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Fibrosis Assessment in Patients with NAFLD

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Liver Elastography

Abstract

Nonalcoholic fatty liver disease (NAFLD) is becoming, next to alcoholic liver disease, the most common cause of chronic liver disease in the industrialized countries. Due to this epidemic proportion of individuals with NAFLD worldwide, liver biopsy is impractical in all patients and noninvasive assessment for the diagnosis of liver fibrosis related to NAFLD is needed. In this review, we summarize the current state of the noninvasive assessment of liver fibrosis in NAFLD and its usefulness for the evaluation of prognosis and follow-up of patients.

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References

  1. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.

    Article  PubMed  Google Scholar 

  2. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288(14):1723–7.

    Article  PubMed  Google Scholar 

  3. Ogden CL, Carroll MD, Lawman HG, Fryar CD, Kruszon-Moran D, Kit BK, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA. 2016;315(21):2292–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Goldberg D, Ditah IC, Saeian K, Lalehzari M, Aronsohn A, Gorospe EC, et al. Changes in the prevalence of hepatitis C virus infection, nonalcoholic steatohepatitis, and alcoholic liver disease among patients with cirrhosis or liver failure on the waitlist for liver transplantation. Gastroenterology. 2017;152(5):1090–9.e1.

    Article  PubMed  Google Scholar 

  5. Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13(4):643–54.e1-9; quiz e39-40.

    Article  PubMed  Google Scholar 

  6. European Association for Study of Liver; Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH clinical practice guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63(1):237–64.

    Article  Google Scholar 

  7. Xiao G, Zhu S, Xiao X, Yan L, Yang J, Wu G. Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: a meta-analysis. Hepatology. 2017;66(5):1486–501.

    Article  PubMed  CAS  Google Scholar 

  8. Wong VW, Vergniol J, Wong GL, Foucher J, Chan AW, Chermak F, et al. Liver stiffness measurement using XL probe in patients with nonalcoholic fatty liver disease. Am J Gastroenterol. 2012;107(12):1862–71.

    Article  PubMed  Google Scholar 

  9. Wong VW, Vergniol J, Wong GL, Foucher J, Chan HL, Le Bail B, et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology. 2010;51(2):454–62.

    Article  PubMed  CAS  Google Scholar 

  10. Siddiqui MS, Yamada G, Vuppalanchi R, Van Natta M, Loomba R, Guy C, et al. Diagnostic accuracy of noninvasive fibrosis models to detect change in fibrosis stage. Clin Gastroenterol Hepatol. 2019;17(9):1877–85.e5.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chow JC, Wong GL, Chan AW, Shu SS, Chan CK, Leung JK, et al. Repeating measurements by transient elastography in non-alcoholic fatty liver disease patients with high liver stiffness. J Gastroenterol Hepatol. 2019;34(1):241–8.

    Article  PubMed  Google Scholar 

  12. Eddowes PJ, Sasso M, Allison M, Tsochatzis E, Anstee QM, Sheridan D, et al. Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease. Gastroenterology. 2019;156(6):1717–30.

    Article  PubMed  Google Scholar 

  13. Liu H, Fu J, Hong R, Liu L, Li F. Acoustic radiation force impulse elastography for the non-invasive evaluation of hepatic fibrosis in non-alcoholic fatty liver disease patients: a systematic review & meta-analysis. PLoS One. 2015;10(7):e0127782.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. Cassinotto C, Boursier J, de Ledinghen V, Lebigot J, Lapuyade B, Cales P, et al. Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology. 2016;63(6):1817–27.

    Article  PubMed  Google Scholar 

  15. Singh S, Venkatesh SK, Wang Z, Miller FH, Motosugi U, Low RN, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol. 2015;13(3):440–51.e6.

    Article  PubMed  Google Scholar 

  16. Loomba R, Cui J, Wolfson T, Haufe W, Hooker J, Szeverenyi N, et al. Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: a prospective study. Am J Gastroenterol. 2016;111(7):986–94.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Pavlides M, Banerjee R, Tunnicliffe EM, Kelly C, Collier J, Wang LM, et al. Multiparametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease severity. Liver Int. 2017;37(7):1065–73.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Imajo K, Kessoku T, Honda Y, Tomeno W, Ogawa Y, Mawatari H, et al. Magnetic resonance imaging more accurately classifies steatosis and fibrosis in patients with nonalcoholic fatty liver disease than transient elastography. Gastroenterology. 2016;150(3):626–37.e7.

