Imaging Evaluation for Steatotic Liver Disease

Author: Shin Mei CHAN ¹ ; Vitor F MARTINS ; Kathleen MARSH ; Kang WANG ; Jake T WEEKS ; Aiguo HAN ; Meng YIN ; Kathryn J. FOWLER ; Claude B. SIRLIN ; Cheng William HONG
Author Information

1. Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
Publication Type:Review Article
From:Korean Journal of Radiology 2026;27(2):137-151
CountryRepublic of Korea
Language:English
Abstract: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, is the fastest-growing cause of chronic liver disease worldwide, affecting approximately 30% of the global population.Imaging is vital for detecting, quantifying, and monitoring hepatic steatosis—the defining abnormality of MASLD—and subsequent fibrosis—the key determinant of liver-related outcomes. This review summarizes the principles, clinical usage, efficacy, and advancements in various imaging modalities for the noninvasive assessment of hepatic steatosis and fibrosis, with an emphasis on ultrasound, CT, and MRI. Additionally, this review explores the evolving landscape of MASLD diagnostic approaches, including machine-learning techniques, opportunistic screening, standardized imaging guidelines, and therapies, emphasizing the pivotal role that radiologists can play in shaping these developments.