Ribeiro TCR, de Paula Boechat Soares V, Campos Fabri J, de Aragão Ramos LE. Noninvasive liver fibrosis assessment in metabolic dysfunction-associated steatotic liver disease. World J Hepatol 2026; 18(1): 111534 [DOI: 10.4254/wjh.v18.i1.111534]
Corresponding Author of This Article
Tarsila C R Ribeiro, PhD, Assistant Professor, Department of Medicine, Gastroenterology, University of Juiz de Fora School of Medicine, University Hospital of the Federal University of Juiz de Fora, Rua Renato Dias , 650/201, Juiz de Fora 36021610, Minas Gerais, Brazil. tarsila.ribeiro@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. Jan 27, 2026; 18(1): 111534 Published online Jan 27, 2026. doi: 10.4254/wjh.v18.i1.111534
Noninvasive liver fibrosis assessment in metabolic dysfunction-associated steatotic liver disease
Tarsila C R Ribeiro, Vitor de Paula Boechat Soares, Julia Campos Fabri, Luiza Esther de Aragão Ramos
Tarsila C R Ribeiro, Department of Medicine, Gastroenterology, University of Juiz de Fora School of Medicine, University Hospital of the Federal University of Juiz de Fora, Juiz de Fora 36021610, Minas Gerais, Brazil
Tarsila C R Ribeiro, Department of Gastroenterology, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora - Suprema, Juiz de Fora 36038-330, Minas Gerais, Brazil
Vitor de Paula Boechat Soares, Julia Campos Fabri, Department of Internal Medicine, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora - Suprema, Juiz de Fora 36038-330, Minas Gerais, Brazil
Luiza Esther de Aragão Ramos, Department of Gastroenterology, Federal University of Juiz de Fora, Juiz de Fora 36038-330, Minas Gerais, Brazil
Co-first authors: Tarsila C R Ribeiro and Vitor de Paula Boechat Soares.
Author contributions: Soares VPB, Fabri JC, Ramos LEA, and Ribeiro TCR contributed to study conception and design, data acquisition, analysis, interpretation, and writing of the manuscript; Ramos LEA contributed to critical review of the manuscript; Ribeiro TCR contributed to interpreting the research findings; All authors approved the final version of the manuscript. Ribeiro TCR and Soares VPB contributed equally to this manuscript and are co-first authors.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: Tarsila C R Ribeiro, PhD, Assistant Professor, Department of Medicine, Gastroenterology, University of Juiz de Fora School of Medicine, University Hospital of the Federal University of Juiz de Fora, Rua Renato Dias , 650/201, Juiz de Fora 36021610, Minas Gerais, Brazil. tarsila.ribeiro@gmail.com
Received: July 2, 2025 Revised: August 6, 2025 Accepted: November 21, 2025 Published online: January 27, 2026 Processing time: 209 Days and 18 Hours
Abstract
Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide, with global prevalence estimated at about 32%. The main predictor of clinical outcome is liver fibrosis severity, making an accurate diagnosis essential. This study evaluated the role and accuracy of noninvasive methods (NIMs) for assessing liver fibrosis in MASLD. A systematic literature search was conducted in the PubMed, Cochrane, SciELO, and LILACS databases using the keywords “metabolic steatotic liver disease”, “noninvasive markers”, “liver fibrosis”, and related terms. A total of 76 articles were selected for review. NIMs offer advantages over liver biopsy due to their simplicity, accessibility, and reproducibility, enabling effective risk stratification at lower costs. Despite some limitations in defining intermediate fibrosis stages, a stepwise approach enhances diagnostic accuracy. Although liver biopsy remains the gold standard, NIMs are increasingly recognized for reliably excluding advanced fibrosis in patients with MASLD, reducing the need for invasive procedures.
Core Tip: Metabolic-dysfunction-associated steatotic liver disease affects approximately 30% of the global population, with a rising prevalence. Although liver biopsy is the gold standard for assessing liver fibrosis and inflammation, it has inherent limitations, leading to the search for noninvasive methods with high reproducibility for evaluating and monitoring patients with metabolic-dysfunction-associated steatotic liver disease. This systematic review summarizes key data on the noninvasive methods for assessing liver fibrosis, highlighting their advantages over liver biopsy in terms of accessibility, cost-effectiveness, and patient safety.
