Non-invasive diagnosis of alcoholic liver disease

Figure 4 Complete non-invasive diagnostic work plan for patients with alcoholic liver disease at Salem Medical Center Heidelberg with follow up. Flow scheme allowed diagnosis of fibrosis in 95% of patients. In the remaining 5% of patients without valid LS measurements, the role of serum markers need to be settled but single hyaluronic acid looks promising. In patients with LS > 30 kPa, cirrhosis is established despite increased transaminase levels. MCV: Mean corpuscular volume; HCC: Hepatocellular carcinoma; LS: Liver stiffness; US: Ultrasonography; GGT: γ-glutamyl transpeptadase; GOT: Glutamic-oxal(o)acetic transaminase; GPT: Glutamate pyruvate transaminase; AFP: α-fetoprotein.