Change in cT1 following interventions in MASLD: A systematic review and meta-analysis.

Abstract

BACKGROUND AND AIMS: Liver corrected T1 (cT1), measured with multiparametric magnetic resonance imaging (mpMRI), offers an alternative to liver biopsy to monitor treatment response and liver disease activity. We aim to perform a systematic evaluation of change in cT1 following a treatment intervention in adults with metabolic dysfunction-associated steatotic liver disease (MASLD). METHOD(S): We searched the Cochrane Library, PubMed Central, and MEDLINE from 2014 to September 2024 for studies that examined cT1 responses following intervention in MASLD. Two authors independently screened records, assessed risk of bias and extracted data. Meta-analyses were performed to explore the mean change in cT1 between baseline and end of study. RESULT(S): A total of 16 studies (n = 1134 individuals) were analysed (13 randomized controlled trials [n = 1077] and 3 prospective diet, lifestyle and bariatric surgery studies [n = 57]). The mean change in cT1 was -57ms [95% CI: -62, -52] over a median 17 weeks (Q1-Q3: 12 - 24). By treatment type, fibroblast growth factor (FGF) analogues, glucagon-like peptide (GLP)-1 receptor agonists and farnesoid X receptor (FXR) agonists, cT1 had a mean change of -79ms [95% CI: -90, -68], -68ms [95% CI: -77, -58] and -62ms [95% CI: -74, -49], respectively. In contrast, the placebo arms showed a mean change in cT1 of 0ms [95% CI: -8, 8]. CONCLUSION(S): Evidence to-date supports a significant treatment-induced reduction in cT1 as compared to minimal changes in the placebo group. Our findings could inform study designs for investigational therapies and support monitoring of treatment response in individuals with MASLD in clinical trials and clinical practice. Copyright © 2025. Published by Elsevier Inc.