti N, and Petrucci L contributed to data curation; Liguori A and Ainora ME contributed to writing the original draft; Liguori A, Ainora ME, Esposto G, Miele L, and Zocco MA contributed to writing and reviewing; Liguori A, Ainora ME, Esposto G, Miele L, and Zocco MA contributed to editing; Miele L, Pompili M, Zocco MA, Grieco A, Riccardi L, and Gasbarrini A contributed to supervision; Gasbarrini A, Miele L, and Zocco MA contributed to funding acquisition; All authors read and approved the final version of the manuscript.
Institutional review board statement: Protocol was approved by local ethic committee [Prot. 20048/19 (28519/19) ID: 2576].
Clinical trial registration statement: Protocol was registered on clinical trial (No. NCT04371042).
Informed consent statement: Written informed consent was obtained by every patient.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: All article data are available in the paper.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maria A Zocco, MD, PhD, Professor, CEMAD, Centro Malattie Apparato Digerente, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 1, Rome 00168, Italy. mariaassunta.zocco@unicatt.it
Received: February 7, 2025
Revised: March 27, 2025
Accepted: June 10, 2025
Published online: July 7, 2025
Processing time: 147 Days and 23.1 Hours
Core Tip

Core Tip: This article provided further insights into the performance of different ultrasound-based techniques for non-invasive multiparametric assessment of liver fibrosis, steatosis, and inflammation in patients with metabolic dysfunction-associated steatotic liver disease. We found that among the analyzed parameters, liver viscosity was associated with the degree of inflammation and ballooning and allows together with ultrasound attenuation and biochemical parameters the identification of patients with metabolic dysfunction-associated steatohepatitis with good reliability. This could help to distinguish patients at high risk from those at low risk, reducing the number of liver biopsies in patients at low risk of metabolic dysfunction-associated steatohepatitis.