Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: a meta-analysis
Open accessAbstract
Many noninvasive methods for diagnosing liver fibrosis (LF) have been proposed. To determine the best method for diagnosing LF in nonalcoholic fatty liver disease (NAFLD), we conducted a systemic review and meta-analysis to compare the performance of aspartate aminotransferase to platelets ratio index (APRI), fibrosis-4 index (FIB-4), BARD score, NAFLD fibrosis score (NFS), FibroScan, shear wave elastography (SWE), and magnetic resonance elastography (MRE) for diagnosing LF in NAFLD. We compared the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUROC) of these noninvasive methods for detecting significant fibrosis (SF), advanced fibrosis (AF), and cirrhosis. Heterogeneity was explored using meta-regression. Sixty-four articles with a total of 13,046 NAFLD subjects were included. The overall mean prevalence of SF, AF, and cirrhosis was 45.0%, 24.0%, and 9.4% in NAFLD patients, respectively. With an APRI threshold of 1.0 and 1.5, the sensitivities and specificities were 50.0% and 84.0% and 18.3% and 96.1%, respectively, for AF. With a FIB-4 threshold of 2.67 and 3.25, the sensitivities and specificities were 26.6% and 96.5% and 31.8% and 96.0%, respectively, for AF. The summary sensitivities and specificities of BARD score (threshold of 2), NFS (threshold of -1.455), FibroScan M (threshold of 8.7-9), SWE, and MRE for detecting AF were 0.76 and 0.61, 0.72 and 0.70, 0.87 and 0.79, 0.90 and 0.93, and 0.84 and 0.90, respectively. The summary AUROC values using APRI, FIB-4, BARD score, NFS, FibroScan M probe, XL probe, SWE, and MRE for diagnosing AF were 0.77, 0.84, 0.76, 0.84, 0.88, 0.85, 0.95, and 0.96, respectively. CONCLUSION: MRE and SWE may have the highest diagnostic accuracy for staging fibrosis in NAFLD patients. Among the four noninvasive simple indexes, NFS and FIB-4 probably offer the best diagnostic performance for detecting AF. (Hepatology 2017;66:1486-1501).
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Several substantial comparative studies have shown that MRE provides at least equal quality in fibrosis staging as ultrasound-based elastography techniques.
“Several substantial comparative studies have shown that MRE provides at least equal quality in fi brosis staging as ultrasound-based elastography techniques.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [158]
The Discussion reports that MRE outperformed FibroScan on some fibrosis measures and that MRE and shear-wave elastography had similarly high accuracy for advanced fibrosis. It also cautions that the MRE and shear-wave evidence comprised no more than five articles per method, with relatively few participants, so the characterization of the comparative studies as substantial is not supported. (LLM, conf=0.83)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Sterling, R. K., Lissen, E., Clumeck, N., Sola, R., Correa, M. C., Montaner, J., S. Sulkowski, M., Torriani, F. J., Dieterich, D. T., Thomas, D. L., et al. (2006) · Hepatology · doi:10.1002/hep.21178 · Cited by 5,021 · cited 1× · see citing works
“Dozens of noninvasive models composed of blood biochemical biomarkers have been proposed to detect LF, including aspartate aminotransferase to platelets ratio index (APRI)((5)) and fibrosis-4 index (FIB-4).((6)) However, APRI and FIB-4 were established based on patients with hepatitis C virus (HCV) infection or HIV/HC…”
MethodWai, C.-T., Greenson, J. K., Fontana, R. J., Kalbfleisch, J. D., Marrero, J. A., Conjeevaram, H. S., & Lok, A. S.-F. (2003) · Hepatology · doi:10.1053/jhep.2003.50346 · Cited by 4,406 · see citing works
Angulo, P., Hui, J. M., Marchesini, G., Bugianesi, E., George, J., Farrell, G. C., Enders, F., Saksena, S., Burt, A. D., Bida, J. P., et al. (2007) · Hepatology · doi:10.1002/hep.21496 · Cited by 3,198 · see citing works
Sampling Variability of Liver Fibrosis in Chronic Hepatitis C
