RadioGraphics Podcast | RSNA Radiology at the Center of Liver Disease Assessment
Dec 16, 2025
Dr. Venkat Katabathina, a specialist in abdominal radiology at UT Health San Antonio, dives into the new MASLD nomenclature, discussing its implications for liver disease diagnostics. He outlines updated guidelines and the expanding role of imaging techniques in assessing liver conditions. Katabathina elaborates on FIB-4 for risk stratification, the importance of advanced imaging in fibrosis assessment, and emerging biomarkers for at-risk patients. He also highlights future imaging research directions, enhancing early detection and treatment strategies.
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Nomenclature Shift Emphasizes Metabolic Cause
- MASLD replaces NAFLD and reframes fatty liver disease around metabolic dysfunction rather than stigma.
- The new nomenclature improves early recognition and aligns care with cardiometabolic risk.
Defining At-Risk Disease
- MASLD requires at least one cardiometabolic criterion like obesity or insulin resistance.
- 'At-risk MASH' denotes active disease with high histologic activity plus ≥stage 2 fibrosis and worse prognosis.
Use FIB-4 First For Fibrosis Triage
- Use FIB-4 as the primary risk-stratification tool to screen for advanced fibrosis.
- Refer patients with FIB-4 >2.67 to hepatology for further assessment and imaging-based testing.