Imaging-Based Assessment of Steatosis, Inflammation and Fibrosis in NAFLD

Abstract

Purpose of Review: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the Western world. Invasive liver biopsy remains the gold standard method for the diagnosis and staging of NAFLD. The aim of this review is to summarize recent research regarding imaging-based assessment of NAFLD. Recent Findings: Novel methods such as controlled attenuation parameter (CAP) and magnetic resonance imaging proton-derived fat fraction (MRI-PDFF) appear promising for steatosis assessment and are currently undergoing validation in NAFLD. Fibrosis can be non-invasively assessed by transient elastography (TE), which is currently the best validated test in NAFLD. MR elastography (MRE) appears very sensitive for fibrosis detection. No imaging technique can accurately detect NASH. Summary: TE is inexpensive and relatively widely available and can reliably exclude advanced fibrosis in NAFLD. MRI offers the most promise for steatosis and fibrosis quantification, but further validation of these techniques is needed.