Non-Invasive Imaging Methods to Evaluate Non-Alcoholic Fatty Liver Disease with Fat Quantification: A Review
Open accessAbstract
Hepatic steatosis without specific causes (e.g., viral infection, alcohol abuse, etc.) is called non-alcoholic fatty liver disease (NAFLD), which ranges from non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), fibrosis, and NASH-related cirrhosis. Despite the usefulness of the standard grading system, liver biopsy has several limitations. In addition, patient acceptability and intra- and inter-observer reproducibility are also concerns. Due to the prevalence of NAFLD and limitations of liver biopsies, non-invasive imaging methods such as ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) that can reliably diagnose hepatic steatosis have developed rapidly. US is widely available and radiation-free but cannot examine the entire liver. CT is readily available and helpful for detection and risk classification, significantly when analyzed using artificial intelligence; however, it exposes users to radiation. Although expensive and time-consuming, MRI can measure liver fat percentage with magnetic resonance imaging proton density fat fraction (MRI-PDFF). Specifically, chemical shift-encoded (CSE)-MRI is the best imaging indicator for early liver fat detection. The purpose of this review is to provide an overview of each imaging modality with an emphasis on the recent progress and current status of liver fat quantification.
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?
Imaging techniques are not ideal for mass screening due to significant drawbacks including high cost, lack of safety, lack of consensus, limited accessibility, and complexity.
“However, these methods are usually used for disease diagnosis and are not ideal for mass screening due to significant drawbacks, including high cost (CT and MRI scans), lack of safety (CT scans), lack of consensus (biomarker-based indices), limited accessibility (transient elastography, MRI scans), and complexity (MRI scans) [41, 42].”
From Effectiveness of body roundness index for the prediction of nonalcoholic fatty liver disease: a systematic review and meta-analysis (2025) · cites this paper as [41]
The Conclusions (page not provided) identify MRI as costly and time-consuming and CT radiation exposure as a drawback. They do not say these methods are unsuitable for mass screening or substantiate CT cost, lack of consensus for biomarker-based indices, or limited access to transient elastography and MRI. The review instead describes CT as readily available. (LLM, conf=0.86)
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
Design and validation of a histological scoring system for nonalcoholic fatty liver disease†
Kleiner, D. E., Brunt, E. M., Van Natta, M., Behling, C., Contos, M. J., Cummings, O. W., Ferrell, L. D., Liu, Y., Torbenson, M. S., Unalp‐Arida, A., et al. (2005) · Hepatology · doi:10.1002/hep.20701 · Cited by 10,791 · see citing works
Nonalcoholic Steatohepatitis: A Proposal for Grading and Staging The Histological Lesions
Brunt, E. M., Janney, C. G., Di Bisceglie, A. M., Neuschwander-Tetri, B. A., & Bacon, B. R. (1999) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.1999.01377.x · Cited by 3,907 · see citing works
The utility of radiological imaging in nonalcoholic fatty liver disease
Saadeh, S. N., Younossi, Z. M., Remer, E. M., Gramlich, T., Ong, J. P., Hurley, M. E., Mullen, K. D., Cooper, J. N., & Sheridan, M. J. (2002) · Gastroenterology · doi:10.1053/gast.2002.35354 · Cited by 2,112 · see citing works
First performance evaluation of a dual-source CT (DSCT) system
Flohr, T. G., McCollough, C. H., Bruder, H., Petersilka, M., Gruber, K., Süβ, C., Grasruck, M., Stierstorfer, K., Krauß, B., Raupach, R., et al. (2005) · European Radiology · doi:10.1007/s00330-005-2919-2 · Cited by 1,413 · see citing works
Photon-counting CT: Technical Principles and Clinical Prospects
Willemink, M. J., Persson, M., Pourmorteza, A., Pelc, N. J., & Fleischmann, D. (2018) · Radiology · doi:10.1148/radiol.2018172656 · Cited by 1,341 · see citing works
Quantitative assessment of liver fat with magnetic resonance imaging and spectroscopy
Reeder, S. B., Cruite, I., Hamilton, G., & Sirlin, C. B. (2011) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.22580 · Cited by 823 · see citing works
Non-alcoholic fatty liver disease: An expanded review
