Non-invasive diagnosis of non-alcoholic fatty liver disease

A study published ahead of print in the Alimentary Pharmacology & Therapeutics investigates the availability and accuracy of non-invasive methods in the diagnosis of NAFLD.

Non-alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of clinical conditions, actually representing an emerging disease of great clinical interest.

Currently, its diagnosis requires liver biopsy, an invasive procedure not free from potential complications.

Several non-invasive diagnostic strategies have been proposed as potential diagnostic alternatives, each with different sensitivities and accuracies.

Dr Festi and colleagues from Italy reviewed non-invasive diagnostic parameters and tools for non-alcoholic fatty liver disease diagnosis, and formulated a diagnostic and prognostic algorithm for a better classification of patients.

The research team searched MEDLINE, EMBASE, Web of Science and Scopus for articles and abstracts in English.

The search terms used the terms 'non-alcoholic fatty liver disease' , 'non invasive method' and 'non-alcoholic fatty liver disease ', 'transient elastography' and 'liver fibrosis'.

The team of doctors selected the articles based on their relevancy to the objective of the review.

Ultrasonography still represents the first-line diagnostic tool for simple liver steatosis

Alimentary Pharmacology & Therapeutics

Ultrasonography still represents the first-line diagnostic tool for simple liver steatosis.

Its sensitivity could be enhanced by the complex biochemical score SteatoTest.

The researchers found that the serum cytokeratin-18 is a promising and accurate non-invasive parameter for the diagnosis of non-alcoholic steatohepatitis.

The staging of liver fibrosis still represents the most important prognostic problem.

The most accurate estimating methods are FibroMeter, FIB-4, Non-alcoholic fatty liver disease  fibrosis score and transient elastography.

Dr Festi's team concluded, "Different non-invasive parameters are available for the accurate diagnosis and prognostic stratification of non-alcoholic fatty liver disease which, if employed in a sequential algorithm, may lead to a reduced use of invasive methods, i.e. liver biopsy."