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Abstract Details
Non-invasive diagnosis and staging of non-alcoholic fatty liver disease
Hormones (Athens). 2022 Sep;21(3):349-368. doi: 10.1007/s42000-022-00377-8.Epub 2022 Jun 4.
1Department of Gastroenterology and Hepatology, University Hospital, Linköping, Sweden. stergios.kechagias@liu.se.
2Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden. stergios.kechagias@liu.se.
3Department of Gastroenterology and Hepatology, University Hospital, Linköping, Sweden.
4Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden.
5Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
6Department of Biomedical Engineering, Linköping University, Linköping, Sweden.
Abstract
Non-alcoholic fatty liver disease (NAFLD) is considered to be the hepatic manifestation of the metabolic syndrome and is characterized by ectopic accumulation of triglycerides in the cytoplasm of hepatocytes, i.e., steatosis. NAFLD has become the most common chronic liver disease, with an estimated global prevalence of 25%. Although the majority of NAFLD patients will never experience liver-related complications, the progressive potential of NAFLD is indisputable, with 5-10% of subjects progressing to cirrhosis, end-stage liver disease, or hepatocellular carcinoma. NAFLD patients with advanced fibrosis are at the highest risk of developing cardiovascular and cirrhosis-related complications. Liver biopsy has hitherto been considered the reference method for evaluation of hepatic steatosis and fibrosis stage. Given the limitations of biopsy for widescale screening, non-invasive tests (NITs) for assessment of steatosis and fibrosis stage, including serum-based algorithms and ultrasound- and magnetic resonance-based methods, will play an increasing role in the management of NAFLD patients. This comprehensive review presents the advantages and limitations of NITs for identification of steatosis and advanced fibrosis in NAFLD. The clinical implications of using NITs to identify and manage NAFLD patients are also discussed.