    Article  PubMed  Google Scholar 

  19. Park CC, Nguyen P, Hernandez C, Bettencourt R, Ramirez K, Fortney L, et al. Magnetic resonance elastography vs transient elastography in detection of fibrosis and noninvasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease. Gastroenterology. 2017;152(3):598–607.e2.

    Article  PubMed  Google Scholar 

  20. Chen J, Yin M, Talwalkar JA, Oudry J, Glaser KJ, Smyrk TC, et al. Diagnostic performance of MR elastography and vibration-controlled transient elastography in the detection of hepatic fibrosis in patients with severe to morbid obesity. Radiology. 2017;283(2):418–28.

    Article  PubMed  Google Scholar 

  21. Cui J, Heba E, Hernandez C, Haufe W, Hooker J, Andre MP, et al. Magnetic resonance elastography is superior to acoustic radiation force impulse for the Diagnosis of fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease: a prospective study. Hepatology. 2016;63(2):453–61.

    Article  PubMed  Google Scholar 

  22. Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328–57.

    Article  PubMed  Google Scholar 

  23. Lim JK, Flamm SL, Singh S, Falck-Ytter YT, Clinical Guidelines Committee of the American Gastroenterological A. American Gastroenterological Association Institute Guideline on the role of elastography in the evaluation of liver fibrosis. Gastroenterology. 2017;152(6):1536–43.

    Article  PubMed  Google Scholar 

  24. Petta S, Vanni E, Bugianesi E, Di Marco V, Camma C, Cabibi D, et al. The combination of liver stiffness measurement and NAFLD fibrosis score improves the noninvasive diagnostic accuracy for severe liver fibrosis in patients with nonalcoholic fatty liver disease. Liver Int. 2015;35(5):1566–73.

    Article  PubMed  Google Scholar 

  25. Petta S, Wong VW, Camma C, Hiriart JB, Wong GL, Vergniol J, et al. Serial combination of non-invasive tools improves the diagnostic accuracy of severe liver fibrosis in patients with NAFLD. Aliment Pharmacol Ther. 2017;46(6):617–27.

    Article  PubMed  CAS  Google Scholar 

  26. Diehl AM, Day C. Cause, pathogenesis, and treatment of nonalcoholic steatohepatitis. N Engl J Med. 2017;377(21):2063–72.

    Article  PubMed  CAS  Google Scholar 

  27. de Franchis R. Expanding consensus in portal hypertension - report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63(3):743–52.

    Article  PubMed  Google Scholar 

  28. Petta S, Sebastiani G, Bugianesi E, Vigano M, Wong VW, Berzigotti A, et al. Non-invasive prediction of esophageal varices by stiffness and platelet in non-alcoholic fatty liver disease cirrhosis. J Hepatol. 2018;69(4):878–85.

    Article  PubMed  Google Scholar 

  29. Boursier J, Vergniol J, Guillet A, Hiriart JB, Lannes A, Le Bail B, et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol. 2016;65(3):570–8.

    Article  PubMed  Google Scholar 

  30. Hudert CA, Tzschatzsch H, Guo J, Rudolph B, Blaker H, Loddenkemper C, et al. US time-harmonic elastography: detection of liver fibrosis in adolescents with extreme obesity with nonalcoholic fatty liver disease. Radiology. 2018;288(1):99–106.

    Article  PubMed  Google Scholar 

  31. Trout AT, Sheridan RM, Serai SD, Xanthakos SA, Su W, Zhang B, et al. Diagnostic performance of MR elastography for liver fibrosis in children and young adults with a spectrum of liver diseases. Radiology. 2018;287(3):824–32.

    Article  PubMed  Google Scholar 

  32. Mouzaki M, Trout AT, Arce-Clachar AC, Bramlage K, Kuhnell P, Dillman JR, et al. Assessment of nonalcoholic fatty liver disease progression in children using magnetic resonance imaging. J Pediatr. 2018;201:86–92.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Byrne CD, Targher G. NAFLD: a multisystem disease. J Hepatol. 2015;62(1 Suppl):S47–64.

    Article  PubMed  Google Scholar 

  34. Targher G, Byrne CD, Lonardo A, Zoppini G, Barbui C. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: a meta-analysis. J Hepatol. 2016;65(3):589–600.

