Liver Ultrasound Elastography in Non-Alcoholic Fatty Liver Disease: A State-of-the-Art Summary

Non-alcoholic fatty liver disease (NAFLD) is a chronic disease which is currently the most common hepatic disorder affecting up to 38% of the general population with differences according to age, country, ethnicity and sex. Both genetic and acquired risk factors such as a high-calorie diet or high intake of saturated fats have been associated with obesity, diabetes and, finally, NAFLD. A liver biopsy has always been considered essential for the diagnosis of NAFLD; however, due to several limitations such as the potential occurrence of major complications, sampling variability and the poor repeatability in clinical practice, it is considered an imperfect option for the evaluation of liver fibrosis over time. For these reasons, a non-invasive assessment by serum biomarkers and the quantification of liver stiffness is becoming the new frontier in the management of patients with NAFLD and liver fibrosis. We present a state-of-the-art summary addressing the methods for the non-invasive evaluation of liver fibrosis in NAFLD patients, particularly the ultrasound-based techniques (transient elastography, ARFI techniques and strain elastography) and their optimal cut-off values for the staging of liver fibrosis.

Automated summary

Non-alcoholic fatty liver disease (NAFLD) is a common chronic disease affecting up to 38% of the general population, with various risk factors such as genetic predisposition and high-calorie diets. Liver biopsy, the traditional method for NAFLD diagnosis, has limitations due to potential complications and sampling variability. Non-invasive assessment methods using serum biomarkers and liver stiffness quantification have emerged as a new frontier in NAFLD management. This article provides a state-of-the-art summary on ultrasound-based techniques and their optimal cut-off values for staging liver fibrosis in NAFLD patients.