Bédossa, P., Dargère, D., & Paradis, V. (2003) · Hepatology · doi:10.1016/j.hep.2003.09.022 · Cited by 2,370 · see citing works
Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis
McPherson, S., Hardy, T., Dufour, J.-F., Petta, S., Romero-Gomez, M., Allison, M., Oliveira, C. P., Francque, S., Van Gaal, L., Schattenberg, J. M., et al. (2017) · American Journal of Gastroenterology · doi:10.1038/ajg.2016.453 · Cited by 945 · see citing works
Harrison, S. A., Oliver, D., Arnold, H. L., Gogia, S., & Neuschwander‐Tetri, B. A. (2008) · Gut · doi:10.1136/gut.2007.146019 · Cited by 869 · see citing works
Imajo, K., Kessoku, T., Honda, Y., Tomeno, W., Ogawa, Y., Mawatari, H., Fujita, K., Yoneda, M., Taguri, M., Hyogo, H., et al. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.11.048 · Cited by 815 · see citing works
Magnetic Resonance Elastography for the Noninvasive Staging of Liver Fibrosis
Huwart, L., Sempoux, C. L., Vicaut, É., Salameh, N., Annet, L., Danse, É., Peeters, F., ter Beek, L. C., Rahier, J., Sinkus, R., et al. (2008) · Gastroenterology · doi:10.1053/j.gastro.2008.03.076 · Cited by 726 · see citing works
Park, C. C., Nguyen, P., Hernandez, C., Bettencourt, R., Ramirez, K., Fortney, L., Hooker, J. C., Sy, E. Z., Savides, M. T., Alquiraish, M. H., et al. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.10.026 · Cited by 715 · see citing works
Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
Vuppalanchi, R., & Chalasani, N. (2008) · Hepatology · doi:10.1002/hep.22603 · Cited by 562 · see citing works
Xiao, G., Yang, J., & Yan, L. (2014) · Hepatology · doi:10.1002/hep.27382 · Cited by 512 · see citing works
Myers, R. P., Pomier–Layrargues, G., Kirsch, R., Pollett, A. F., Duarte‐Rojo, A., Wong, D., Beaton, M. D., Levstik, M. A., Crotty, P., & Elkashab, M. (2011) · Hepatology · doi:10.1002/hep.24624 · Cited by 502 · see citing works
Shear elasticity probe for soft tissues with 1-D transient elastography
Sandrin, L., Tanter, M., Gennisson, J., Catheline, S., & Fink, M. (2002) · IEEE Transactions on Ultrasonics Ferroelectrics and Frequency Control · doi:10.1109/58.996561 · Cited by 428 · see citing works
Liver fibrosis: non‐invasive assessment with MR elastography
Huwart, L., Peeters, F., Sinkus, R., Annet, L., Salameh, N., ter Beek, L. C., Horsmans, Y., & BEERS, B. E. V. (2006) · NMR in Biomedicine · doi:10.1002/nbm.1030 · Cited by 416 · see citing works
Fraser, A., Longnecker, M. P., & Lawlor, D. A. (2007) · Gastroenterology · doi:10.1053/j.gastro.2007.08.077 · Cited by 327 · see citing works
Real-Time Elastography for Noninvasive Assessment of Liver Fibrosis in Chronic Viral Hepatitis
Friedrich‐Rust, M., Ong, M. F., Herrmann, E. M., Dries, V., Samaras, P., Zeuzem, S., & Sarrazin, C. (2007) · American Journal of Roentgenology · doi:10.2214/ajr.06.0322 · Cited by 324 · see citing works
Martín‐Carbonero, L., Benhamou, Y., Puoti, M., Berenguer, J., Mallolas, J., Quereda, C., Arizcorreta, A., Gonzalez, A., Rockstroh, J. K., Asensi, V., et al. (2003) · Clinical Infectious Diseases · doi:10.1086/380130 · Cited by 271 · see citing works
Loomba, R. S., Cui, J. Y., Wolfson, T. J., Haufe, W. M., Hooker, J. C., Szeverenyi, N. M., Ang, B., Bhatt, A., Wang, K., Aryafar, H., et al. (2016) · The American Journal of Gastroenterology · doi:10.1038/ajg.2016.65 · Cited by 202 · see citing works
Afdhal, N. H., Bacon, B. R., Patel, K., Lawitz, E., Gordon, S. C., Nelson, D. R., Challies, T. L., Nasser, I. A., Garg, J., Wei, L. J., et al. (2014) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2014.12.014 · Cited by 198 · see citing works
Cui, J. Y., Heba, E. R., Hernandez, C., Haufe, W. M., Hooker, J. C., André, M. P., Valasek, M. A., Aryafar, H., Sirlin, C. B., & Loomba, R. S. (2015) · Hepatology · doi:10.1002/hep.28337 · Cited by 191 · see citing works
Wong, G. L., Wong, V. W., Choi, P. C., Chan, A. W. H., Chum, R. H., Chan, H. K., Lau, K. K., Chim, A. M., Yiu, K. K., Chan, F. K., et al. (2008) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2008.02.038 · Cited by 159 · see citing works
