Masood M, Thandassery RB. Noninvasive prediction of clinically significant portal hypertension in metabolic dysfunction-associated steatotic liver disease compared to other chronic liver diseases. World J Hepatol 2025; 17(9): 109691 [DOI: 10.4254/wjh.v17.i9.109691]
Corresponding Author of This Article
Ragesh Babu Thandassery, DM, MD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4300 W 7th Street, Little Rock, AR 72205, United States. doc.ragesh@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 27, 2025; 17(9): 109691 Published online Sep 27, 2025. doi: 10.4254/wjh.v17.i9.109691
Noninvasive prediction of clinically significant portal hypertension in metabolic dysfunction-associated steatotic liver disease compared to other chronic liver diseases
Muaaz Masood, Ragesh Babu Thandassery
Muaaz Masood, Division of Gastroenterology and Hepatology, Department of Medicine, Center for Digestive Health, Virginia Mason Franciscan Health, Seattle, WA 98101, United States
Ragesh Babu Thandassery, Division of Gastroenterology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
Ragesh Babu Thandassery, Division of Gastroenterology, Department of Internal Medicine, Central Arkansas Veterans Healthcare System, Little Rock, AR 72202, United States
Author contributions: Masood M was responsible for manuscript writing; Thandassery RB was responsible for concept, manuscript revision, final approval of manuscript; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
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: Ragesh Babu Thandassery, DM, MD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4300 W 7th Street, Little Rock, AR 72205, United States. doc.ragesh@gmail.com
Received: May 18, 2025 Revised: June 10, 2025 Accepted: September 9, 2025 Published online: September 27, 2025 Processing time: 130 Days and 10.3 Hours
Abstract
Liver biopsy is rarely performed for the diagnosis of compensated advanced chronic liver disease (cACLD) in the current clinical hepatology practice. In the early stage, cACLD presents without portal hypertension, and in the later stage, it presents with portal hypertension. Hepatic venous pressure gradient measurement is the gold standard for diagnosing portal hypertension, but it is rarely used due to its invasive nature. The recent Baveno VII consensus recommends a noninvasive strategy for the diagnosis of cACLD and clinically significant portal hypertension (CSPH). However, there is some uncertainty regarding the diagnostic accuracy of Baveno VII criteria for predicting CSPH among patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This is pertinent as MASLD has become the most important cause of cACLD in the United States. This mini-review outlines the diagnostic performance of Baveno VII criteria and other noninvasive criteria for predicting CSPH in patients with cACLD from MASLD compared to non-MASLD causes.
Core Tip: The management of chronic liver disease has increasingly become noninvasive. The Baveno VII consensus recommends a noninvasive strategy to diagnose compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH). However, the diagnostic accuracy of the Baveno criteria for predicting CSPH among patients with metabolic dysfunction-associated steatotic liver disease (MASLD) is not well-established. This is pertinent as MASLD has become the leading cause of cACLD in the United States. In this mini-review, we outline the diagnostic performance of the Baveno criteria and other noninvasive scores for predicting CSPH in patients with MASLD and non-MASLD related cACLD.
