Published online Apr 8, 2015. doi: 10.4254/wjh.v7.i4.638
Peer-review started: November 3, 2014
First decision: December 4, 2014
Revised: December 13, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: April 8, 2015
Core tip: Current data suggest that ultrasound and the fibrosis-4 score are probably the most appealing methods for detecting steatosis and for distinguishing nonalcoholic steatohepatitis from simple steatosis, respectively, because of their low cost and relatively high accuracy. However, currently available methods, both serologic and imaging, cannot obviate the need for liver biopsy for diagnosing nonalcoholic steatohepatitis due to their substantial false positive and false negative rates. Therefore, the current role of these methods is probably limited in patients who are unwilling or have contraindications for undergoing biopsy.