Cui, J. Y., Ang, B., Haufe, W. M., Hernandez, C., Verna, E. C., Sirlin, C. B., & Loomba, R. S. (2015) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13196 · Cited by 155 · see citing works
Wright, M., Goldin, R. D., Fabre, A., Lloyd, J., Thomas, H. C., TREPO, C. G., Pradat, P., & Thursz, M. R. (2003) · Gut · doi:10.1136/gut.52.4.574 · Cited by 131 · see citing works
Alkhouri, N., Sedki, E., Alisi, A., López, R., Pinzani, M., Feldstein, A. E., & Nobili, V. (2012) · Liver International · doi:10.1111/liv.12024 · Cited by 112 · see citing works
Ochi, H., Hirooka, M., Koizumi, Y., Miyake, T., Tokumoto, Y., Soga, Y., Tada, F., Abe, M., Hiasa, Y., & Onji, M. (2012) · Hepatology · doi:10.1002/hep.25756 · Cited by 111 · see citing works
Noninvasive Parameters and hepatic fibrosis scores in children with nonalcoholic fatty liver disease
Yang, H. R. (2012) · World Journal of Gastroenterology · doi:10.3748/wjg.v18.i13.1525 · Cited by 104 · see citing works
The Evaluation of Hepatic Fibrosis Scores in Children with Nonalcoholic Fatty Liver Disease
Mansoor, S., Yerian, L. M., Kohli, R., Xanthakos, S. A., Angulo, P., Ling, S. C., López, R., Carter-Kent, C. A., Feldstein, A. E., & Alkhouri, N. (2014) · Digestive Diseases and Sciences · doi:10.1007/s10620-014-3494-7 · Cited by 101 · see citing works
Tapper, E. B., Sengupta, N., Hunink, M. G. M., Afdhal, N. H., & Lai, M. (2015) · The American Journal of Gastroenterology · doi:10.1038/ajg.2015.241 · Cited by 90 · see citing works
Mann, J. P., Vito, R. D., Mosca, A., Alisi, A., Armstrong, M. J., Raponi, M., Baumann, U., & Nobili, V. (2015) · Hepatology · doi:10.1002/hep.28374 · Cited by 90 · see citing works
Alkhouri, N., Mansoor, S., Giammaria, P., Liccardo, D., López, R., & Nobili, V. (2014) · PLoS ONE · doi:10.1371/journal.pone.0104558 · Cited by 89 · see citing works
Shear Wave Elastography in the Evaluation of Liver Fibrosis in Children
Tutar, O., Beşer, Ö. F., Adaletli, İ., Tunç, N., Taşkın, D. G., Kantarcı, F., Mihmanlı, İ., Cokugras, F. C., Kutlu, T., Özbay, G., et al. (2014) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000000329 · Cited by 87 · see citing works
Shi, Y., Xia, F., Li, Q.-J., Li, J.-H., Yu, B., Li, Y., An, H., Glaser, K. J., Tao, S., Ehman, R. L., et al. (2016) · The American Journal of Gastroenterology · doi:10.1038/ajg.2016.56 · Cited by 73 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Rinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R. (2023) · Hepatology · doi:10.1097/hep.0000000000000323 · Cited by 2,667 · see citing works
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
Berzigotti, A., Tsochatzis, E., Boursier, J., Castera, L., Cazzagon, N., Friedrich-Rust, M., Petta, S., & Thiele, M. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.05.025 · Cited by 1,925 · see citing works
Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease
Castera, L., Friedrich-Rust, M., & Loomba, R. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.12.036 · Cited by 1,494 · see citing works
Gut microbiota and human NAFLD: disentangling microbial signatures from metabolic disorders
Aron‐Wisnewsky, J., Vigliotti, C., Witjes, J. J., Le, P. T., Holleboom, A. G., Verheij, J., Nieuwdorp, M., & Clément, K. (2020) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-020-0269-9 · Cited by 1,085 · see citing works
Li, J., Zou, B., Yeo, Y. H., Feng, Y., Xie, X., Lee, D. H., Fujii, H., Wu, Y., Kam, L. Y., Ji, F., et al. (2019) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(19)30039-1 · Cited by 1,036 · see citing works
Cusi, K., Isaacs, S., Barb, D., Basu, R., Caprio, S., Garvey, W. T., Kashyap, S., Mechanick, J. I., Mouzaki, M., Nadolsky, K., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.03.010 · Cited by 1,021 · see citing works
