Noninvasive tools to assess liver disease.


Journal Article (Review)

PURPOSE OF REVIEW: Improved understanding of the pathophysiology of fibrosis and recent technological advances have resulted in the development of several serum biomarkers and imaging tools as noninvasive alternatives to biopsy. This review highlights some of the recent advances and potential application of these tools in clinical practice. RECENT FINDINGS: Several newer approaches have been used to improve the semiquantitative histological assessment of fibrosis in relation to biomarker development. These include statistical considerations, smooth muscle actin morphometry, and emerging microscopy techniques to quantify fibrillar collagen. Serum marker panels, initially developed for determining disease stage in chronic hepatitis C infection, have now been adapted for use in nonalcoholic fatty liver disease. Genetic markers of disease progression have been validated, and newer proteomic technologies are increasingly being applied towards biomarker discovery. A sequential approach or the combination of serum markers and transient elastography is able to significantly reduce the need for biopsy for the diagnosis of cirrhosis. Serum markers also appear to provide useful prognostic information in end-stage liver disease. Newer imaging methods and breath tests require further validation, but appear promising adjunctive techniques for prediction of advanced stage fibrosis and providing functional assessment. SUMMARY: Current noninvasive tools have potential diagnostic and prognostic utility for end-stage liver disease. Adapting these methods into clinical practice remains a challenge.

Full Text

Duke Authors

Cited Authors

  • Patel, K

Published Date

  • May 2010

Published In

Volume / Issue

  • 26 / 3

Start / End Page

  • 227 - 233

PubMed ID

  • 20179592

Pubmed Central ID

  • 20179592

Electronic International Standard Serial Number (EISSN)

  • 1531-7056

Digital Object Identifier (DOI)

  • 10.1097/MOG.0b013e3283383c68


  • eng

Conference Location

  • United States