Benedict, M., & Zhang, X. (2017) · World Journal of Hepatology · doi:10.4254/wjh.v9.i16.715 · Cited by 756 · see citing works
Lipid droplets and liver disease: from basic biology to clinical implications
Gluchowski, N. L., Becuwe, M., Walther, T. C., & Farese, R. V. (2017) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2017.32 · Cited by 675 · see citing works
Flohr, T. G., Petersilka, M., Henning, A., Ulzheimer, S., Ferda, J., & Schmidt, B. T. (2020) · Physica Medica · doi:10.1016/j.ejmp.2020.10.030 · Cited by 591 · see citing works
Noninvasive, Quantitative Assessment of Liver Fat by MRI‐PDFF as an Endpoint in NASH Trials
Caussy, C., Reeder, S. B., Sirlin, C. B., & Loomba, R. S. (2018) · Hepatology · doi:10.1002/hep.29797 · Cited by 573 · see citing works
Noureddin, M., Lam, J., Peterson, M. R., Middleton, M., Hamilton, G., Le, T.-A., Bettencourt, R., Changchien, C., Brenner, D. A., Sirlin, C., et al. (2013) · Hepatology · doi:10.1002/hep.26455 · Cited by 550 · see citing works
Bohte, A. E., van Werven, J. R., Bipat, S., & Stoker, J. (2010) · European Radiology · doi:10.1007/s00330-010-1905-5 · Cited by 544 · see citing works
Pathogenesis of Nonalcoholic Steatohepatitis
Machado, M. V., & Diehl, A. M. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.02.066 · Cited by 541 · see citing works
Park, S. H., Kim, P. N., Kim, K. W., Lee, S., Yoon, S. E., Park, S. W., Ha, H. K., Lee, M.-G., Hwang, S. H., Lee, S., et al. (2006) · Radiology · doi:10.1148/radiol.2391050361 · Cited by 538 · see citing works
Comparison of CT Methods for Determining the Fat Content of the Liver
Kodama, Y., Ng, C. S., Wu, T. T., Ayers, G. D., Curley, S. A., Abdalla, E. K., Vauthey, J., & Charnsangavej, C. (2007) · American Journal of Roentgenology · doi:10.2214/ajr.06.0992 · Cited by 516 · see citing works
Proton density fat‐fraction: A standardized mr‐based biomarker of tissue fat concentration
Reeder, S. B., Hu, P., & Sirlin, C. B. (2012) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.23741 · Cited by 504 · see citing works
Use of Liver Imaging and Biopsy in Clinical Practice
Tapper, E. B., & Lok, A. S.-F. (2017) · New England Journal of Medicine · doi:10.1056/nejmra1610570 · Cited by 452 · see citing works
Younossi, Z. M., Loomba, R. S., Anstee, Q. M., Rinella, M. E., Bugianesi, E., Marchesini, G., Neuschwander‐Tetri, B. A., Serfaty, L., Negro, F., Caldwell, S. H., et al. (2017) · Hepatology · doi:10.1002/hep.29721 · Cited by 431 · see citing works
Radiologic evaluation of nonalcoholic fatty liver disease
Lee, S. S. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i23.7392 · Cited by 427 · see citing works
Compressed sensing MRI: a review of the clinical literature
Jaspan, O., Fleysher, R., & Lipton, M. L. (2015) · British Journal of Radiology · doi:10.1259/bjr.20150487 · Cited by 395 · see citing works
Meisamy, S., Hines, C. D. G., Hamilton, G., Sirlin, C. B., McKenzie, C. A., Yu, H., Brittain, J. H., & Reeder, S. B. (2011) · Radiology · doi:10.1148/radiol.10100708 · Cited by 383 · see citing works
Liver biopsy: The best, not the gold standard
Bédossa, P., & Carrat, F. (2008) · Journal of Hepatology · doi:10.1016/j.jhep.2008.10.014 · Cited by 349 · see citing works
Quantification of Liver Fat with Magnetic Resonance Imaging
Reeder, S. B., & Sirlin, C. B. (2010) · Magnetic Resonance Imaging Clinics of North America · doi:10.1016/j.mric.2010.08.013 · Cited by 343 · see citing works
Yokoo, T., Serai, S. D., Pirasteh, A., Bashir, M. R., Hamilton, G., Hernando, D., Hu, P., Hetterich, H., Kühn, J., Kukuk, G. M., et al. (2017) · Radiology · doi:10.1148/radiol.2017170550 · Cited by 338 · see citing works
Self-citationMaterial Separation Using Dual-Energy CT: Current and Emerging Applications
Patiño, M., Iamurri, A. P., Agrawal, M. D., Simeone, F. J., Gupta, R., Hahn, P. F., & Sahani, D. V. (2016) · Radiographics · doi:10.1148/rg.2016150220 · Cited by 331 · see citing works
Nonalcoholic Fatty Liver Disease Review: Diagnosis, Treatment, and Outcomes
Ahmed, A., Wong, R. J., & Harrison, S. A. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.07.029 · Cited by 330 · see citing works
Quantification of liver fat content with CT and MRI: state of the art
Starekova, J., Hernando, D., Pickhardt, P. J., & Reeder, S. B. (2021) · Radiology · doi:10.1148/radiol.2021204288 · Cited by 320 · cited 1× · see citing works
“However, most US examinations are qualitative and restricted in their performance, especially in overweight individuals at high risk of NAFLD [19].”