Eslam, M., Sarin, S. K., Wong, V. W., Fan, J.-G., Kawaguchi, T., Ahn, S. H., Zheng, M., Shiha, G. E.-S., Yilmaz, Y. N., Gani, R. A., et al. (2020) · Hepatology International · doi:10.1007/s12072-020-10094-2 · Cited by 837 · see citing works
Current and future pharmacological therapies for NAFLD/NASH
Sumida, Y., & Yoneda, M. (2017) · Journal of Gastroenterology · doi:10.1007/s00535-017-1415-1 · Cited by 670 · see citing works
NAFLD as a Continuum: From Obesity to Metabolic Syndrome and Diabetes
Godoy-Matos, A. F., Silva Júnior, W. S., & Valerio, C. M. (2020) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-020-00570-y · Cited by 643 · see citing works
Noninvasive biomarkers in NAFLD and NASH — current progress and future promise
Wong, V. W., Adams, L. A., de Lédinghen, V., Wong, G. L., & Sookoian, S. C. (2018) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-018-0014-9 · Cited by 617 · see citing works
Kanwal, F., Shubrook, J. H., Adams, L. A., Pfotenhauer, K., Wai-Sun Wong, V., Wright, E., Abdelmalek, M. F., Harrison, S. A., Loomba, R., Mantzoros, C. S., et al. (2021) · Gastroenterology · doi:10.1053/j.gastro.2021.07.049 · Cited by 618 · see citing works
Zaharia, O. P., Strassburger, K., Strom, A., Bönhof, G. J., Karusheva, Y., Antoniou, S., Bódis, K., Markgraf, D. F., Burkart, V., Müssig, K., et al. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30187-1 · Cited by 600 · see citing works
Ferraioli, G., Wong, V. W., Castéra, L., Berzigotti, A., Sporea, I., Dietrich, C. F., Choi, B. I., Wilson, S. R., Kudo, M., & Barr, R. G. (2018) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2018.07.008 · Cited by 574 · see citing works
Determinants of Fibrosis Progression and Regression in NASH
Schuppan, D., Surabattula, R., & Wang, X. Y. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2017.11.012 · Cited by 479 · see citing works
(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 510 · see citing works
Liver fibrosis: Direct antifibrotic agents and targeted therapies
Schuppan, D., Ashfaq–Khan, M., Yang, A. T., & Kim, Y. O. (2018) · Matrix Biology · doi:10.1016/j.matbio.2018.04.006 · Cited by 440 · see citing works
Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus
Targher, G., Lonardo, A., & Byrne, C. D. (2018) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.173 · Cited by 397 · see citing works
Selvaraj, E. A., Mózes, F. E., Jayaswal, A. N. A., Zafarmand, M. H., Vali, Y., Lee, J. A., Levick, C. K., Young, L. A. J., Palaniyappan, N., Liu, C.-H., et al. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.04.044 · Cited by 376 · see citing works
Advances in non-invasive assessment of hepatic fibrosis
Loomba, R. S., & Adams, L. A. (2020) · Gut · doi:10.1136/gutjnl-2018-317593 · Cited by 351 · see citing works
Limitations of non-invasive tests for assessment of liver fibrosis
Patel, K., & Sebastiani, G. (2020) · JHEP Reports · doi:10.1016/j.jhepr.2020.100067 · Cited by 323 · see citing works
Sun, D.-Q., Jin, Y., Wang, T.-Y., Zheng, K. I., Rios, R. S., Zhang, H.-Y., Targher, G., Byrne, C., Yuan, W., & Zheng, M. (2020) · Metabolism: Clinical and Experimental · doi:10.1016/j.metabol.2020.154433 · Cited by 294 · see citing works
Anstee, Q. M., Lawitz, E. J., Alkhouri, N., Wong, V. W., Romero‐Gomez, M., Okanoue, T., Trauner, M., Kersey, K., Li, G., Han, L., et al. (2019) · Hepatology · doi:10.1002/hep.30842 · Cited by 277 · see citing works
Tokushige, K., Ikejima, K., Ono, M., Eguchi, Y., Kamada, Y., Itoh, Y., Akuta, N., Yoneda, M., Iwasa, M., Yoneda, M., et al. (2021) · Journal of Gastroenterology · doi:10.1007/s00535-021-01796-x · Cited by 276 · see citing works
Non-alcoholic fatty liver disease: A patient guideline
Francque, S. M., Marchesini, G., Kautz, A., Walmsley, M., Dorner, R., Lazarus, J. V., Zelber-Sagi, S., Hallsworth, K., Busetto, L., Frühbeck, G., et al. (2021) · JHEP Reports · doi:10.1016/j.jhepr.2021.100322 · Cited by 264 · see citing works
Noninvasive evaluation of nonalcoholic fatty liver disease: Current evidence and practice
