Abstract
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are becoming some of the major health problems in well-developed countries, together with the increasing prevalence of obesity, metabolic syndrome, and all of their systemic complications. As the future prognoses are even more disturbing and point toward further increase in population affected with NAFLD/NASH, there is an urgent need for widely available and reliable diagnostic methods. Consensus on a non-invasive, accurate diagnostic modality for the use in ongoing clinical trials is also required, particularly considering a current lack of any registered drug for the treatment of NAFLD/NASH. The aim of this narrative review was to present current information on methods used to assess liver steatosis and fibrosis. There are several imaging modalities for the assessment of hepatic steatosis ranging from simple density analysis by computed tomography or conventional B-mode ultrasound to magnetic resonance spectroscopy (MRS), magnetic resonance imaging proton density fat fraction (MRI-PDFF) or controlled attenuation parameter (CAP). Fibrosis stage can be assessed by magnetic resonance elastography (MRE) or different ultrasound-based techniques: transient elastography (TE), shear-wave elastography (SWE) and acoustic radiation force impulse (ARFI). Although all of these methods have been validated against liver biopsy as the reference standard and provided good accuracy, the MRS and MRI-PDFF currently outperform other methods in terms of diagnosis of steatosis, and MRE in terms of evaluation of fibrosis.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver condition with globally increasing incidence rates
There are several noninvasive, accurate methods of the assessment of hepatic steatosis or fibrosis, liver biopsy is currently the only method that allows for the precise assessment of both, and the assessment of the inflammatory process
Brief summary on the use of imaging techniques on detection of liver steatosis and fibrosis is shown on Figures 8 and 9, respectively
Summary
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver condition with globally increasing incidence rates. As there are many ongoing clinical trials on new therapies for patients with non-invasive methods of more assessment liver steatosis been proposed and NAFLD and NASH, new representative methods should be of characterized by thehave clinical utility to validated in the recent. Those should be non-invasive, widely available and cost-effective. As there are many ongoing clinical trials status on new therapies for patients with NAFLD and NASH, new This is a narrative review aimed at presenting the current information on various methods used methods should be characterized by the clinical utility to perform regular follow-up in for the assessment of liver steatosis and fibrosis.
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