Review
Copyright ©The Author(s) 2019.
World J Gastroenterol. Mar 21, 2019; 25(11): 1307-1326
Published online Mar 21, 2019. doi: 10.3748/wjg.v25.i11.1307
Table 3 Imaging modalities for diagnosing nonalcoholic fatty liver disease related fibrosis
TestDescriptionAccuracyAdvantagesDisadvantagesGuideline recommendation
VCTEMeasuring the velocity of a 50 mHz shear wave, which is positively related to liver stiffnessAUROC 0.83, 0.87, and 0.92 , respectively, for AF, SF, and cirrhosis with M probe[28]; AUROC 0.82, 0.86, and 0.94, respectively, for AF, SF, and cirrhosis with XL probe[117]Relatively low cost; Good reproducibility Short processing time; Can be used in ambulatory clinic settingFasting for 2 h; Device- and operator- dependency; Influenced by obesity, congestion, and inflammation; Uncertain cut-off values; Intermediate stages due to two cut-offsFibroScan can be used to identify those at low or high risk for AF[32,34]
SWEA method integrated into conventional ultrasound provides a 2-D, real-time, color map of liver elasticityAUROC 0.86, 0.89, and 0.88, respectively, for AF, SF, and cirrhosis[123]Good reproducibility; Not affected by obesity or ascitesRelatively high cost; Fasting for 2 h; Device- and operator- dependency; Quality criteria not well definedNA
ARFIA method integrated into a conventional ultrasound measures shear wave speedAUROC 0.77, 0.84, and 0.84, respectively, for AF, SF, and cirrhosis[123]Good reproducibility; Not affected by obesity or ascites ROI smaller than transient elastographyHigh cost; Fasting for 2 h; Device- and operator- dependency; Quality criteria not well defined; Intermediate stages due to two cut-offsNA
MREA noninvasive MRI based method measures liver stiffness by a modified phase-contrast methodAUROC 0.87, 0.90, and 0.91, respectively, for AF, SF, and cirrhosis[131]Good reproducibility; Not affected by obesity or ascitesHigh cost; Time consuming; Fasting for 2 h; Device- and operator- dependency; Intermediate stages due to two cut-offsMRE is clinically useful tools for identifying advanced fibrosis in patients with nonalcoholic fatty liver disease[34]