Zhou, J., Cai, J., She, Z., & Li, H. (2019) · World Journal of Gastroenterology · doi:10.3748/wjg.v25.i11.1307 · Cited by 248 · see citing works
Wattacheril, J. J., Abdelmalek, M. F., Lim, J. K., & Sanyal, A. J. (2023) · Gastroenterology · doi:10.1053/j.gastro.2023.06.013 · Cited by 236 · see citing works
Heyens, L. J. M., Busschots, D., Koek, G. H., Robaeys, G., & Francque, S. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.615978 · Cited by 243 · see citing works
Nonalcoholic fatty liver disease in adults: current concepts in etiology, outcomes, and management
Marjot, T., Moolla, A., Cobbold, J. F., Hodson, L., & Tomlinson, J. W. (2020) · Endocrine Reviews · doi:10.1210/endrev/bnz009 · Cited by 228 · see citing works
Sterling, R. K., Duarte‐Rojo, A., Patel, K., Asrani, S. K., Alsawas, M., Dranoff, J. A., Fiel, M. I., Murad, M. H., Leung, D. H., Levine, D., et al. (2024) · Hepatology · doi:10.1097/hep.0000000000000843 · Cited by 232 · see citing works
Differential Clinical Characteristics and Mortality Outcomes in Persons With NAFLD and/or MAFLD
Nguyen, V. H., Le, M. H., Cheung, R. C., & Nguyen, M. H. (2021) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.05.029 · Cited by 217 · see citing works
Choi, K. J., Jang, J. K., Lee, S. S., Sung, Y. S., Shim, W. H., Kim, H. S., Yun, J., Choi, J., Lee, Y., Kang, B.-K., et al. (2018) · Radiology · doi:10.1148/radiol.2018180763 · Cited by 219 · see citing works
Non-alcoholic fatty liver disease: pathophysiological concepts and treatment options
Grander, C., Grabherr, F., & Tilg, H. (2023) · Cardiovascular Research · doi:10.1093/cvr/cvad095 · Cited by 216 · see citing works
Boursier, J., Hagström, H., Ekstedt, M., Moreau, C., Bonacci, M., Cure, S., Ampuero, J., Nasr, P., Tallab, L., Canivet, C. M., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2021.12.031 · Cited by 206 · see citing works
Petta, S., Sebastiani, G., Viganò, M., Ampuero, J., Wai-Sun Wong, V., Boursier, J., Berzigotti, A., Bugianesi, E., Fracanzani, A. L., Cammà, C., et al. (2021) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.06.045 · Cited by 197 · see citing works
Abdelhameed, F., Kite, C., Lagojda, L., Dallaway, A., Chatha, K. K., Chaggar, S. S., Dalamaga, Μ., Kassi, E. N., Kyrou, I., & Randeva, H. S. (2024) · Current Obesity Reports · doi:10.1007/s13679-024-00574-z · Cited by 193 · see citing works
Ampuero, J., Pais, R., Aller, R., Gallego‐Durán, R., Crespo, J., García‐Monzón, C., Boursier, J., Vilar‐Gómez, E., Petta, S., Zheng, M., et al. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2019.05.051 · Cited by 184 · see citing works
Simon, T. G., Henson, J., Osganian, S., Masia, R., Chan, A. T., Chung, R. T., & Corey, K. E. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2019.04.061 · Cited by 180 · see citing works
Katsagoni, C. N., Papatheodoridis, G. V., Ioannidou, P., Deutsch, M., Alexopoulou, A., Papadopoulos, N., Papageorgiou, M.-V., Fragopoulou, E., & Kontogianni, M. D. (2018) · British Journal of Nutrition · doi:10.1017/s000711451800137x · Cited by 167 · see citing works
Sterling, R. K., Patel, K., Duarte‐Rojo, A., Asrani, S. K., Alsawas, M., Dranoff, J. A., Fiel, M. I., Murad, M. H., Leung, D. H., Levine, D., et al. (2024) · Hepatology · doi:10.1097/hep.0000000000000845 · Cited by 166 · see citing works
Perakakis, N., Stefanakis, K., & Mantzoros, C. S. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154320 · Cited by 163 · see citing works
Tincopa, M. A., & Loomba, R. S. (2023) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(23)00066-3 · Cited by 163 · see citing works
Kanwal, F., Kramer, J. R., Li, L., Yang, Y., Cao, Y., Yu, X., Samuel, R. E., Ali, B., Desiderio, R., Cholankeril, G. T., et al. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.4661 · Cited by 163 · see citing works
Cao, Y.-T., Xiang, L.-L., Qi, F., Zhang, Y., Chen, Y., & Zhou, X. (2022) · EClinicalMedicine · doi:10.1016/j.eclinm.2022.101547 · Cited by 159 · see citing works
