Abstract
Noninvasive serum and imaging methods offer accessible, accurate, and safe assessment
of fibrosis severity in nonalcoholic fatty liver disease. In contrast, current serum
and imaging methods for the prediction of nonalcoholic steatohepatitis are not sufficiently
accurate for routine clinical use. Serum fibrosis markers that incorporate direct
measures of fibrogenesis (for example, hyaluronic acid) or fibrinolysis are generally
more accurate than biomarkers not incorporating direct measures of fibrogenesis. Elastography
methods are more accurate than serum markers for fibrosis assessment and particularly
for the determination of cirrhosis, but have a significant failure and/or unreliability
rate in obese individuals. To overcome this, combining serum and elastography methods
in a sequential manner minimizes indeterminate results and maintains accuracy. The
accuracy of current noninvasive methods for monitoring fibrosis response to treatment
are limited; however, new tools derived from “omic” methodologies offer promise for
the future.
Keywords
nonalcoholic fatty liver disease - nonalcoholic steatohepatitis - elastography - serum
biomarkers
