Peer-Reviewed Publication
Nat Med2026July 24, 2026Journal Article
Prospective validation of imaging and serum diagnostic biomarkers of steatohepatitis and fibrosis in MASLD: the LITMUS Imaging Study.
Michael Pavlides1,2,3, Yasaman Vali4, Ferenc E Mózes5,6, Kristy Wonders7,8, Salma Akhtar5, Paul D Hockings9, Elizabeth Shumbayawonda10, Kay Pepin11, Isabel Fernandez-Lizaranzu12,13, Diana Julie Leeming14, Jeremy F Cobbold15,16, Michael E D Allison17, Guruprasad P Aithal18,19, Manuel Romero-Gomez20,21, Rocio Aller22, Juan M Pericàs23, Jérôme Boursier24,25, Salvatore Petta26, Jörn M Schattenberg27, Mattias Ekstedt28, Annalisa Berzigotti29,30, Hannele Yki-Järvinen31,32, Miljen Martic33, Theresa Tuthill34, Clifford A Brass35, Michael Kalutkiewicz11, Rajarshi Banerjee10, Richard L Ehman36, Moritz J Schneider9, Dina Tiniakos7,37, Morten Karsdal14, Jeremy Magnanensi38, Céline Fournier-Poizat39, Vlad Ratziu40,41, Carla Yunis42, Elisabetta Bugianesi43, Stephen A Harrison5, , Patrick M Bossuyt4, Quentin M Anstee44,45
1Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK. michael.pavlides@cardiov.ox.ac.uk.
2Translational Gastroenterology and Liver Unit, University of Oxford, Oxford, UK. michael.pavlides@cardiov.ox.ac.uk.
3Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK. michael.pavlides@cardiov.ox.ac.uk.
4Department of Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
5Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
6Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany.
7Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
8Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
9Antaros Medical AB, Mölndal, Sweden.
10Perspectum Ltd., Oxford, UK.
11Resoundant Inc., Rochester, MN, USA.
12Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
13Hepatic and Digestive Diseases Networking Biomedical Research Centre (CIBERehd), Grupo de Física Interdisciplinar, Universidad de Sevilla, Sevilla, Spain.
14Nordic Bioscience, Biomarkers & Research, Herlev, Denmark.
15Translational Gastroenterology and Liver Unit, University of Oxford, Oxford, UK.
16Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK.
17Liver Unit, Department of Medicine, Cambridge NIHR Biomedical Research Centre, Cambridge University NHS Foundation Trust, Cambridge, UK.
18NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.
19Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
20Digestive Diseases Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
21Hepatic and Digestive Diseases Networking Biomedical Research Centre (CIBERehd), Instituto de Biomedicina de Sevilla, Universidad de Sevilla, Sevilla, Spain.
22Department of Gastroenterology, Clinic University Hospital, Medical School, University of Valladolid, CIBERINFEC, Valladolid, Spain.
23Liver Unit, Vall d'Hebron Institut de Recerca, Vall d'Hebron Barcelona Hospital, Universitat Autònoma de Barcelona, Centros de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.
24HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France.
25Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France.
26Section of Gastroenterology and Hepatology, PROMISE, Palermo, Italy.
27Department of Internal Medicine II, Saarland University Medical Center, Homburg, Germany.
28Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
29Department for Visceral Medicine and Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
30Department of Biomedical Research, University of Bern, Bern, Switzerland.
31Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
32Minerva Foundation Institute for Medical Research, Helsinki, Finland.
33Novartis Institutes for BioMedical Research, Basel, Switzerland.
34Digital Sciences and Translational Imaging, Pfizer Inc., Cambridge, MA, USA.
35Resolution Therapeutics, London, UK.
36Department of Radiology, Mayo Clinic, Rochester, MN, USA.
37Department of Pathology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
38Genfit S.A., Loos, France.
39Echosens, Paris, France.
40ICAN Institute for Cardiometabolism and Nutrition, INSERM UMRS 1138 CRC, Sorbonne Université, Paris, France.
41Assistance-Publique Hôpitaux de Paris, INSERM UMRS 1138 CRC, Paris, France.
42Research and Development, Pfizer Inc., Lake Mary, FL, USA.
43Department of Medical Sciences, University of Turin, Torino, Italy.
44Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. quentin.anstee@newcastle.ac.uk.
45Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. quentin.anstee@newcastle.ac.uk.
Abstract
There is a need for robust evaluations of noninvasive biomarkers for metabolic dysfunction-associated steatotic liver disease. This prospective multicenter study assessed the diagnostic accuracy of imaging (including liver stiffness measurement (LSM) using magnetic resonance elastography (MRE) and FibroScan (vibration-controlled transient elastography (VCTE)), serum biomarkers (including NIS2+) an…
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