How Is MASH Severity Staged? What Would an Ideal MASH NIT Algorithm Look Like?

In this FAQ Video Module, Jonathan Yeh, PA, from Columbia University Irving Medical Center, discusses the evolution of Metabolic Dysfunction-Associated Steatohepatitis (MASH) diagnosis and fibrosis staging. Formerly known as NASH, MASH was traditionally diagnosed through liver biopsy, but non-invasive testing (NITs) is now widely accepted for fibrosis assessment.

Key non-invasive methods include FibroScan, which uses Vibration-Controlled Transient Elastography (VCTE), the Enhanced Liver Fibrosis (ELF) Test, and the FibroSure Blood Test. When used together, these tests provide a reliable assessment of fibrosis stage, significantly reducing the need for invasive liver biopsy.

Fibrosis staging follows the METAVIR system, which categorizes fibrosis from Stage 0 (no fibrosis) to Stage 4 (cirrhosis). Additionally, necroinflammatory activity is scored from A0 to A3, representing increasing hepatitis severity. By integrating FibroScan with ELF or FibroSure blood test results, healthcare providers can improve diagnostic accuracy and ensure more effective patient management.

As non-invasive fibrosis staging continues to evolve, incorporating these advanced diagnostic tools allows for earlier detection, better disease monitoring, and improved treatment strategies for patients with MASH.

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