Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2018; 10(2): 231-245
Published online Feb 27, 2018. doi: 10.4254/wjh.v10.i2.231
Digital liver biopsy: Bio-imaging of fatty liver for translational and clinical research
Marcello Mancini, Paul Summers, Francesco Faita, Maurizia R Brunetto, Francesco Callea, Andrea De Nicola, Nicole Di Lascio, Fabio Farinati, Amalia Gastaldelli, Bruno Gridelli, Peppino Mirabelli, Emanuele Neri, Piero A Salvadori, Eleni Rebelos, Claudio Tiribelli, Luca Valenti, Marco Salvatore, Ferruccio Bonino
Marcello Mancini, Ferruccio Bonino, Institute of Biostructure and Bioimaging, National Research Council, Naples 80145, Italy
Paul Summers, European Institute of Oncology (IEO) IRCCS, Milan 20141, Italy
Francesco Faita, Nicole Di Lascio, Piero A Salvadori, Institute of Clinical Physiology (IFC), National Research Council (CNR), Pisa 56124, Italy
Maurizia R Brunetto, Eleni Rebelos, Hepatology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa 56125, Italy
Francesco Callea, Department of Pathology, Children Hospital Bambino Gesù IRCCS, Rome 00165, Italy
Andrea De Nicola, ASL 2 Abruzzo, Policlinico SS Annunziata, Chieti 66100, Italy
Fabio Farinati, Department of Gastroenterology, Oncology and Surgical Sciences, University of Padua, Padua 35121, Italy
Amalia Gastaldelli, Cardio-metabolic Risk Laboratory, Institute of Clinical Physiology (IFC), National Research Council (CNR), Pisa 56124, Italy
Bruno Gridelli, Ferruccio Bonino, Institute for Health, University of Pittsburgh Medical Center (UPMC), Chianciano Terme 53042, Italy
Peppino Mirabelli, Marco Salvatore, IRCCS SDN SpA, Naples 80143, Italy
Emanuele Neri, Diagnostic Radiology 3, Department of Translational Research, University of Pisa and “Ospedale S. Chiara” AOUP, Pisa 56126, Italy
Claudio Tiribelli, Ferruccio Bonino, Fondazione Italiana Fegato (FIF), Area Science Park, Campus Basovizza, Trieste 34012, Italy
Luca Valenti, Department of Pathophysiology and Transplantation, Università degli Studi di Milano and Department of Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca’ Granda Ospedale Policlinico, Milan 20122, Italy
Author contributions: All authors contributed equally to this paper through conception and design, literature review, drafting, critical revision and editing, and approval of the final version.
Supported by the Italian Ministry of Health Project, No. RF-2010-2314264. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Ferruccio Bonino, MD, Full Professor, Senior Scientist, Institute for Health, University of Pittsburgh Medical Center (UPMC), Lungarno Bruno Buozzi 13, Chianciano Terme 53042, Italy.
Telephone: +39-33-7221762 Fax: +39-5-0995457
Received: December 26, 2017
Peer-review started: December 27, 2017
First decision: January 15, 2018
Revised: January 27, 2018
Accepted: February 25, 2018
Article in press: February 25, 2018
Published online: February 27, 2018

The rapidly growing field of functional, molecular and structural bio-imaging is providing an extraordinary new opportunity to overcome the limits of invasive liver biopsy and introduce a “digital biopsy” for in vivo study of liver pathophysiology. To foster the application of bio-imaging in clinical and translational research, there is a need to standardize the methods of both acquisition and the storage of the bio-images of the liver. It can be hoped that the combination of digital, liquid and histologic liver biopsies will provide an innovative synergistic tri-dimensional approach to identifying new aetiologies, diagnostic and prognostic biomarkers and therapeutic targets for the optimization of personalized therapy of liver diseases and liver cancer. A group of experts of different disciplines (Special Interest Group for Personalized Hepatology of the Italian Association for the Study of the Liver, Institute for Biostructures and Bio-imaging of the National Research Council and Bio-banking and Biomolecular Resources Research Infrastructure) discussed criteria, methods and guidelines for facilitating the requisite application of data collection. This manuscript provides a multi-Author review of the issue with special focus on fatty liver.

Keywords: Biobank, Bio-imaging, Fatty liver, Genomics, Liver biopsy, Liver cancer, Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis, Magnetic resonance, Radiomics, Ultrasound

Core tip: The manuscript provides an extended expert review on the issue of bio-imaging of the liver with special focus on fatty liver and the need for a new integrated approach to bio-banking.