Noninvasive Evaluation of Nonalcoholic Fatty Liver Disease

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver diseases and can progress to advanced fibrosis and end-stageliver disease. Thus, intensive research has been performed to develop noninvasive methods for the diagnosis of nonalcoholic steatohepatitis (NASH) and fibrosis. Currently, no single noninvasive tool covers all of the stages of pathologies and conditions ofNAFLD, and the cost and feasibility of known techniques are also important issues. Blood biomarkers for NAFLD may be useful toselect subjects who need ultrasonography (US) screening for NAFLD, and noninvasive tools for assessing fibrosis may be helpful toexclude the probability of significant fibrosis and to predict advanced fibrosis, thus guiding the decision of whether to perform liverbiopsy in patients with NAFLD. Among various methods, magnetic resonance-based methods have been shown to perform betterthan other methods in assessing steatosis as well as in detecting hepatic fibrosis. Many genetic markers are associated with the development and progression of NAFLD. Further well-designed studies are needed to determine which biomarker panels, imaging studies, genetic marker panels, or combinations thereof perform well for diagnosing NAFLD, differentiating NASH and fibrosis, andfollowing-up NAFLD, respectively.