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Review Article

Adopting AI-assisted digital pathology imaging analysis in MASH histology assessments

Daniel Yan Zheng Lim1, Wei Qiang Leow2,3, Daniela S. Allende4, Wah-Kheong Chan5, Vincent Wai-Sun Wong6, George Boon Bee Goh1,3
Published online: June 18, 2026
1Dept of Gastroenterology and Hepatology, Singapore General Hospital
2Dept of Anatomical Pathology, Singapore General Hospital
3Duke-NUS Medical School, Singapore
4Cleveland Clinic, Cleveland, OH, USA
5Gastroenterology and Hepatology Unit, Department of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
6Medical Data Analytics Center, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
Corresponding author:  George Boon Bee Goh,
Email: goh.boon.bee@singhealth.com.sg
Received: 25 March 2026   • Revised: 9 June 2026   • Accepted: 13 June 2026
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Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is the most common chronic liver disease worldwide, associated with considerable clinical and economic burden. Early detection and timely intervention of Metabolic Dysfunction Associated Steatohepatitis (MASH) remains a key cornerstone of management. Traditionally, histopathology assessment is central to the characterization of MASH disease activity and fibrosis, albeit with inherent limitations. The advent of artificial intelligence (AI) has provided transformative tools to augment many aspects of MASH diagnostics, including histology assessment. New technologies enabling digitalization of pathology slides and allowing for further AI assisted model analysis have helped to address some of the previous limitations. In this review, we highlight the key AI assisted digital pathology tools, including utility, performance and clinical impact. Limitations and real-world considerations in adopting these AI tools are also explored.

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