Boursier, J., Guillaume, M., Leroy, V., Irlès, M., Roux, M., Lannes, A., Foucher, J., Zuberbuhler, F., Delabaudière, C., Barthelon, J., et al. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2019.04.020 · Cited by 157 · see citing works
Arab, J. P., Dirchwolf, M., Álvares‐da‐Silva, M. R., Francisco Barrera, M., Benítez, C., Castellanos, M., Castro‐Narro, G., Chávez-Tapia, N. C., Chiodi, D., Cotrim, H. P., et al. (2020) · Annals of Hepatology · doi:10.1016/j.aohep.2020.09.006 · Cited by 142 · see citing works
Ekstedt, M., Nasr, P., & Kechagias, S. (2017) · Current Hepatology Reports · doi:10.1007/s11901-017-0378-2 · Cited by 141 · see citing works
Tokushige, K., Ikejima, K., Ono, M., Eguchi, Y., Kamada, Y., Itoh, Y., Akuta, N., Yoneda, M., Iwasa, M., Yoneda, M., et al. (2021) · Hepatology Research · doi:10.1111/hepr.13688 · Cited by 145 · see citing works
Exploring the landscape of steatotic liver disease in the general US population
Ciardullo, S., Carbone, M., Invernizzi, P., & Perseghin, G. (2023) · Liver International · doi:10.1111/liv.15695 · Cited by 128 · see citing works
Non-invasive assessment of liver fibrosis and prognosis: an update on serum and elastography markers
Agbim, U. A., & Asrani, S. K. (2019) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2019.1579641 · Cited by 126 · see citing works
2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
Choi, J. H., Lee, K. A., Moon, J. H., Chon, S., Kim, D. J., Kim, H. J., Kim, N. H., Seo, J. A., Kim, M. K., Lim, J. H., et al. (2023) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2023.0282 · Cited by 129 · see citing works
Liang, J., Ampuero, J., Niu, H., Imajo, K., Noureddin, M., Behari, J., Lee, D. H., Ehman, R. L., Rorsman, F., Vessby, J., et al. (2023) · Journal of Hepatology · doi:10.1016/j.jhep.2023.04.025 · Cited by 123 · see citing works
Noninvasive Assessment of Liver Fibrosis
Castéra, L., Rinella, M. E., & Tsochatzis, E. A. (2025) · New England Journal of Medicine · doi:10.1056/nejmra2403308 · Cited by 115 · see citing works
Tests for diagnosing and monitoring non-alcoholic fatty liver disease in adults
Byrne, C. D., Patel, J., Scorletti, E., & Targher, G. (2018) · BMJ · doi:10.1136/bmj.k2734 · Cited by 110 · see citing works
Non-invasive testing and risk-stratification in patients with MASLD
Zoncapè, M., Liguori, A., & Tsochatzis, E. A. (2024) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2024.01.013 · Cited by 112 · see citing works
Decharatanachart, P., Chaiteerakij, R., Tiyarattanachai, T., & Treeprasertsuk, S. (2021) · BMC Gastroenterology · doi:10.1186/s12876-020-01585-5 · Cited by 109 · see citing works
Kim, B. K., Tamaki, N., Imajo, K., Yoneda, M., Sutter, N., Jung, J., Tuo, L., Tu, X. M., Bergstrom, J., Nguyen, K., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.07.020 · Cited by 109 · see citing works
Chen, V. L., Oliveri, A., Miller, M. J., Wijarnpreecha, K., Du, X., Chen, Y., Cushing, K. C., Lok, A. S., & Speliotes, E. K. (2023) · Gastroenterology · doi:10.1053/j.gastro.2023.01.040 · Cited by 108 · see citing works
MR elastography of liver: current status and future perspectives
İdilman, İ. S., Li, J., Yin, M., & Venkatesh, S. K. (2020) · Abdominal Radiology · doi:10.1007/s00261-020-02656-7 · Cited by 104 · see citing works
Younossi, Z. M., Noureddin, M., Bernstein, D., Kwo, P. Y., Russo, M. W., Shiffman, M. L., Younes, Z. H., & Abdelmalek, M. F. (2020) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001054 · Cited by 104 · see citing works
Clinical and Molecular Biomarkers for Diagnosis and Staging of NAFLD
Mauro, S. D., Scamporrino, A., Filippello, A., Pino, A. D., Scicali, R., Malaguarnera, R., Purrello, F., & Piro, S. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms222111905 · Cited by 104 · see citing works
Miller, D. M., McCauley, K. F., & Dunham‐Snary, K. J. (2025) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.70132 · Cited by 125 · see citing works
