Abstract
To review the available modalities for quantification of liver fat in nonalcoholic fatty liver disease (NAFLD) and their clinical significance. Ultrasonography remains the first line imaging used to diagnose NAFLD as it is widely available and relatively inexpensive. Controlled attenuation parameter can be used as a screening tool for fatty liver as it is reasonably accurate and provides simultaneous estimation of hepatic fibrosis. Magnetic resonance imaging proton density fat fraction and magnetic resonance spectroscopy are the most accurate noninvasive modalities for quantification of hepatic steatosis. Liver biopsy remains the gold standard but is limited by the invasive nature of the procedure, and observer and sampling variability. This may be improved with novel computer-assisted stereological analysis or second harmonic generation microscopy. Understanding the advantages and disadvantages of each of the modalities will help one choose the most suitable method for quantifying hepatic steatosis in NAFLD.
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