Abstract
Obesity is associated with significant comorbidities, including non-alcoholic fatty liver disease (NAFLD). Given its potential to progress to advanced liver disease, monitoring the extent and progress of liver fibrosis and assessing its fibrosis stage are essential. Although liver biopsy is considered to be the gold standard for liver fibrosis staging, it is an invasive procedure with risk of complications. Considering the rising prevalence of obesity and NAFLD globally, developing non-invasive diagnostic methods is a priority. Transient elastography (TE) is increasingly being used to assess the severity of liver disease. However, in the presence of severe obesity, the increased thickness of subcutaneous adipose tissue and changes in anatomy may affect its diagnostic accuracy. Two-dimensional shear wave elastography (2D-SWE) assesses the liver stiffness in real time along with simultaneous anatomic B-mode ultrasound imaging and allows selection of the region of interest. This would suggest that 2D-SWE has several advantages over TE in patients with severe obesity. The purpose of this review is to examine the current literature addressing the use of 2D-SWE in the assessment of liver fibrosis in patients with NAFLD. This review also examines the evidence on the use of 2D-SWE in patients with obesity and NAFLD and compares it to TE as a novel and non-invasive method of assessing liver fibrosis.
Highlights
Over one-third of the world’s population today are either overweight or obese [1,2].If recent secular trends continue, it is estimated that about 38% and 20% of the world’s adult population will be overweight and obese, respectively, by 2030 [3]
non-alcoholic fatty liver disease (NAFLD) represents a spectrum of disorders ranging from simple hepatic steatosis or non-alcoholic fatty liver to non-alcoholic steatohepatitis (NASH), which is histologically characterised by hepatocyte injury, inflammation, and variable degrees of fibrosis that can further lead to advanced fibrosis and cirrhosis [16,17,18]
This review examines the evidence on the use of 2D-SWE in patients with obesity and NAFLD and compares it to transient elastography (TE) as a novel and non-invasive method of assessing liver fibrosis
Summary
Over one-third of the world’s population today are either overweight or obese [1,2]. If recent secular trends continue, it is estimated that about 38% and 20% of the world’s adult population will be overweight and obese, respectively, by 2030 [3]. NAFLD represents a spectrum of disorders ranging from simple hepatic steatosis or non-alcoholic fatty liver (the most common form) to non-alcoholic steatohepatitis (NASH), which is histologically characterised by hepatocyte injury, inflammation, and variable degrees of fibrosis that can further lead to advanced fibrosis and cirrhosis [16,17,18]. Two-dimensional shear wave elastography (2D-SWE) has emerged as a novel non-invasive diagnostic tool that could be useful for people with obesity [24,26]. The purpose of this review is to examine the current literature addressing the use of 2D-SWE in the assessment of liver fibrosis in patients with. This review examines the evidence on the use of 2D-SWE in patients with obesity and NAFLD and compares it to TE as a novel and non-invasive method of assessing liver fibrosis
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