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      Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease

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          Abstract

          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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          Author and article information

          Journal
          0374630
          3841
          Gastroenterology
          Gastroenterology
          Gastroenterology
          0016-5085
          1528-0012
          1 April 2020
          18 January 2019
          April 2019
          21 September 2020
          : 156
          : 5
          : 1264-1281.e4
          Affiliations
          [1 ]Department of Hepatology, Hôpital Beaujon, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1149, University of Paris-VII, Clichy, France
          [2 ]Department of Internal Medicine 1, Division of Gastroenterology, Hepatology, Goethe University Hospital, Frankfurt, Germany
          [3 ]Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, California
          Author notes
          Reprint requests Address requests for reprints to: Laurent Castera, MD, PhD, Service d’Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, 100 boulevard du General Leclerc, 92110 Clichy, France. laurent.castera@ 123456bjn.aphp.fr .
          Article
          PMC7505052 PMC7505052 7505052 nihpa1567724
          10.1053/j.gastro.2018.12.036
          7505052
          30660725
          c717eb24-c93c-44b5-bf4e-0b5cd13ff771
          History
          Categories
          Article

          MRE,MRI-PDFF,Serum Biomarkers,ARFI,SWE,NAFLD,Steatosis,NASH,Fibrosis,Noninvasive,VCTE,CAP

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