Author information
1
NAFLD Research Center, Department of Medicine, University of California at San Diego, La Jolla, CA, United states; Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, United states; Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, United states. Electronic address: roloomba@ucsd.edu.
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a major public health problem afflicting approximately 1 billion individuals worldwide. Liver biopsy is considered the gold standard to assess severity of liver disease in patients with NAFLD. However, it is invasive, has high inter-observer variability, and is associated with adverse effects, including pain, infection, and rarely death. It is also impractical due to the large number of individuals who have NAFLD. Therefore, there is a strong need for the non-invasive assessment of disease severity in NAFLD. Over the last 2 decades, tremendous advances have been made in non-invasive imaging assessment of NAFLD. In this review, we will discuss the available evidence to quantify liver fat as well as liver fibrosis non-invasively using imaging modalities. We would also discuss the limitations of current modalities to detect the progressive form for NAFLD termed as nonalcoholic steatohepatitis (NASH). Finally we will discuss emerging comparative efficacy of various imaging based elastographic modalities and their diagnostic test characteristics to detect advanced fibrosis or cirrhosis.