AbstractMetabolic dysfunction-associated steatohepatitis (MASH) is a rising global disease signaling the urgent need for non-invasive tests (NITs). Recent work demonstrated that dynamic 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging can identify MASH by measuring liver glucose transport rate, K1, and liver CT attenuation.

摘要代谢功能障碍相关脂肪性肝炎（MASH）是一种新兴的全球疾病，表明迫切需要进行非侵入性检测（NIT）。最近的研究表明，动态18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）成像可以通过测量肝脏葡萄糖转运率，K1和肝脏CT衰减来识别MASH。

By combining dynamic PET/CT with the serum-based fibrosis-4 (FIB-4) test, we were able to better distinguish clinical MASH from fibrotic subtypes, enabling determination of the core tenets of MASH: steatosis, inflammation, and fibrosis. Future studies using FDG-PET technology can further enable concomitant prediction of MASH severity and extrahepatic comorbidities such as cardiovascular disease..

通过将动态PET/CT与基于血清的纤维化-4（FIB-4）测试相结合，我们能够更好地区分临床MASH和纤维化亚型，从而能够确定MASH的核心原则：脂肪变性，炎症和纤维化。未来使用FDG-PET技术的研究可以进一步预测MASH的严重程度和肝外合并症，如心血管疾病。。

IntroductionMetabolic dysfunction-associated steatohepatitis (MASH) is a severe form of metabolic dysfunction-associated steatotic liver disease (MASLD) that is associated with liver cirrhosis and hepatocellular cancer1 (MASLD and MASH are new nomenclature for nonalcoholic fatty liver disease, NAFLD and nonalcoholic steatohepatitis, NASH, respectively2.

引言代谢功能障碍相关脂肪性肝炎（MASH）是一种严重的代谢功能障碍相关脂肪性肝病（MASLD），与肝硬化和肝细胞癌相关1（MASLD和MASH分别是非酒精性脂肪性肝病，NAFLD和非酒精性脂肪性肝炎，NASH的新命名2）。

Increasing global MASLD prevalence makes early diagnosis of MASLD and MASH important to prevent severe liver damage and extrahepatic disorders possibly related to MASLD such as atherosclerotic cardiovascular disease3. MASH is widely underdiagnosed due to its asymptomatic nature and has varying rates of progression, making disease severity gradation difficult.

全球MASLD患病率的增加使得MASLD和MASH的早期诊断对于预防严重的肝损伤和可能与MASLD相关的肝外疾病（如动脉粥样硬化性心血管疾病）非常重要3。MASH由于其无症状性质而被广泛诊断不足，并且进展速度不同，使得疾病严重程度分级困难。

The gold standard for diagnosing MASH is a liver biopsy, but complication risks and patient discomfort present a need for non-invasive methods that can characterize the core tenets of MASH: steatosis, inflammation, and fibrosis1. Non-invasive modalities such as an ultrasound-based transient or shear wave elastography have validated data relevant for liver steatosis and fibrosis but not inflammation4.MRI-based technique such a MR-PDFF and MR elastography can detect steatosis and fibrotic MASH with excellent accuracy5.

诊断MASH的金标准是肝活检，但并发症风险和患者不适需要非侵入性方法来表征MASH的核心原则：脂肪变性，炎症和纤维化1。非侵入性方式，如基于超声的瞬态或剪切波弹性成像，已经验证了与肝脏脂肪变性和纤维化相关的数据，但没有炎症4.基于MRI的技术，如MR-PDFF和MR弹性成像可以以优异的准确性检测脂肪变性和纤维化MASH 5。

Advancement in MRI technology has enabled detection of inflammation using damping ratio6. These modalities unlike PET are limited by their static nature, and inability to scan other organs simultaneously which is relevant in systemic diseases such as MASH.Glucose uptake is altered by MASH-related inflammation and hepatic steatosis and can be worsened by tissue fibrosis and collagen deposition as the disease progresses.

MRI技术的进步使得能够使用阻尼比检测炎症6。这些与PET不同的方式受到其静态性质的限制，并且无法同时扫描与MASH等全身性疾病相关的其他器官。与MASH相关的炎症和肝脂肪变性会改变葡萄糖的摄取，并且随着疾病的进展，组织纤维化和胶原沉积会加剧葡萄糖的摄取。

Positron emission tomography (PET) with the radiotracer 18F-fluorodeoxyglucose (FDG) can be used to visually capture glucose kinetics an.