Marcondes‐de‐Castro, I. A., Reis‐Barbosa, P. H., Marinho, T. D. S., Águila, M. B., & Mandarim‐de‐Lacerda, C. A. (2023) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16272 · Cited by 103 · see citing works
Pediatric NAFLD: an overview and recent developments in diagnostics and treatment
Draijer, L. G., Benninga, M. A., & Koot, B. G. P. (2019) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2019.1595589 · Cited by 102 · see citing works
Chen, Y., Li, H., Li, S., Xu, Z., Tian, S., Wu, J., Liang, X., Li, X., Liu, Z., Xiao, J., et al. (2021) · BMC Gastroenterology · doi:10.1186/s12876-021-01782-w · Cited by 101 · see citing works
Roeb, E., Canbay, A. E., Tacke, F., Bantel, H., Bojunga, J., de Laffolie, J., Demir, M., Denzer, U. W., Geier, A., Hofmann, W. P., et al. (2022) · Zeitschrift für Gastroenterologie · doi:10.1055/a-1880-2283 · Cited by 102 · see citing works
Świderska, M., Maciejczyk, M., Zalewska, A., Pogorzelska, J., Flisiak, R., & Chabowski, A. (2019) · Free Radical Research · doi:10.1080/10715762.2019.1635691 · Cited by 107 · see citing works
Lefebvre, T. L., Wartelle‐Bladou, C., Wong, P. Y. N., Sebastiani, G., Giard, J., Castel, H., Murphy-Lavallée, J., Olivié, D., Ilinca, A. P., Sylvestre, M., et al. (2019) · European Radiology · doi:10.1007/s00330-019-06331-4 · Cited by 100 · see citing works
Petta, S., Wong, V. W., Bugianesi, E., Fracanzani, A. L., Cammà, C., Hiriart, J., Wong, G. L., Vergniol, J., Chan, A. W. H., Giannetti, A., et al. (2019) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000153 · Cited by 98 · see citing works
Osteoprotegerin Promotes Liver Steatosis by Targeting the ERK–PPAR-γ–CD36 Pathway
Zhang, C., Luo, X., Chen, J., Zhou, B., Yang, M., Liu, R., Liu, D., Gu, H. F., Zhu, Z., Zheng, H., et al. (2019) · Diabetes · doi:10.2337/db18-1055 · Cited by 95 · see citing works
Ballestri, S., Mantovani, A., Baldelli, E., Lugari, S., Maurantonio, M., Nascimbeni, F., Marrazzo, A., Romagnoli, D., Targher, G., & Lonardo, A. (2021) · Diagnostics · doi:10.3390/diagnostics11010098 · Cited by 93 · see citing works
Castéra, L. (2020) · Liver International · doi:10.1111/liv.14347 · Cited by 92 · see citing works
A review of non‐alcoholic fatty liver disease in non‐obese and lean individuals
Ahadi, M., Molooghi, K., Masoudifar, N., Namdar, A. B., Vossoughinia, H., & Farzanehfar, M. (2020) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.15353 · Cited by 91 · see citing works
Value of Liver Function Tests in Cirrhosis
Sharma, P. (2021) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2021.11.004 · Cited by 90 · see citing works
Xu, X., Jiang, L., Wu, C., Pan, L., Lou, Z., Peng, C., Dong, Y., & Ruan, B. (2021) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2021.07.013 · Cited by 88 · see citing works
The Link between NAFLD and Metabolic Syndrome
Radu, F., Potcovaru, C.-G., Salmen, T., Filip, P. V., Pop, C. S., & Fierbinteanu-Braticevici, C. G. (2023) · Diagnostics · doi:10.3390/diagnostics13040614 · Cited by 87 · see citing works
Ajmera, V. H., Liu, A., Singh, S., Yachoa, G., Ramey, M., Bhargava, M., Zamani, A., Lopez, S. J., Mangla, N., Bettencourt, R., et al. (2019) · Hepatology · doi:10.1002/hep.30974 · Cited by 84 · see citing works
Castéra, L. (2018) · Liver International · doi:10.1111/liv.13658 · Cited by 83 · see citing works
Busting the myth of methotrexate chronic hepatotoxicity
Martino, V. D., Weil, D., Verhoeven, F., Aubin, F., Avouac, J., Vuitton, L., Lioté, F., Thévenot, T., & Wendling, D. (2022) · Nature Reviews Rheumatology · doi:10.1038/s41584-022-00883-4 · Cited by 83 · see citing works
Chen, Q., Li, Q., Li, D., Chen, X., Liu, Z., Hu, G., Wang, J., & Ling, W. (2020) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2020.03.010 · Cited by 81 · see citing works
Long, M. T., Gandhi, S., & Loomba, R. S. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154259 · Cited by 79 · see citing works
Screening for Nonalcoholic Fatty Liver Disease in the Primary Care Clinic.
