MRI Study at ARRS Raises Questions About Disparities in Detection of MASLD
New research revealed that Hispanic Americans with evidence of hepatic steatosis on MRI but no formal diagnosis of MASLD had over a fourfold higher risk of developing hepatocellular carcinoma in comparison to those who had a formal diagnosis of MASLD.
Significant disparities may be preventing early detection and timely intervention for people at risk for metabolic-associated steatotic liver disease (MASLD), according to magnetic resonance imaging (MRI) research presented at the American Roentgen Ray Society (ARRS) conference.
For the study, researchers compared the progression of disease outcomes with a cohort of 10,280 people with a formal MASLD diagnosis in 2018 and a cohort of 5,103 people with MRI evidence of hepatic steatosis and concomitant metabolic risk factors without a formal MASLD diagnosis.
Over a five-year surveillance period, the study authors found that people without a formal diagnosis of MASLD had more than double the risk of developing hepatocellular carcinoma (HCC) and were 45.9 percent more likely to develop cirrhosis in comparison to people with a formal diagnosis of MASLD.
The above imaging reveals a proliferative hepatocellular carcinoma (HCC) in a 48-year-old patient. Emerging research presented at the recent American Roentgen Ray Society (ARRS) conference suggests significant disparities with the detection of MASLD and subsequent complications such as HCC and cirrhosis. (Images courtesy of Academic Radiology.)
“In our study, patients with metabolic risk factors and imaging evidence of hepatic steatosis on MRI, but without a formal diagnosis of MASLD, were more likely to be diagnosed with significant complications of chronic liver disease, including cirrhosis and HCC, over a 5-year surveillance period,” noted study authors Emmanuel Mgboji, B.S., and Jessica Fried, M.D., who are affiliated with the Department of Radiology at the University of Michigan.
The researchers also noted significant racial disparities for people without a formal diagnosis of MASLD. Caucasian Americans without a formal MASLD diagnosis had a nearly 2.5-fold higher relative risk of developing HCC. In the cohort with MRI evidence of hepatic steatosis and concomitant metabolic risk factors without a formal MASLD diagnosis, the study authors said African Americans and Hispanic Americans had over 3.4-fold and over 4.2-fold higher risks, respectively for HCC.
Hispanic Americans also had nearly a 2.8-fold higher risk for cirrhosis, according to the researchers.
“Significant differences in relative risks were observed when patients were stratified by racial groups, with relatively higher relative risks for diagnosis of cirrhosis and HCC in the Hispanic and African American cohorts,” added Mgboji and Fried.
The study authors emphasized the urgency of continued research into contributing factors with disparities in diagnosing and treating MASLD, a disease that reportedly affects 25 percent of the worldwide population.
“Further research is necessary to elucidate why there are disparities in the identification, management, and treatment for some patients with imaging evidence of hepatic steatosis and co-existent metabolic comorbidities,” emphasized Mgboji and Fried.
Reference
1. Mgboji E, Fried J. Mitigating Disparities in MASLD: Advancing early image detection and management. Presented at the American Roentgen Ray Society (ARRS) conference April 27-May 1, 2025, San Diego. Available at: https://www2.arrs.org/am25/ . Accessed May 2, 2025.
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