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Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease
Open accessAbstract
Nonalcoholic fatty liver disease (NAFLD) is estimated to afflict approximately 1 billion individuals worldwide. In a subset of NAFLD patients, who have the progressive form of NAFLD termed nonalcoholic steatohepatitis (NASH), it can progress to advanced fibrosis, cirrhosis, hepatocellular carcinoma, and liver-related morbidity and mortality. NASH is typically characterized by a specific pattern on liver histology, including steatosis, lobular inflammation, and ballooning with or without peri-sinusoidal fibrosis. Thus, key issues in NAFLD patients are the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis. Until now, liver biopsy has been the gold standard for identifying these 2 critical end points, but has well-known limitations, including invasiveness; rare but potentially life-threatening complications; poor acceptability; sampling variability; and cost. Furthermore, due to the epidemic proportion of individuals with NAFLD worldwide, liver biopsy evaluation is impractical, and noninvasive assessment for the diagnosis of NASH and fibrosis is needed. Although much of the work remains to be done in establishing cost-effective strategies for screening for NASH, advanced fibrosis, and cirrhosis, in this review, we summarize the current state of the noninvasive assessment of liver disease in NAFLD, and we provide an expert synthesis of how these noninvasive tools could be utilized in clinical practice. Finally, we also list the key areas of research priorities in this area to move forward clinical practice.
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“Non-invasive tools perform well to rule-in and rule-out steatosis and fibrosis, 2”
From Muscle fat content is strongly associated with NASH: a longitudinal study in patients with morbid obesity (2021) · cites this paper as [2]
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Metadata
- Authors
- Castera, L., Friedrich-Rust, M., & Loomba, R.
- Affiliations
- University of California San Diego (US)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 156
- Issue
- 5
- Pages
- 1264-1281.e4
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC7505052
- OpenAlex
- W2909812323
- Cited by
- 1,494
- References
- 213
- Citations by year
- 2026: 156 · 2025: 212 · 2024: 213 · 2023: 210 · 2022: 249 · 2021: 258 · 2020: 148 · 2019: 46
- FWCI
- 25.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Gastroenterology (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, cc-by-nc)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Allergan
- National Institute of Environmental Health Sciences
- Gilead Sciences
- Bristol-Myers Squibb
- Boehringer Ingelheim
- National Institutes of Health (P42ES010337)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, non-invasive assessment, liver fibrosis, liver cirrhosis, liver biopsy limitations, steatosis, ballooning, hepatocellular carcinoma
- MeSH terms
- Biopsy, Humans, Liver, Liver Cirrhosis, Liver Function Tests, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Predictive Value of Tests, Prognosis, Severity of Illness Index, Ultrasonography, Reproducibility of Results, Biomarkers, Elasticity Imaging Techniques, Non-alcoholic Fatty Liver Disease
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