Assessing the Liver Fat Score's Efficacy in MASLD Diagnosis: A Comparative Study with MRI-PDFF

Purpose: This study evaluates the concordance between the liver fat score (LFS) and magnetic resonance imaging-proton density fat fraction (MRI-PDFF) in quantifying hepatic steatosis in Metabolic-associated steatotic liver disease(MASLD) patients. Methods: In this single-center prospective study, 271 adult participants underwent MRI-PDFF assessment between January 2023 and August 2024. Participants were categorized based on MRI-PDFF results into healthy controls (<5%), mild steatosis (5%–9.9%), and moderate-to-severe steatosis (≥10%). Clinical and laboratory data were collected to calculate LFS, and its correlation with MRI-PDFF was analyzed using Pearson correlation and receiver operating characteristic (ROC) curve analyses. Results: LFS showed a significant positive correlation with MRI-PDFF ( r =0.59, P <0.001). For distinguishing MASLD patients from healthy controls, LFS achieved an area under the ROC curve (AUC) of 0.886, with an optimal cutoff value of -0.6508, yielding 85.29% sensitivity and 86.57% specificity. However, LFS demonstrated limited ability to differentiate between mild and moderate-to-severe steatosis (AUC=0.737). Conclusion: LFS correlates well with MRI-PDFF in assessing hepatic fat content and serves as a convenient alternative for MASLD screening.