Role of imaging-based biomarkers in NAFLD: Recent advances in clinical application and future research directions - PubMed (original) (raw)

Review

Role of imaging-based biomarkers in NAFLD: Recent advances in clinical application and future research directions

Rohit Loomba. J Hepatol. 2018 Feb.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a major public health problem afflicting approximately one billion individuals worldwide. Liver biopsy is considered the gold standard for assessment of liver disease severity in patients with NAFLD. However, it is invasive, has high inter-observer variability, and is associated with adverse effects, including pain, infection and, albeit rarely, death. It is also impractical because of the large number of individuals who have NAFLD. Therefore, tools to non-invasively assess disease severity in NAFLD are urgently needed. Over the last two decades, tremendous advances have been made in the assessment of NAFLD by non-invasive imaging. In this review, we will discuss the different non-invasive imaging modalities available to quantify liver fat and liver fibrosis. We will also discuss the limitations of current modalities to detect the progressive form for NAFLD, termed non-alcoholic steatohepatitis. Finally, we will discuss the comparative efficacy of various imaging-based elastographic modalities for detection of advanced fibrosis or cirrhosis, as well as their diagnostic characteristics.

Keywords: Biomarker; MRE; VCTE.

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Figures

Figure 1

A patient with stage 3 fibrosis and NASH underwent a SWE (using GE) with a reading of 2.04 m/s, an ARFI (Siemens ultrasound) with a reading of 2.60 m/s, a 2D MRE at 60 Hz (GE 3 Tesla) with a reading 4.5 K pa, and a 3D MRE at 60 hz (GE 3 Tesla) with a reading of 3.2 Kpa. These readings are suggestive of advanced fibrosis across all four modalities.

References

1. Chalasani N, Younossi Z, Lavine JE, et al. The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology. 2017 - PubMed
1. Singh S, Allen AM, Wang Z, et al. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13:643–54. e1–9. quiz e39–40. - PMC - PubMed
1. Dulai PS, Singh S, Patel J, et al. Increased risk of mortality by fibrosis stage in non-alcoholic fatty liver disease: Systematic Review and Meta-analysis. Hepatology. 2017 - PMC - PubMed
1. Angulo P, Kleiner DE, Dam-Larsen S, et al. Liver Fibrosis, but No Other Histologic Features, Is Associated With Long-term Outcomes of Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology. 2015;149:389–97. e10. - PMC - PubMed
1. Ekstedt M, Hagstrom H, Nasr P, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61:1547–54. - PubMed

Role of imaging-based biomarkers in NAFLD: Recent advances in clinical application and future research directions - PubMed (original) (raw)