放射性示踪剂18F-氟脱氧葡萄糖（FDG）的正电子发射断层扫描（PET）可用于视觉捕获葡萄糖动力学和。

Data availability

数据可用性

Deidentified data may be provided upon reasonable request.

可根据合理要求提供身份不明的数据。

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Download referencesAcknowledgementsWe would like to thank our patients for their valued time and efforts in participating. We thank Aarna Shah for her contribution to the paper’s review.FundingUniversity of California Davis start-up funds to SS and GBW, and UC Davis Collaborative for Diagnostic Innovation grant to SS and GBW.

下载参考文献致谢我们要感谢患者宝贵的时间和努力。我们感谢Aarna Shah对论文评论的贡献。资助加利福尼亚大学戴维斯分校向SS和GBW提供创业资金，以及加州大学戴维斯分校向SS和GBW提供诊断创新资助。

NIH R01 DK124803 grant GBW. NIH 5K12HD051958 Building Interdisciplinary Research Careers in Women’s Health at UC (University of California) Davis Grant for VL.Author informationAuthor notesThese authors contributed equally: Sean Romeo and Connie Chan.Authors and AffiliationsDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of California, Davis, CA, USASean Romeo & Souvik SarkarSchool of Medicine, University of California, Davis, CA, USAConnie ChanDepartment of Pathology and Laboratory Medicine, University of California, Davis, CA, USAKaren MatsukumaDepartment of Radiology, University of California, Davis, CA, USAMichael T.

NIH R01 DK124803授予GBW。NIH 5K12HD051958在加州大学戴维斯分校授予VL的女性健康跨学科研究职业。作者信息作者注意到这些作者做出了同样的贡献：肖恩·罗密欧和康妮·陈。作者和附属机构加利福尼亚大学戴维斯分校内科胃肠学和肝病学系，USASean Romeo＆Souvik SarkarSchool of Medicine，加利福尼亚大学戴维斯分校，USAConnie ChanDepartment of Pathology and Laboratory Medicine，University of California，Davis，CA，USAKaren MATSUKUMA加利福尼亚大学戴维斯分校放射科，CA，USAMACHAEL T。

Corwin, Guobao Wang & Souvik SarkarDepartment of Surgery, University of California, Davis, CA, USAVictoria LyoDivision of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USAShuai ChenAuthorsSean RomeoView author publicationsYou can also search for this author in.

Corwin，Guobao Wang＆Souvik Sarkar美国加利福尼亚大学戴维斯分校外科，美国加利福尼亚大学戴维斯分校公共卫生科学系生物统计学系Victoria Lyodistration of Biostatistics，Department of Public Health Sciences，University of California，Davis，CA，USAShuai ChenAuthorsSean RomeoView author Publications你也可以在中搜索这位作者。

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PubMed Google ScholarContributionsSR: data collection, analysis and drafting of the manuscript, CC: review, drafting, and revision of the manuscript, KM: review of pathology and manuscript editing, MC: radiology reads and manuscript editing, VL: analysis, study design, manuscript editing, SC: analysis, interpretation of data, manuscript editing, GW: analysis, interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content, SS: study concept, design, planning, implementation and writing.Corresponding authorCorrespondence to.

PubMed谷歌学术贡献SSR：手稿的数据收集，分析和起草，CC：手稿的审查，起草和修订，KM：病理学和手稿编辑的审查，MC：放射学阅读和手稿编辑，VL：分析，研究设计，手稿编辑，SC：分析，数据解释，手稿编辑，GW：分析，数据解释；起草手稿；重要知识内容手稿的批判性修订，SS：学习概念，设计，计划，实施和写作。对应作者对应。

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苏维克·萨卡尔。道德宣言

Competing interests

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SS grants to UC Davis from Gilead Sciences. No other conflicts of interest.

Gilead Sciences向加州大学戴维斯分校提供SS拨款。没有其他利益冲突。

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Reprints and permissionsAbout this articleCite this articleRomeo, S., Chan, C., Matsukuma, K. et al. Positron emission tomography combined with serum biomarkers detects fibrotic MASH.

转载和许可本文引用本文Romeo，S.，Chan，C.，Matsukuma，K。等人。正电子发射断层扫描结合血清生物标志物检测纤维化MASH。

Sci Rep 14, 21939 (2024). https://doi.org/10.1038/s41598-024-72655-xDownload citationReceived: 17 July 2023Accepted: 06 September 2024Published: 20 September 2024DOI: https://doi.org/10.1038/s41598-024-72655-xShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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