BackgroundPiekarski, J., Goldberg, H. I., Royal, S. A., Axel, L., & Moss, A. A. (1980) · Radiology · doi:10.1148/radiology.137.3.6934563 · Cited by 290 · see citing works
Webb, M., Yeshua, H., Zelber‐Sagi, S., Santo, E., Brazowski, E., Halpern, Z., & Oren, R. (2009) · American Journal of Roentgenology · doi:10.2214/ajr.07.4016 · Cited by 286 · see citing works
Quantification of liver iron with MRI: State of the art and remaining challenges
Hernando, D., Levin, Y. S., Sirlin, C. B., & Reeder, S. B. (2014) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.24584 · Cited by 280 · see citing works
Birnbaum, B. A., Hindman, N. M., Lee, J., & Babb, J. S. (2007) · Radiology · doi:10.1148/radiol.2421052066 · Cited by 275 · see citing works
Mikolasevic, I., Orlic, L., Franjic, N., Hauser, G., Stimac, D., & Milic, S. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i32.7236 · Cited by 273 · see citing works
Fatty Liver Disease: MR Imaging Techniques for the Detection and Quantification of Liver Steatosis
Cassidy, F. H., Yokoo, T., Aganović, L., Hanna, R. F., Bydder, M., Middleton, M. S., Hamilton, G., Chavez, A. D., Schwimmer, J. B., & Sirlin, C. B. (2009) · Radiographics · doi:10.1148/rg.291075123 · Cited by 271 · see citing works
Lin, S. C., Heba, E. R., Wolfson, T. J., Ang, B., Gamst, A. C., Han, A., Erdman, J. W., O’Brien, W. D., André, M. P., Sirlin, C. B., et al. (2014) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2014.11.027 · Cited by 253 · see citing works
Field map estimation with a region growing scheme for iterative 3‐point water‐fat decomposition
Yu, H., Reeder, S. B., Shimakawa, A. S., Brittain, J. H., & Pelc, N. J. (2005) · Magnetic Resonance in Medicine · doi:10.1002/mrm.20654 · Cited by 217 · see citing works
Effect of PRESS and STEAM sequences on magnetic resonance spectroscopic liver fat quantification
Hamilton, G., Middleton, M. S., Bydder, M., Yokoo, T., Schwimmer, J. B., Kono, Y., Patton, H. M., Lavine, J. E., & Sirlin, C. B. (2009) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.21809 · Cited by 215 · see citing works
Jayakumar, S., Middleton, M. S., Lawitz, E. J., Mantry, P. S., Caldwell, S. H., Arnold, H., Mae Diehl, A., Ghalib, R., Elkhashab, M., Abdelmalek, M. F., et al. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2018.09.024 · Cited by 208 · see citing works
Pickhardt, P. J., Park, S. H., Hahn, L., Lee, S., Bae, K. T., & Yu, E. S. (2011) · European Radiology · doi:10.1007/s00330-011-2349-2 · Cited by 194 · see citing works
Taylor, K. J., Riely, C. A., Hammers, L., Flax, S. D., Weltin, G. G., Garcia-Tsao, G., Conn, H. O., Kuc, R. E., & Barwick, K. W. (1986) · Radiology · doi:10.1148/radiology.160.1.3520657 · Cited by 192 · see citing works
The Role of Multiparametric US of the Liver for the Evaluation of Nonalcoholic Steatohepatitis
Sugimoto, K., Moriyasu, F., Oshiro, H., Takeuchi, H., Abe, M., Yoshimasu, Y., Kasai, Y., Sakamaki, K., Hara, T., & Itoi, T. (2020) · Radiology · doi:10.1148/radiol.2020192665 · Cited by 191 · see citing works
Yu, H., Shimakawa, A. S., Hines, C. D. G., McKenzie, C. A., Hamilton, G., Sirlin, C. B., Brittain, J. H., & Reeder, S. B. (2011) · Magnetic Resonance in Medicine · doi:10.1002/mrm.22840 · Cited by 190 · see citing works
Alcohol-induced steatosis in liver cells
Donohue, T. M. (2007) · World Journal of Gastroenterology · doi:10.3748/wjg.v13.i37.4974 · Cited by 188 · see citing works
Joint estimation of water/fat images and field inhomogeneity map
Hernando, D., Haldar, J. P., Sutton, B. P., Ma, J., Kellman, P., & Liang, Z. (2008) · Magnetic Resonance in Medicine · doi:10.1002/mrm.21522 · Cited by 183 · see citing works
Robust sound speed estimation for ultrasound-based hepatic steatosis assessment
Imbault, M., Faccinetto, A., Osmanski, B.-F., Tissier, A., Deffieux, T., Gennisson, J., Vilgrain, V., & Tanter, M. (2017) · Physics in Medicine and Biology · doi:10.1088/1361-6560/aa6226 · Cited by 182 · see citing works
Pirmoazen, A. M., Khurana, A., El Kaffas, A., & Kamaya, A. (2020) · Theranostics · doi:10.7150/thno.40249 · Cited by 165 · see citing works
Ferraioli, G., Kumar, V., Ozturk, A., Nam, K., de Korte, C. L., & Barr, R. G. (2022) · Radiology · doi:10.1148/radiol.210736 · Cited by 163 · see citing works
Ultrasound backscatter and attenuation in human liver with diffuse disease
Lu, Z. F., Zagzebski, J. A., & Lee, F. T. (1999) · Ultrasound in Medicine & Biology · doi:10.1016/s0301-5629(99)00055-1 · Cited by 162 · see citing works
Paige, J. S., Bernstein, G. S., Heba, E. R., Costa, E. A. C., Ferreira, M. P. F. D., Wolfson, T. J., Gamst, A. C., Valasek, M. A., Lin, G., Han, A., et al. (2017) · American Journal of Roentgenology · doi:10.2214/ajr.16.16726 · Cited by 161 · see citing works
Fujiwara, Y., Kuroda, H., Abe, T., Ishida, K., Oguri, T., Noguchi, S., Sugai, T., Kamiyama, N., & Takikawa, Y. (2018) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2018.06.017 · Cited by 160 · see citing works
Bae, J. S., Lee, D. H., Lee, J. Y., Kim, H., Yu, S. J., Lee, J., Cho, E. J., Lee, Y. B., Han, J. K., & Choi, B. I. (2019) · European Radiology · doi:10.1007/s00330-019-06272-y · Cited by 151 · see citing works
Graffy, P. M., Sandfort, V., Summers, R. M., & Pickhardt, P. J. (2019) · Radiology · doi:10.1148/radiol.2019190512 · Cited by 146 · see citing works
Pickhardt, P. J., Graffy, P. M., Reeder, S. B., Hernando, D., & Li, K. (2018) · American Journal of Roentgenology · doi:10.2214/ajr.17.19391 · Cited by 139 · see citing works
Wang, K., Mamidipalli, A., Retson, T., Bahrami, N., Hasenstab, K. A., Blansit, K., Bass, E., Delgado, T. I., Cunha, G. M., Middleton, M. S., et al. (2019) · Radiology Artificial Intelligence · doi:10.1148/ryai.2019180022 · Cited by 138 · see citing works
Addressing phase errors in fat‐water imaging using a mixed magnitude/complex fitting method
Hernando, D., Hines, C. D. G., Yu, H., & Reeder, S. B. (2011) · Magnetic Resonance in Medicine · doi:10.1002/mrm.23044 · Cited by 136 · see citing works
Tamaki, N., Munaganuru, N., Jung, J., Yonan, A. Q., Loomba, R. R., Bettencourt, R., Ajmera, V., Valasek, M. A., Behling, C., Sirlin, C. B., et al. (2022) · Gut · doi:10.1136/gutjnl-2021-324264 · Cited by 130 · see citing works
Toh, J. Z. K., Pan, X.-H., Tay, P. W. L., Ng, C. H., Yong, J. N., Xiao, J., Koh, J. H., Tan, E. Y., Tan, E. X. X., Dan, Y. Y., et al. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.09.021 · Cited by 130 · see citing works
Nonalcoholic fatty liver disease: diagnosis and management.
Wilkins, T., Tadkod, A., Hepburn, I. S., & Schade, R. R. (2013) · PubMed · Cited by 118 · see citing works
Quantification of Liver Fat in the Presence of Iron and Iodine
Fischer, M. A., Gnannt, R., Raptis, D. A., Reiner, C. S., Clavien, P., Schmidt, B. T., Leschka, S., Alkadhi, H., & Goetti, R. P. (2011) · Investigative Radiology · doi:10.1097/rli.0b013e31820e1486 · Cited by 117 · see citing works
MRI: the new reference standard in quantifying hepatic steatosis?
Raptis, D. A., Fischer, M. A., Graf, R., Nanz, D., Weber, A., Moritz, W., Tian, Y., Oberkofler, C. E., & Clavien, P. (2011) · Gut · doi:10.1136/gutjnl-2011-300155 · Cited by 116 · see citing works
Sound speed correction in ultrasound imaging
Napolitano, D., Chou, C.-H., McLaughlin, G. W., Ji, T.-L., Mo, L., DeBusschere, D., & Steins, R. (2006) · Ultrasonics · doi:10.1016/j.ultras.2006.06.061 · Cited by 115 · see citing works
Ozturk, A., Grajo, J. R., Gee, M. S., Benjamin, A., Zubajlo, R. E., Thomenius, K. E., Anthony, B., Samir, A. E., & Dhyani, M. (2018) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2018.07.019 · Cited by 114 · see citing works
Computed tomography attenuation values in fatty liver
Bydder, G. M., Chapman, R. W., Harry, D. S., Bassan, L., Sherlock, S., & Kreel, L. (1981) · Journal of Computed Tomography · doi:10.1016/0149-936x(81)90054-0 · Cited by 112 · see citing works
Performance of the Attenuation Imaging Technology in the Detection of Liver Steatosis
Ferraioli, G., Maiocchi, L., Savietto, G., Tinelli, C., Nichetti, M., Rondanelli, M., Calliada, F., Preda, L., & Fìlice, C. (2020) · Journal of Ultrasound in Medicine · doi:10.1002/jum.15512 · Cited by 110 · see citing works
Mancini, M., Prinster, A., Annuzzi, G., Liuzzi, R., Giacco, R., Medagli, C., Cremone, M., Clemente, G., Maurea, S., Riccardi, G., et al. (2009) · Metabolism · doi:10.1016/j.metabol.2009.05.032 · Cited by 108 · see citing works
Jeon, S. K., Lee, J. M., Joo, I., Yoon, J. H., Lee, D. H., Lee, J. Y., & Han, J. K. (2019) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2019.02.008 · Cited by 106 · see citing works
Tamaki, N., Koizumi, Y., Hirooka, M., Yada, N., Takada, H., Nakashima, O., Kudo, M., Hiasa, Y., & Izumi, N. (2018) · Hepatology Research · doi:10.1111/hepr.13179 · Cited by 97 · see citing works
Burgio, M. D., Ronot, M., Reizine, É., Rautou, P., Castéra, L., Paradis, V., Garteiser, P., BEERS, B. E. V., & Vilgrain, V. (2019) · European Radiology · doi:10.1007/s00330-019-06480-6 · Cited by 97 · see citing works
Imajo, K., Toyoda, H., Yasuda, S., Suzuki, Y., Sugimoto, K., Kuroda, H., Akita, T., Tanaka, J., Yasui, Y., Tamaki, N., et al. (2021) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.11.003 · Cited by 90 · see citing works
Kullberg, J., Hedström, A., Brandberg, J., Strand, R., Johansson, L., Bergström, G. M. L., & Ahlström, H. K. (2017) · Scientific Reports · doi:10.1038/s41598-017-08925-8 · Cited by 89 · see citing works
Shen, F., Zheng, R.-D., Shi, J., Mi, Y., Chen, G., Hu, X., Liu, Y., Wang, X., Pan, Q., Chen, G., et al. (2015) · Liver International · doi:10.1111/liv.12809 · Cited by 88 · see citing works
Quantification of Hepatic Steatosis With Dual-Energy Computed Tomography
Artz, N. S., Hines, C. D. G., Brunner, S. T., Agni, R. M., Kühn, J., Roldán‐Alzate, A., Chen, G., & Reeder, S. B. (2012) · Investigative Radiology · doi:10.1097/rli.0b013e318261fad0 · Cited by 86 · see citing works
Jaubert, O., Arrieta, C., da Cruz, G. J. L., Bustin, A., Schneider, T., Georgiopoulos, G. A., Masci, P. G., Sing‐Long, C., Botnar, R. M., & Prieto, C. (2020) · Magnetic Resonance in Medicine · doi:10.1002/mrm.28311 · Cited by 84 · see citing works
Roldán-Valadéz, E., Favila, R., Martı́nez-López, M., Uribe, M., Rı́os, C., & Méndez‐Sánchez, N. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2010.04.018 · Cited by 83 · see citing works
Artz, N. S., Haufe, W. M., Hooker, C. A., Hamilton, G., Wolfson, T. J., Campos, G. M., Gamst, A. C., Schwimmer, J. B., Sirlin, C. B., & Reeder, S. B. (2015) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.24842 · Cited by 82 · see citing works
Diagnostic accuracy of hepatorenal index in the detection and grading of hepatic steatosis
Chauhan, A., Sultan, L. R., Furth, E. E., Jones, L. P., Khungar, V., & Sehgal, C. M. (2016) · Journal of Clinical Ultrasound · doi:10.1002/jcu.22382 · Cited by 76 · see citing works
Quantification of liver iron content with CT—added value of dual-energy
Fischer, M. A., Reiner, C. S., Raptis, D. A., Donati, O. F., Goetti, R. P., Clavien, P., & Alkadhi, H. (2011) · European Radiology · doi:10.1007/s00330-011-2119-1 · Cited by 70 · see citing works
Jang, J. K., Lee, E. S., Seo, J. W., Kim, Y. R., Kim, S. Y., Cho, Y. Y., & Lee, D. H. (2022) · Radiology · doi:10.1148/radiol.220220 · Cited by 69 · see citing works
Caussy, C., Brissot, J., Singh, S., Bassirian, S., Hernandez, C., Bettencourt, R., Rizo, E., Richards, L., Sirlin, C. B., & Loomba, R. S. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2019.11.060 · Cited by 66 · see citing works
Tyagi, A., Yeganeh, O., Levin, Y. S., Hooker, J. C., Hamilton, G., Wolfson, T. J., Gamst, A. C., Zand, A. K., Heba, E. R., Loomba, R. S., et al. (2015) · Abdominal Imaging · doi:10.1007/s00261-015-0542-5 · Cited by 64 · see citing works
Park, J., Lee, J. M., Lee, G., Jeon, S. K., & Joo, I. (2022) · Korean Journal of Radiology · doi:10.3348/kjr.2021.0112 · Cited by 63 · see citing works
Byun, J., Lee, S. S., Sung, Y. S., Shin, Y., Yun, J., Kim, H. S., Yu, E. S., Lee, M.-G., & Lee, M.-G. (2018) · European Radiology · doi:10.1007/s00330-018-5905-1 · Cited by 47 · see citing works
Mann, L. W., Higgins, D. M., Peters, C. N., Cassidy, S., Hodson, K. K., Coombs, A., Taylor, R., & Hollingsworth, K. G. (2015) · Radiology · doi:10.1148/radiol.2015150320 · Cited by 44 · see citing works
Gómez, E. V., Vuppalanchi, R., Gawrieh, S., Samala, N. R., & Chalasani, N. (2023) · Hepatology · doi:10.1097/hep.0000000000000023 · Cited by 44 · see citing works
Kang, B.-K., Kim, M., Song, S.-Y., Jun, D. W., & Jang, K. (2017) · British Journal of Radiology · doi:10.1259/bjr.20170378 · Cited by 43 · see citing works
Ferraioli, G., Tinelli, C., Lissandrin, R., Zicchetti, M., Rondanelli, M., Perani, G., Bernuzzi, S., Salvaneschi, L., & Fìlice, C. (2014) · Hepatology International · doi:10.1007/s12072-014-9573-1 · Cited by 41 · see citing works
In vivomagnetic resonance spectroscopy of liver tumors and metastases
ter Voert, E. E. G. W. (2011) · World Journal of Gastroenterology · doi:10.3748/wjg.v17.i47.5133 · Cited by 40 · see citing works
Jung, J., Han, A., Madamba, E. V., Bettencourt, R., Loomba, R., Boehringer, A. S., André, M. P., Erdman, J. W., O’Brien, W. D., Fowler, K. J., et al. (2022) · Radiology · doi:10.1148/radiol.211131 · Cited by 40 · see citing works
Hamilton, G., Middleton, M. S., Hooker, J. C., Haufe, W. M., Forbang, N. I., Allison, M., Loomba, R. S., & Sirlin, C. B. (2015) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.24946 · Cited by 38 · see citing works
Schwartz, F. R., Ashton, J. R., Wildman‐Tobriner, B., Molvin, L. Z., Ramírez-Giraldo, J. C., Samei, E., Bashir, M. R., & Marin, D. (2023) · European Journal of Radiology · doi:10.1016/j.ejrad.2023.110734 · Cited by 36 · see citing works
Patel, B. N., Kumbla, R. A., Berland, L. L., Fineberg, N. S., & Morgan, D. E. (2013) · Journal of Computer Assisted Tomography · doi:10.1097/rct.0000000000000027 · Cited by 34 · see citing works
Ma, J., Song, Z., & Yan, F. (2014) · PLoS ONE · doi:10.1371/journal.pone.0110964 · Cited by 33 · see citing works
Jeon, S. K., Lee, J. M., & Joo, I. (2020) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2020.11.009 · Cited by 33 · see citing works
Detection of fatty liver using virtual non-contrast dual-energy CT
Zhang, P. P., Choi, H. H., & Ohliger, M. A. (2022) · Abdominal Radiology · doi:10.1007/s00261-022-03482-9 · Cited by 31 · see citing works
Hong, C. W., Wolfson, T. J., Sy, E. Z., Schlein, A. N., Hooker, J. C., Dehkordy, S. F., Hamilton, G., Reeder, S. B., Loomba, R. S., & Sirlin, C. B. (2017) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.25843 · Cited by 31 · see citing works
Niehoff, J. H., Woeltjen, M. M., Saeed, S., Michael, A. E., Boriesosdick, J., Borggrefe, J., & Kröger, J. R. (2022) · European Journal of Radiology · doi:10.1016/j.ejrad.2022.110185 · Cited by 29 · see citing works
Kumagai, H., Yokoyama, K., Katsuyama, K., Hara, S., Yamamoto, H., Yamagata, T., Taniguchi, N., Hirota, N., & Itoh, K. (2014) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2014.03.019 · Cited by 25 · see citing works
Urdzik, J., Bjerner, T., Wanders, A., Weis, J., DURAJ, F. F., Haglund, U., & Norén, A. (2011) · Journal of Hepatology · doi:10.1016/j.jhep.2011.10.006 · Cited by 21 · see citing works
Procter, A. J., Sun, J., Malcolm, P. N., & Toms, A. P. (2019) · BMC Medical Imaging · doi:10.1186/s12880-019-0311-y · Cited by 21 · see citing works
Epidemiology of Hepatic Steatosis at a Tertiary Care Center
Fraum, T. J., Ludwig, D. R., Kilian, S. J., Curtis, W. A., Pilgram, T. K., Sirlin, C. B., & Fowler, K. J. (2017) · Academic Radiology · doi:10.1016/j.acra.2017.10.002 · Cited by 13 · see citing works
Kang, H., Lee, D. H., Park, S., & Han, J. K. (2021) · European Journal of Radiology · doi:10.1016/j.ejrad.2021.109687 · Cited by 11 · see citing works
Jang, W., Song, J. S., Kim, S. H., & Yang, J. D. (2021) · Diagnostics · doi:10.3390/diagnostics11040634 · Cited by 7 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
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
High Global Prevalence of Steatotic Liver Disease and Associated Subtypes: A Meta-analysis
Ho, G. J. K., Tan, F. X. N., Sasikumar, N. A., Tham, E. K. J., Ko, D., Kim, D. H., Danpanichkul, P., Yu, Z., Xianda, C., Zhang, Z., et al. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2025.02.006 · Cited by 75 · see citing works
ENGINEERING INNOVATIONS IN HEALTHCARE: A REVIEW OF DEVELOPMENTS IN THE USA
Ayo-Farai, O., Babarinde, A. O., Maduka, C. P., & Okongwu, C. C. (2023) · Engineering Science & Technology Journal · doi:10.51594/estj.v4i6.638 · Cited by 39 · see citing works
Yuan, H., Jung, E.-S., Chae, S., Jung, S., Daily, J. W., & Park, S. (2024) · Nutrients · doi:10.3390/nu16183061 · Cited by 36 · see citing works
Santoro, S., Khalil, M., Abdallah, H., Farella, I., Noto, A., Dipalo, G. M., Villani, P., Bonfrate, L., Ciaula, A. D., & Portincasa, P. (2024) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2024.03.004 · Cited by 27 · see citing works
Khanmohammadi, S., Fallahtafti, P., Habibzadeh, A., Ezzatollahi Tanha, A., Alamdari, A. A., Fallahtafti, P., & Shafi Kuchay, M. (2025) · Lipids in Health and Disease · doi:10.1186/s12944-025-02544-3 · Cited by 19 · see citing works
“…for disease diagnosis and are not ideal for mass screening due to significant drawbacks, including high cost (CT and MRI scans), lack of safety (CT scans), lack of consensus (biomarker-based indices), limited accessibility (transient elastography, MRI scans), and complexity (MRI scans) [41, 42].”
Leca, B. M., Lagojda, L., Kite, C., Karteris, E., Kassi, E. N., Randeva, H. S., & Kyrou, I. (2024) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2024.2365791 · Cited by 19 · see citing works
Wan, Y., Wang, D., Li, H., & Xu, Y. (2023) · Journal of Radiation Research and Applied Sciences · doi:10.1016/j.jrras.2023.100658 · Cited by 15 · see citing works
Osta, E., Rios, F. S., Jaganathan, S., Thomas, C., Tsai, E., Surabhi, V. R., Prasad, S. R., & Katabathina, V. S. (2025) · Radiographics · doi:10.1148/rg.240221 · Cited by 13 · see citing works
Mosca, A., Pietrobattista, A., & Maggiore, G. (2024) · Pediatric Reports · doi:10.3390/pediatric16020025 · Cited by 13 · see citing works
Salaheldin, M., Aly, H. I. S., Lau, L. H. S., Afify, S., & El‐Kassas, M. (2023) · Diagnostics · doi:10.3390/diagnostics13162631 · Cited by 13 · see citing works
Altered hepatic metabolism in Down syndrome
Dunn, L. N., Niemeyer, B. F., Eduthan, N. P., Schade, K. A., Waugh, K. A., Brown, C., Rachubinski, A. L., Timkovich, A. E., Orlicky, D. J., Galbraith, M. D., et al. (2026) · Cell Reports · doi:10.1016/j.celrep.2025.116835 · Cited by 11 · see citing works
Serum proteome signatures associated with liver steatosis in adolescents with obesity
Giraudi, P. J., Pascut, D., Banfi, C., Ghilardi, S., Tiribelli, C., Bondesan, A., Caroli, D., Minocci, A., & Sartório, A. (2024) · Journal of Endocrinological Investigation · doi:10.1007/s40618-024-02419-x · Cited by 10 · see citing works
Liang, Z., Huang, R., & Zhang, L. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2024.1467773 · Cited by 10 · see citing works
Rocca, A., Komici, K., Brunese, M. C., Pacella, G., Avella, P., Benedetto, C. D., Caiazzo, C., Zappia, M., Brunese, L., & Vallone, G. (2024) · La radiologia medica · doi:10.1007/s11547-024-01786-y · Cited by 9 · see citing works
