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Several semi\u2010quantitative scoring systems have been designed for this purpose, of which the most used is the NASH Clinical Research Network (NASH CRN) system, in which the grade of disease is assessed on the severity of steatosis, hepatocyte ballooning and lobular inflammation. There has been recent interest in the role of portal inflammation (PI) in MASLD. The arguments for and against the inclusion of a semi\u2010quantitative score for PI in grading MASLD activity are discussed in detail.<\/jats:p>","DOI":"10.1111\/his.70090","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T03:00:06Z","timestamp":1767841206000},"page":"958-969","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Head to head: should portal inflammation be part of grading necroinflammatory activity in metabolic dysfunction\u2010associated steatotic liver disease?"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9868-8269","authenticated-orcid":false,"given":"Daniela","family":"Allende","sequence":"first","affiliation":[{"name":"Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3011-7774","authenticated-orcid":false,"given":"Alastair 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