LAD-NASH Score và FAST Score CHẨN ĐOÁN NGUY CƠ MASLD

The LAD-NASH score uses multiparameter ultrasound to determine the risk of MASH: a direct comparison with the FAST score. LAD-NASH versus FAST for high-risk MASH patients.

Kim Seung-seob Sunyoung Lee Jae Seung Lee,Min Young Lee 

Department of Diagnostic Imaging and Institute of Diagnostic Imaging Research, Severance Hospital, Yonsei University School of Medicine, Seoul

Accepted May 27, 2026

Copyright © 2026 Korean Society of Ultrasound Medicine (KSUM). 

 SUMMARY

Non-invasive scoring systems have been proposed to identify patients at risk for metabolic disorder-associated fatty liver disease (MASH) who may benefit from pharmacological therapy. The LAD-NASH score (a combined model of attenuation coefficient, dispersion gradient, and liver stiffness for the determination of non-alcoholic fatty liver disease), a multiparameter ultrasound-based (US) model combining attenuation coefficient, dispersion gradient, and liver stiffness to determine non-alcoholic fatty liver disease, has been recently developed for this purpose. This study aimed to validate the LAD-NASH score for determining MASH risk in patients with metabolic disorder-associated fatty liver disease (MASLD) confirmed by biopsy and compare its diagnostic efficacy with 

FibroScan-aspartate aminotransferase (FAST) score. This study enrolled consecutive patients who underwent multiparametric ultrasound and liver biopsy on the same day from February 2023 to April 2024. At-risk MASH was defined as MASH confirmed by biopsy with a MASLD activity score of 24 and fibrosis stage >F2. Diagnostic efficacy of LAD-NASH and FAST scores was assessed using the area under the recipient activity characteristic curve (AUROC).

A total of 70 patients diagnosed with MASLD by biopsy were included in the study (mean age 44 years; 34 male; mean body mass index 28.7 kg/m²; MASH risk 27.1%). LAD-NASH and FAST scores showed comparable diagnostic efficacy in determining MASH risk (AUROC, 0.740; 95% confidence interval [CI], 0.621 to 0.838 vs. 0.739; 95% CI, 0.621 to 0.837; P=0.995). Using an exclusion threshold of ≤0.264, the LAD-NASH score showed 100% sensitivity and 100% negative predictive value for MASH risk. LAD-NASH and FAST scores demonstrated comparable diagnostic efficacy in determining MASH risk. Because it is based solely on multiparameter ultrasound, the LAD-NASH score may be a useful non-invasive exclusion tool for risk assessment MASH.

Keywords: Elastography ultrasound, Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis