Incorporation of Noninvasive Measures of Liver Fibrosis Into Clinical Practice: Diagnosis and Prognosis

Clin Gastroenterol Hepatol. 2015 Nov;13(12):2190-204. doi: 10.1016/j.cgh.2015.07.030. Epub 2015 Jul 27.

Abstract

Noninvasive methods are increasingly used for the assessment of liver fibrosis. Two categories of markers include serum-based markers (biologic properties) or ultrasound and magnetic resonance imaging-based techniques that use the principles of elastography (physical properties) to indirectly assess liver fibrosis. Serum markers can be either direct or indirect markers of the fibrosis process. Common elastography-based studies include vibration-controlled transient elastography, point shear wave elastography, and 2-dimensional shear wave elastography and magnetic resonance elastography. A common theme among all techniques is the inability to accurately differentiate between minimal or moderate stages of fibrosis but superior performance in identifying subjects with cirrhosis or normal liver parenchyma. Noninvasive markers may also serve as prognostic tools to course the natural history of chronic liver disease as well as identify cirrhotic patients at highest risk of future decompensation. Further research is needed to identify the role of noninvasive markers in following asymptomatic individuals, especially in patients with nonalcoholic fatty liver disease.

Keywords: ARFI; BARD; Elastography; Imaging; Liver Cirrhosis; Liver Stiffness; Magnetic Resonance Imaging; NAFLD Fibrosis Score; SWE; Serum Markers; Shear Wave; TE.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Diagnostic Tests, Routine / methods*
  • Elasticity Imaging Techniques / methods
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Liver Cirrhosis / diagnosis*
  • Magnetic Resonance Imaging / methods
  • Prognosis
  • Radiography

Substances

  • Biomarkers