Volume 88 - 2025 - Fasc.1 - Georges Brohée Prize
Precision imaging in chronic liver disease management
Metabolic dysfunction-associated fatty liver disease (MAFLD)
affects over a quarter of the global population, with up to 30%
developing Metabolic Dysfunction-Associated Steatohepatitis
(MASH), a progressive form that can silently lead to fibrosis,
cirrhosis, and liver cancer. Current diagnostic methods, including
blood-based scores and imaging, are insufficient for early detection,
leading to late-stage diagnoses in most patients. Liver biopsy
remains the diagnostic gold standard but is invasive, costly, and
prone to high inter- and intra-reader variability, limiting its
utility in routine care and clinical trials. Our research highlights
myosteatosis—fat infiltration in skeletal muscle—as a potential
early, non-invasive marker of MASH. In preclinical models and
clinical studies, myosteatosis correlated with the presence of MASH
and distinguished it from isolated steatosis. Notably, reductions in
myosteatosis following interventions such as bariatric surgery or
dietary regimens were associated with histological improvements
in MASH, suggesting a potential role in predicting treatment
response. In larger cohorts, myosteatosis was identified as a strong
predictor of all-cause mortality. In parallel, we utilized a VCAM-
1-targeted molecular imaging technique and demonstrated a high
accuracy in detecting inflammation in preclinical MASH models.
This technology is now advancing to clinical trials for validation
in humans. Taken together, our data support that targeted medical
imaging may enable early, non-invasive diagnosis and monitoring
of MASH, reducing reliance on liver biopsy and improving patient
outcomes.