Pandyarajan, V., Gish, R. G., Alkhouri, N., & Noureddin, M. (2019) · PubMed Central · Cited by 78 · see citing works
Role of Ultrasound Methods for the Assessment of NAFLD
Petzold, G. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11154581 · Cited by 78 · see citing works
Advances in the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease
Yin, X., Guo, X., Liu, Z., & Wang, J. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24032844 · Cited by 78 · see citing works
Trends in Diagnostic Imaging of Cardiac Amyloidosis: Emerging Knowledge and Concepts
Oda, S., Kidoh, M., Nagayama, Y., Takashio, S., Usuku, H., Ueda, M., Yamashita, T., Ando, Y., Tsujita, K., & Yamashita, Y. (2020) · Radiographics · doi:10.1148/rg.2020190069 · Cited by 77 · see citing works
Ivashkin, V. T., Maevskaya, M. V., Жаркова, М. С., Kotovskaya, Y. V., Ткачева, О. Н., Troshina, E. A., Shestakova, M. V., Maev, I. V., Breder, V. V., Geyvandova, N. I., et al. (2022) · Russian Journal of Gastroenterology Hepatology Coloproctology · doi:10.22416/1382-4376-2022-32-4-104-140 · Cited by 77 · see citing works
Martinou, E., Pericleous, M., Stefanova, I., Kaur, V., & Angelidi, A. M. (2022) · Diagnostics · doi:10.3390/diagnostics12020407 · Cited by 76 · see citing works
Lemoine, M., Assoumou, L., Wit, S. D., Girard, P., Valantin, M., Katlama, C., Necsoi, C., Campa, P., Hüfner, A., Wiesch, J. S. Z., et al. (2018) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000001936 · Cited by 73 · see citing works
Soon, G. S. T., & Wee, A. (2020) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2020.0181 · Cited by 71 · see citing works
Kupriyanova, Y., Zaharia, O., Bobrov, P., Karusheva, Y., Burkart, V., Szendroedi, J., Hwang, J., Roden, M., Roden, M., Al‐Hasani, H., et al. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.11.030 · Cited by 71 · see citing works
Zaharia, O., Straßburger, K., Knebel, B., Kupriyanova, Y., Karusheva, Y., Wolkersdorfer, M. F., Bódis, K. B., Markgraf, D. F., Burkart, V., Hwang, J., et al. (2020) · Diabetes Care · doi:10.2337/dc20-0329 · Cited by 71 · see citing works
Liver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage
Parikh, N. S., Kamel, H., Navi, B. B., Iadecola, C., Merkler, A. E., Jesudian, A. B., Dawson, J., Falcone, G. J., Sheth, K. N., Roh, D. J., et al. (2020) · Stroke · doi:10.1161/strokeaha.119.028161 · Cited by 70 · see citing works
Sumida, Y., Yoneda, M., Tokushige, K., Kawanaka, M., Fujii, H., Yoneda, M., Imajo, K., Takahashi, H., Eguchi, Y., Ono, M., et al. (2021) · Life · doi:10.3390/life11020143 · Cited by 70 · see citing works
Duarte‐Rojo, A., Taouli, B. A., Leung, D. H., Levine, D., Nayfeh, T., Hasan, B., Alsawaf, Y., Saadi, S. M., Majzoub, A. M., Manolopoulos, A., et al. (2024) · Hepatology · doi:10.1097/hep.0000000000000852 · Cited by 74 · see citing works
Clinical assessment and management of liver fibrosis in non-alcoholic fatty liver disease
Campos-Murguía, A., Ruiz‐Margáin, A., González-Regueiro, J. A., & Macías‐Rodríguez, R. U. (2020) · World Journal of Gastroenterology · doi:10.3748/wjg.v26.i39.5919 · Cited by 69 · see citing works
Grgurević, I., Podrug, K., Mikolašević, I., Kukla, M., Madir, A., & Tsochatzis, E. A. (2020) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2020/9181368 · Cited by 68 · see citing works
Decharatanachart, P., Chaiteerakij, R., Tiyarattanachai, T., & Treeprasertsuk, S. (2021) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848211062807 · Cited by 67 · see citing works
Wu, S., Yang, Z., Zhou, J., Zeng, N., He, Z., Zhan, S., Jia, J., & You, H. (2018) · Hepatology International · doi:10.1007/s12072-018-9907-5 · Cited by 67 · see citing works
Elastography Techniques for the Assessment of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease
Honda, Y., Yoneda, M., Imajo, K., & Nakajima, A. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21114039 · Cited by 67 · see citing works
Heredia, N. I., Zhang, X., Balakrishnan, M., Daniel, C. R., Hwang, J. P., McNeill, L. H., & Thrift, A. P. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106903 · Cited by 63 · see citing works
- Authors
- Xiao, G., Zhu, S., Xiao, X., Yan, L., Yang, J., & Wu, G.
- Affiliations
- Huazhong University of Science and Technology (CN)
- Tongji Hospital (CN)
- Henan Medical University (CN)
- Department of Liver Surgery,West China Hospital of Sichuan University,Chengdu,China
- West China Hospital of Sichuan University (CN)
- Corresponding author
- Wu, Gang
- Venue
- Hepatology
- Published
- 2017-09-26
- Volume
- 66
- Issue
- 5
- Pages
- 1486-1501
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- OpenAlex
- W2622132351
- Cited by
- 895
- References
- 32
- Citations by year
- 2026: 68 · 2025: 85 · 2024: 109 · 2023: 118 · 2022: 142 · 2021: 147 · 2020: 117 · 2019: 62 · 2018: 38 · 2017: 7
- FWCI
- 47.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81600482, 81472201, 81172150)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Keywords
- non-alcoholic fatty liver disease, liver fibrosis, noninvasive fibrosis assessment, APRI, FIB-4, NAFLD fibrosis score, BARD score, FibroScan, shear wave elastography, magnetic resonance elastography, liver cirrhosis, diagnostic accuracy, sensitivity and specificity, ultrasound elastography, liver stiffness, meta-regression
- MeSH terms
- China, Fibrosis, Humans, Liver, Liver Cirrhosis, Ultrasonography, Prevalence, Elasticity Imaging Techniques, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