    Article  PubMed  Google Scholar 

  35. Mantovani A, Byrne CD, Bonora E, Targher G. Nonalcoholic fatty liver disease and risk of incident Type 2 diabetes: a meta-analysis. Diabetes Care. 2018;41(2):372–82.

    Article  PubMed  CAS  Google Scholar 

  36. Mantovani A, Zaza G, Byrne CD, Lonardo A, Zoppini G, Bonora E, et al. Nonalcoholic fatty liver disease increases risk of incident chronic kidney disease: a systematic review and meta-analysis. Metabolism. 2018;79:64–76.

    Article  PubMed  CAS  Google Scholar 

  37. Caballeria L, Pera G, Arteaga I, Rodriguez L, Aluma A, Morillas RM, et al. High prevalence of liver fibrosis among european adults with unknown liver disease: a population-based study. Clin Gastroenterol Hepatol. 2018;16(7):1138–45.e5.

    Article  PubMed  Google Scholar 

  38. Roulot D, Roudot-Thoraval F, Kouacou N, Costes JL, Elourimi G, et al. Concomitant screening for liver fibrosis and steatosis in French type 2 diabetic patients using Fibroscan. Liver Int. 2017;37(12):1897–906.

    Article  PubMed  CAS  Google Scholar 

  39. Kwok R, Choi KC, Wong GL, Zhang Y, Chan HL, Luk AO, et al. Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: a prospective cohort study. Gut. 2016;65(8):1359–68.

    Article  PubMed  CAS  Google Scholar 

  40. de Ledinghen V, Vergniol J, Gonzalez C, Foucher J, Maury E, Chemineau L, et al. Screening for liver fibrosis by using FibroScan((R)) and FibroTest in patients with diabetes. Dig Liver Dis. 2012;44(5):413–8.

    Article  PubMed  Google Scholar 

  41. Doycheva I, Cui J, Nguyen P, Costa EA, Hooker J, Hofflich H, et al. Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE. Aliment Pharmacol Ther. 2016;43(1):83–95.

    Article  PubMed  CAS  Google Scholar 

  42. Garg H, Aggarwal S, Shalimar, Yadav R, Datta Gupta S, Agarwal L, et al. Utility of transient elastography (fibroscan) and impact of bariatric surgery on nonalcoholic fatty liver disease (NAFLD) in morbidly obese patients. Surg Obes Relat Dis. 2018;14(1):81–91.

    Article  PubMed  Google Scholar 

  43. EASL. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388–402.

    Article  Google Scholar 

  44. Kwok R, Tse YK, Wong GL, Ha Y, Lee AU, Ngu MC, et al. Systematic review with meta-analysis: non-invasive assessment of non-alcoholic fatty liver disease--the role of transient elastography and plasma cytokeratin-18 fragments. Aliment Pharmacol Ther. 2014;39(3):254–69.

    Article  PubMed  CAS  Google Scholar 

  45. Wong VW, Irles M, Wong GL, Shili S, Chan AW, Merrouche W, et al. Unified interpretation of liver stiffness measurement by M and XL probes in non-alcoholic fatty liver disease. Gut. 2019;68(11):2057–64.

    Article  PubMed  CAS  Google Scholar 

  46. Friedrich-Rust M, Nierhoff J, Lupsor M, Sporea I, Fierbinteanu-Braticevici C, Strobel D, et al. Performance of acoustic radiation force impulse imaging for the staging of liver fibrosis: a pooled meta-analysis. J Viral Hepat. 2012;19(2):e212–9.

    Article  PubMed  CAS  Google Scholar 

  47. Nierhoff J, Chavez Ortiz AA, Herrmann E, Zeuzem S, Friedrich-Rust M. The efficiency of acoustic radiation force impulse imaging for the staging of liver fibrosis: a meta-analysis. Eur Radiol. 2013;23(11):3040–53.

    Article  PubMed  Google Scholar 

  48. Costa-Silva L, Ferolla SM, Lima AS, Vidigal PVT, Ferrari TCA. MR elastography is effective for the non-invasive evaluation of fibrosis and necroinflammatory activity in patients with nonalcoholic fatty liver disease. Eur J Radiol. 2018;98:82–9.

    Article  PubMed  Google Scholar 

  49. Loomba R, Wolfson T, Ang B, Hooker J, Behling C, Peterson M, et al. Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study. Hepatology. 2014;60(6):1920–8.