GLP-1 receptor agonists in the treatment of diabetic non–alcoholic steatohepatitis patients
Adeghate, E. A. (2024) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2024.2328796 · Cited by 9 · see citing works
Assessment of Hepatic Steatosis Using Ultrasound-Based Techniques: Focus on Fat Quantification
Rou, W. S. (2024) · Clinical Ultrasound · doi:10.18525/cu.2024.9.1.1 · Cited by 8 · see citing works
Relevance of lipid droplets in metabolic dysfunction-associated steatotic liver disease
Weiskirchen, R., & Lonardo, A. (2026) · Expert Opinion on Therapeutic Targets · doi:10.1080/14728222.2026.2671694 · Cited by 8 · see citing works
El‐Kassas, M., Othman, H. A., Elbadry, M., Alswat, K., & Yilmaz, Y. N. (2024) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2024.102415 · Cited by 6 · see citing works
Evaluating Pediatric NAFLD with Controlled Attenuation Parameter: A Comprehensive Narrative Review
Arteaga, Í., Chacón, C., Martínez-Escudé, A., Ruiz-Rojano, I., Diez-Fadrique, G., Carmona-Cervelló, M., & Torán‐Monserrat, P. (2025) · Diagnostics · doi:10.3390/diagnostics15030299 · Cited by 6 · see citing works
Abdelhamed, W., Amin, M. A., Waked, I. A., & El‐Kassas, M. (2025) · World Journal of Gastroenterology · doi:10.3748/wjg.v31.i45.111643 · Cited by 5 · see citing works
Borji, S., Sani, H. S., Ghorbani, S., Soltani, M., Mohammadi, V., & Elahi, R. (2024) · Journal of Ultrasound · doi:10.1007/s40477-024-00965-x · Cited by 5 · see citing works
Nguyen, L. N. B., & Vo, T. D. (2025) · Life · doi:10.3390/life15111702 · Cited by 4 · see citing works
Novel Noninvasive Paraclinical Study Method for Investigation of Liver Diseases
Győrfi, N., Gál, A. R., Fincsúr, A., Kalmar-Nagy, K., Mintál, K., Hormay, E., Miseta, A., Tornóczky, T., Nemeth, A. K., Bogner, P., et al. (2023) · Biomedicines · doi:10.3390/biomedicines11092449 · Cited by 4 · see citing works
Yi, J., Patel, K., Miller, R. J. H., Marcinkiewicz, A. M., Shanbhag, A. D., Hijazi, W., Dharmavaram, N. L., Lemley, M. H., Zhou, J., Zhang, W., et al. (2025) · medRxiv · doi:10.1101/2025.06.09.25329157 · Cited by 4 · see citing works
Boskabadi, A. R., Khodabandelu, S., Rahimi, Y., Motamedi, A., Asili, P., Ghasempour, A., Keshavarzian, A., Noori, S., & Rahmanian, M. (2025) · Current Clinical Pharmacology · doi:10.2174/0127724328371387250606060831 · Cited by 3 · see citing works
Kong, Y., Chen, H., Chen, Y., & Wang, C. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1788249 · Cited by 3 · see citing works
Stage Wise Classification and Prediction of Non-Alcoholic Fatty Liver Disease using Hybrid Approach
Prabagaran, A., Balamurugan, M., Kalavathi, S., Padmanabhan, P., & Angelin Blessy, J. (2024) · International Conference on Intelligent Data Communication Technologies and Internet of Things (IDCIoT) · doi:10.1109/idciot59759.2024.10467932 · Cited by 3 · see citing works
Hany, M., Demerdash, H. M., Abouelnasr, A. A., & Torensma, B. (2024) · Biomarker Insights · doi:10.1177/11772719241256496 · Cited by 3 · see citing works
Cannella, R., Matteini, F., Gagliano, D. S., Mazzola, M., Agnello, F., Soresi, M., Petta, S., & Bartolotta, T. V. (2025) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2025.05.020 · Cited by 3 · see citing works
Torgersen, J., Newcomb, C. W., Carbonari, D. M., Smith, S. M., Brecker, K. L., Rajapakse, C. S., Jones, B. C., Cottrell, C., Grewal, R., Price, J. C., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0327668 · Cited by 2 · see citing works
Multifocal fatty liver nodules mimicking a metastatic disease: A case report
Duong, H. Q., Kajiura, S., Truong, T. D., Ngo, M. T., Nguyen, K. X., Pham, H. K., Ta, T. B., Nguyen, D. T., & Hayashi, R. (2023) · Radiology Case Reports · doi:10.1016/j.radcr.2023.11.040 · Cited by 2 · see citing works
Chiang, H.-J., Chuang, Y., Li, C., Lin, C., Eng, H., Chen, C., Cheng, Y., & Chou, M. (2024) · Diagnostics · doi:10.3390/diagnostics14080807 · Cited by 2 · see citing works
Wang, X., Sun, J., Chang, N., Liu, M., & Zhang, S. (2025) · BMC Medical Imaging · doi:10.1186/s12880-025-01559-7 · Cited by 2 · see citing works
Wang, L., Li, W., Li, Y., Li, X., & Ju, S. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1620649 · Cited by 2 · see citing works
Haddad, R. R., Battula, N. S., Chay, T., Patel, T., Dumaru, N., Maddukuri, S., & Khan, S. (2025) · Cureus · doi:10.7759/cureus.84259 · Cited by 1 · see citing works
