Noninvasive Measures of Liver Fibrosis : Hepatology (original) (raw)

Articles

From the Departments of Medicine, and the 1 Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX; and the 2Division of Gastroenterology and Liver Center, University of California at San Francisco, San Francisco, CA.

Abbreviations: ECM, extracellular matrix; MMP, matrix metalloproteinases; TIMP, tissue inhibitor of metalloproteinase; AST, aspartate aminotransferase; ALT, alanine aminotransferase; HCV, hepatitis C virus; GGT, gamma glutamyltransferase; APRI, AST to platelet ratio index; MEGX, monoethylglycinexylidide.

Supported by the NIH (Grants R01 DK 50574 and R01 DK 57830 to D.C.R.; P30 DK 26743 to D.M.B.) and the Burroughs Welcome Fund (D.C.R. is the recipient of a BWF Translational Scientist Award).

Address reprint requests to: Don C. Rockey, University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Digestive and Liver Diseases, 5323 Harry Hines Blvd, Dallas, TX 75390-8887. E-mail:[email protected]; fax:214-648-0274.

Published online in Wiley InterScience (www.interscience.wiley.com).

Potential conflict of interest: Nothing to report.

Abstract

As novel therapies for liver fibrosis evolve, non-invasive measurement of liver fibrosis will be required to help manage patients with chronic liver disease. Although liver biopsy is the current and time-honored gold standard for measurement of liver fibrosis, it is poorly suited to frequent monitoring because of its expense and morbidity, and its accuracy suffers from sampling variation. At the current writing, serum markers and imaging methods are available and increasingly in use as alternatives to biopsy. However, many questions remain about their indications, accuracy, and cost-effectiveness, and more investigation is required before they are put into widespread use. The development of safe, inexpensive, and reliable noninvasive fibrosis measurement tools remains a research priority in clinical hepatology.