    Article  PubMed  CAS  Google Scholar 

  50. Patel NS, Hooker J, Gonzalez M, Bhatt A, Nguyen P, Ramirez K, et al. Weight loss decreases magnetic resonance elastography estimated liver stiffness in nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2017;15(3):463–4.

    Article  PubMed  Google Scholar 

  51. Jayakumar S, Middleton MS, Lawitz EJ, Mantry PS, Caldwell SH, Arnold H, et al. Longitudinal correlations between MRE, MRI-PDFF, and liver histology in patients with non-alcoholic steatohepatitis: Analysis of data from a phase II trial of selonsertib. J Hepatol. 2019;70(1):133–41.

    Article  PubMed  Google Scholar 

  52. Nogami A, Yoneda M, Kobayashi T, Kessoku T, Honda Y, Ogawa Y, et al. Assessment of 10-year changes in liver stiffness using vibration-controlled transient elastography in non-alcoholic fatty liver disease. Hepatol Res. 2019;49(8):872–80.

    Article  PubMed  Google Scholar 

  53. Shili S, Wong GL-H, Jean-Baptiste H, Liu L, Chermak F, Shu S, et al. SAT-288-Liver stiffness measurement predicts long-term survival and complications in non-alcoholic fatty liver disease. J Hepatol. 2019;70(1):e763.e4.

    Article  Google Scholar 

  54. Jiang W, Huang S, Teng H, Wang P, Wu M, Zhou X, et al. Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. BMJ Open. 2018;8(8):e021787.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Lee MS, Bae JM, Joo SK, Woo H, Lee DH, Jung YJ, et al. Prospective comparison among transient elastography, supersonic shear imaging, and ARFI imaging for predicting fibrosis in nonalcoholic fatty liver disease. PLoS One. 2017;12(11):e0188321.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  56. Petta S, Wong VW, Camma C, Hiriart JB, Wong GL, Marra F, et al. Improved noninvasive prediction of liver fibrosis by liver stiffness measurement in patients with nonalcoholic fatty liver disease accounting for controlled attenuation parameter values. Hepatology. 2017;65(4):1145–55.

    Article  PubMed  CAS  Google Scholar 

  57. Loong TC, Wei JL, Leung JC, Wong GL, Shu SS, Chim AM, et al. Application of the combined FibroMeter vibration-controlled transient elastography algorithm in Chinese patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol. 2017;32(7):1363–9.

    Article  PubMed  CAS  Google Scholar 

  58. Tapper EB, Challies T, Nasser I, Afdhal NH, Lai M. The performance of vibration controlled transient elastography in a US cohort of patients with nonalcoholic fatty liver disease. Am J Gastroenterol. 2016;111(5):677–84.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  59. Petta S, Di Marco V, Camma C, Butera G, Cabibi D, Craxi A. Reliability of liver stiffness measurement in non-alcoholic fatty liver disease: the effects of body mass index. Aliment Pharmacol Ther. 2011;33(12):1350–60.

    Article  PubMed  CAS  Google Scholar 

  60. Palmeri ML, Wang MH, Rouze NC, Abdelmalek MF, Guy CD, Moser B, et al. Noninvasive evaluation of hepatic fibrosis using acoustic radiation force-based shear stiffness in patients with nonalcoholic fatty liver disease. J Hepatol. 2011;55(3):666–72.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Takeuchi H, Sugimoto K, Oshiro H, Iwatsuka K, Kono S, Yoshimasu Y, et al. Liver fibrosis: noninvasive assessment using supersonic shear imaging and FIB4 index in patients with non-alcoholic fatty liver disease. J Med Ultrason. 2018;45(2):243–9.

    Article  Google Scholar 

  62. Herrmann E, de Ledinghen V, Cassinotto C, Chu WC, Leung VY, Ferraioli G, et al. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: an individual patient data-based meta-analysis. Hepatology. 2018;67(1):260–72.

    Article  PubMed  CAS  Google Scholar 

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de Ledinghen, V. (2020). Fibrosis Assessment in Patients with NAFLD. In: Mueller, S. (eds) Liver Elastography. Springer, Cham. https://doi.org/10.1007/978-3-030-40542-7_10

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  • DOI: https://doi.org/10.1007/978-3-030-40542-7_10

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