Hepatic steatosis grading on ultrasound — 6 month update

pete_manc_UK said:

Fatty liver on an incidental scan two years ago and nobody followed it up.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 341 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 15 months: CAP dropped to 234 dB/m (minimal steatosis) and stiffness normalized to 6.199999999999999 kPa. Hepatologist says the liver is essentially healing itself as the metabolic stress resolves.

GLP-1 agonists may become first-line NASH therapy. The Phase 3 data on semaglutide for NASH is very promising.

amsterdam_pete said:

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 341 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible…

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

pete_manc_UK said:

Fatty liver on an incidental scan two years ago and nobody followed it up.

This matches mine closely enough to be worth saying so out loud. Posting only so the count is not one.

From the other side of the consultation, briefly.

ATTAIN trial (survodutide) context for liver and MASH: survodutide, a GLP-1/glucagon dual agonist, showed -18.7% body weight at 46 weeks in the Phase 3 ATTAIN trial. NASH resolution was achieved in ~60% of patients[1].

This is relevant to liver and MASH because survodutide's glucagon agonism specifically targets hepatic lipid metabolism — making it potentially the best-in-class agent for NASH/MAFLD comorbid with obesity.