Endoscopic Ultrasound Shear Wave Elastography Study

Inclusion Criteria: 1. 18 years of age or older 2. Willing and able to provide informed consent 3. Patient scheduled to undergo EUS with liver biopsy, either same session or separately; if separate, liver biopsy should be performed within 3 months of the EUS (either before or after) with no interval bariatric procedure/surgery or weight change of \>10% total body weight 4. Patient scheduled to undergo or have undergone FibroScan, which should be performed within 3 months of the EUS (either before or after) with no interval bariatric procedure/surgery or weight change of \>10% total body weight 5. BMI \>/=28 6. Clinical suspicion of MASLD (hepatic steatosis with at least one of five cardiometabolic risk factors: 1) overweight or obesity, 2) elevated glucose, 3) low HDL-C, 4) hypertension, and/or 5) hypertriglyceridemia) or MASH (additionally characterized by the presence of inflammation and hepatocellular ballooning) with or without fibrosis, as determined by non-invasive or minimally invasive techniques (e.g. abdominal ultrasound, FibroScan) Exclusion Criteria: 1. Patients with surgically altered anatomy that precludes adequate endosonographic visualization of the liver parenchyma 2. Prior history of Hepatitis B or C infection 3. Decompensated cirrhosis (GI bleeding, ascites, encephalopathy) 4. Histological evidence of other concomitant chronic liver disease on biopsy 5. Inadequate liver biopsy 6. Prior history of or current excess alcohol consumption (\>140 g/week and \>210 g/week for females and males, respectively) documented in EMR