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Two major international studies have delivered the strongest evidence to date on which noninvasive tests can accurately diagnose and measure the severity of metabolic dysfunction-associated steatotic liver disease (MASLD) and its more severe form, MASH, reducing reliance on liver biopsy.

Published in The Lancet and Nature Medicine, the studies form part of the LITMUS program, the largest international effort to evaluate diagnostic tools for liver disease.

The main LITMUS Study, published in The Lancet, assessed blood tests and ultrasound-based liver stiffness measurements in more than 1,500 patients—the largest international study of its kind.

The companion LITMUS Imaging Study, published in Nature Medicine, examined advanced MRI and elastography techniques in more than 350 patients.

Professor Quentin Anstee, Ruth & Lionel Jacobson Chair in Personalized Medicine at Newcastle University, U.K., and honorary consultant hepatologist at Newcastle Hospitals NHS Foundation Trust, is joint senior author of both studies and the LITMUS consortium coordinator.

He said, "Together, these two studies give us the most complete picture yet of which diagnostic tests work for liver disease, and how to combine them into a pathway health systems can easily implement.

"For advanced liver scarring and cirrhosis, we now have tools good enough to use with real confidence. Detecting active liver inflammation remains more challenging, but promising noninvasive tests are becoming available."

MASLD affects up to one in three adults worldwide and as many as seven in 10 people living with obesity or type 2 diabetes .

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