Beyond the image: The new era of Quantitative Ultrasound in MASLD

The multimodal ultrasound approach offers superior clinical confidence by correlating multiple biomarkers in a single examination. This transition from qualitative to quantitative imaging positions ultrasound as the frontline modality for the early detection, risk stratification, and longitudinal management of MASLD patients. This session explores the evolution of Ultrasound from a subjective screening tool to a quantitative, multimodal platform. We focus on how integrated technologies, Attenuation Imaging (ATI), Shear Wave Elastography (SWE), and Dispersion Imaging (SWD), provide a comprehensive, non-invasive "one-stop-shop" for assessing steatosis, fibrosis, and inflammation.

Learning Objective:

1. Differentiate MASLD Phenotypes: Master the clinical shift from NAFLD to MASLD and identify the specific roles of steatosis, fibrosis, and inflammation in disease progression.

2. Quantify Steatosis with ATI: Implement Attenuation Imaging (ATI) to provide objective, standardized fat quantification that overcomes the limitations of traditional B-mode "bright liver" assessment.

3. Stage Fibrosis via Shear Wave: Utilize 2D Shear Wave Elastography (SWE) to accurately measure liver stiffness and categorize fibrosis stages (F0–F4) with high reproducibility.

4. Evaluate Inflammation through Dispersion: Explore the clinical utility of Shear Wave Dispersion (SWD) as a non-invasive surrogate marker for tissue viscosity and necroinflammatory activity (MASH).

5. Optimize Multiparametric Workflow: Integrate these biomarkers into a single, unified clinical report to enhance diagnostic confidence and facilitate long-term patient monitoring.