Zhaivoronok, M., Dynnyk, O., Deresh, N., Nosenko, T., & Kobyliak, N. M. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1698952 · Cited by 1 · see citing works
Klisic, A. N., Tomašević, R., Đjurašković, S., Mercantepe, F., & Ninić, A. (2026) · Archives of Medical Science · doi:10.5114/aoms/219846 · Cited by 1 · see citing works
Stage Wise Classification and prediction of Alzheimer disease using Hybrid Appraoch
Prabagaran, A., Dwivedi, V., Neelam, N., Rani, J., Blessy, J. A., & Padmanabhan, P. (2024) · International Conference on Intelligent Technologies (CONIT) · doi:10.1109/conit61985.2024.10627243 · Cited by 1 · see citing works
Yu, S.-M. (2024) · Journal of the Korean Physical Society · doi:10.1007/s40042-023-01004-4
Lê, H. L., Lê, L. L., Phạm, T. H., Bùi, T. H. M., Ngô, T. H., & Viên, T. N. (2024) · VietNam Military Medical Unisversity · doi:10.56535/jmpm.v49.801
Murugan, V. (2024) · IP Journal of Nutrition Metabolism and Health Science · doi:10.18231/j.ijnmhs.2024.020
Fagoonee, S., & Panella, R. (2024) · Minerva Biotechnology and Biomolecular Research · doi:10.23736/s2724-542x.24.03224-3
Stetson, A. E., Herdes, R. E., Kochis, M. A., Bizimana, C., Sy, M., Beltran, F., Nzenwa, I. C., Filho, J. C. J. P., Pratt, J. S. A., & Griggs, C. L. (2025) · Research Square · doi:10.21203/rs.3.rs-6480681/v1
Ultrasound Elastography of the Liver and Fat Quantification in Pediatric Patients
Williams-Weekes, T., Paltiel, H. J., & Lee, E. Y. (2025) · Radiologic Clinics of North America · doi:10.1016/j.rcl.2025.03.003
Milito, M. M., Mihajlovic, M., Mallia, A., Ghilardi, S., Tiribelli, C., Bonazza, D., Rosso, N., Palmisano, S., Banfi, C., & Giraudi, P. J. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262210943
Torgersen, J., Newcomb, C. W., Carbonari, D. M., Smith, S. M., Brecker, K. L., Rajapakse, C. S., Jones, B. C., Cottrell, C., Grewal, R., Price, J. C., et al. (2026) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofag023
Lee, C.-Y., Kim, S.-Y., Kim, S., & Yu, S.-M. (2026) · Applied Magnetic Resonance · doi:10.1007/s00723-026-01843-x
Qasrawi, H., Dweikat, T., Hindi, I., Shakhshir, O. I., Alem, A. S., Shakhshir, A., Salahat, I. A., & Hamaida, J. M. (2026) · Journal of Medical Case Reports · doi:10.1186/s13256-026-06159-9
Yu, H., Li, Y., Cai, W., Liu, Y., Liu, Y., Wen, H., Guo, L., Zhou, H. K., Gao, J., & Zhou, Y. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1799359
Yaylı, Ş. B., Ozlugedik, F., Pecco, N., Mitsuhashi, S., Chandrasekhara, V., & Erickson, B. J. (2026) · IEEE/CVF Winter Conference on Applications of Computer Vision Workshops (WACVW) · doi:10.1109/wacvw68408.2026.00044
Lev‐Cohain, N., Sosna, J., & Katz‐Brull, R. (2026) · NMR in Biomedicine · doi:10.1002/nbm.70367
AI-Based CT Liver Segmentation and Fatty Liver Measurement
Lee, M.-C., Lu, C.-L., Shiue, Y.-L., Su, C.-Y., Chou, C.-P., & Pan, C.-T. (2026) · IEEE International Instrumentation and Measurement Technology Conference · doi:10.1109/i2mtc66907.2026.11694569
Deng, B., Gong, Y., Wang, X., Wang, X., Chen, D., Chen, X., Xu, Q., Zhou, H., Cui, Y., & Doblaré, M. (2026) · Advanced Intelligent Systems · doi:10.1002/aisy.70589
Alkan, S., Faraşat, M., Akçura, C., Güney, S. C., Buyuker, M., Pekindil, G., Kutbay, N. Ö., & Hekimsoy, Z. (2026) · Medicina · doi:10.3390/medicina62102010
- Authors
- Jang, W., & Song, J. S.
- Affiliations
- Jeonbuk National University Hospital (KR)
- Corresponding author
- Song, Ji Soo
- Venue
- Diagnostics
- Publisher
- MDPI AG
- Published
- 2023-05-25
- Volume
- 13
- Issue
- 11
- Pages
- 1852
- ISSN
- 2075-4418 (ISSN-L)
- PMC
- PMC10252963
- OpenAlex
- W4378378984
- Cited by
- 55
- References
- 101
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 19 · 2023: 5
- FWCI
- 2.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diagnostics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Jeonbuk National University
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Keywords
- non-alcoholic fatty liver disease, hepatic steatosis, liver fat quantification, non-invasive imaging, liver ultrasound, computed tomography, magnetic resonance imaging, proton density fat fraction, chemical shift-encoded MRI, liver biopsy limitations, liver fibrosis
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
