Macrovesicular steatosis (MaS) affects liver transplant outcomes. Traditional visual biopsy assessment is subjective and shows inter-observer variability (weighted κ = 0.595 in our cohort), which complicates allocation and prognostication. We developed a semi-automated image analysis method using HALCON Progress (evaluation license, 2019–2023) to quantify MaS in H Spearman ρ = 0.498–0.615; all p 30%), limited coverage of microvesicular fat, and single-center validation. Multi-center evidence across scanners and patient groups is still needed before routine use.
Malamutmann et al. (Sun,) studied this question.