Potential Drawbacks of Noninvasive Diagnostic Methods for Nonalcoholic Fatty Liver Disease

References

1. 1.↵
   1. Eslam M,
   2. Sanyal AJ,
   3. George J

   . Toward more accurate nomenclature for fatty liver diseases. Gastroenterology 2019;157:590–3.

   OpenUrlPubMed
2. 2.↵
   1. Dai W,
   2. Ye L,
   3. Liu A,
   4. et al

   . Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: a meta-analysis. Medicine (Baltimore) 2017;96:e8179.

   OpenUrlPubMed
3. 3.↵
   1. Lonardo A,
   2. Nascimbeni F,
   3. Maurantonio M,
   4. Marrazzo A,
   5. Rinaldi L,
   6. Adinolfi LE

   . Nonalcoholic fatty liver disease: evolving paradigms. World J Gastroenterol 2017;23:6571–92.

   OpenUrlPubMed
4. 4.↵
   1. Angulo P,
   2. Kleiner DE,
   3. Dam-Larsen S,
   4. et al

   . Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology 2015;149:389–97.e10.

   OpenUrlCrossRefPubMed
5. 5.↵
   1. Ekstedt M,
   2. Hagström H,
   3. Nasr P,
   4. et al

   . Fibrosis stage is the strongest predictor for disease-specific mortality in MASLD after up to 33 years of follow-up. Hepatology 2015;61:1547–54.

   OpenUrlCrossRefPubMed
6. 6.↵
   1. Ye Q,
   2. Zou B,
   3. Yeo YH,
   4. et al

   . Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020;5:739–52.

   OpenUrlPubMed
7. 7.↵
   1. Kumar R,
   2. Mohan S

   . Non-alcoholic fatty liver disease in lean subjects: characteristics and implications. J Clin Transl Hepatol 2017;5:216–23.

   OpenUrlPubMed
8. 8.↵
   1. Kumar R,
   2. Rastogi A,
   3. Sharma MK,
   4. et al

   . Clinicopathological characteristics and metabolic profiles of non-alcoholic fatty liver disease in Indian patients with normal body mass index: do they differ from obese or overweight non-alcoholic fatty liver disease? Indian J Endocrinol Metab 2013;17:665–71.

   OpenUrlPubMed
9. 9.↵
   1. Sookoian S,
   2. Pirola CJ

   . Systematic review with meta-analysis: risk factors for non-alcoholic fatty liver disease suggest a shared altered metabolic and cardiovascular profile between lean and obese patients. Aliment Pharmacol Ther 2017;46:85–95.

   OpenUrlCrossRefPubMed
10. 10.↵
    1. Younes R,
    2. Bugianesi E

    . MASH in lean individuals. Semin Liver Dis 2019;39:86–95.

    OpenUrlCrossRefPubMed
11. 11.↵
    1. Hagström H,
    2. Nasr P,
    3. Ekstedt M,
    4. et al

    . Risk for development of severe liver disease in lean patients with nonalcoholic fatty liver disease: a long-term follow-up study. Hepatol Commun 2018;2:48–57.

    OpenUrlPubMed
12. 12.↵
    1. Ratziu V,
    2. Charlotte F,
    3. Heurtier A

    , LIDO Study Groupet al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 2005;128:1898–906.

    OpenUrlCrossRefPubMedWeb of Science
13. 13.↵
    1. Janiec DJ,
    2. Jacobson ER,
    3. Freeth A,
    4. Spaulding L,
    5. Blaszyk H

    . Histologic variation of grade and stage of non-alcoholic fatty liver disease in liver biopsies. Obes Surg 2005;15:497–501.

    OpenUrlCrossRefPubMed
14. 14.↵
    1. Mardini H,
    2. Record C

    . Detection assessment and monitoring of hepatic fibrosis: biochemistry or biopsy? Ann Clin Biochem 2005;42:441–7.

    OpenUrlCrossRefPubMed
15. 15.↵
    1. Festi D,
    2. Schiumerini R,
    3. Marzi L,
    4. et al

    . Review article: the diagnosis of non-alcoholic fatty liver disease – availability and accuracy of non-invasive methods. Aliment Pharmacol Ther 2013;37:392–400.

    OpenUrlCrossRefPubMed
16. 16.↵
    1. Sozio MS

    . Fibroscan for the rest of us-how to incorporate Fibroscan into management of patients with liver disease. Clin Gastroenterol Hepatol 2019;17:1714–7.

    OpenUrlPubMed
17. 17.↵
    1. Kumagai E,
    2. Korenaga K,
    3. Korenaga M,
    4. et al

    . Appropriate use of virtual touch quantification and FibroScan M and XL probes according to the skin capsular distance. J Gastroenterol 2016;51:496–505.

    OpenUrlPubMed
18. 18.↵
    1. Cassinotto C,
    2. Boursier J,
    3. de Lédinghen V,
    4. et al

    . Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology 2016;63:1817–27.

    OpenUrlCrossRefPubMed
19. 19.↵
    1. Das K,
    2. Sarkar R,
    3. Ahmed SM,
    4. et al

    . “Normal” liver stiffness measure (LSM) values are higher in both lean and obese individuals: a population-based study from a developing country. Hepatology 2012;55:584–93.

    OpenUrlCrossRefPubMedWeb of Science
20. 20.↵
    1. Petroff D,
    2. Blank V,
    3. Newsome PN,
    4. et al

    . Assessment of hepatic steatosis by controlled attenuation parameter using the M and XL probes: an individual patient data meta-analysis. Lancet Gastroenterol Hepatol 2021;6:185–98.

    OpenUrlPubMed
21. 21.↵
    1. de Lédinghen V,
    2. Wong VW,
    3. Vergniol J,
    4. et al

    . Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: comparison between M and XL probe of FibroScan®. J Hepatol 2012;56:833–9.

    OpenUrlCrossRefPubMedWeb of Science
22. 22.↵
    1. de Lédinghen V,
    2. Vergniol J,
    3. Capdepont M,
    4. et al

    . Controlled attenuation parameter (CAP) for the diagnosis of steatosis: a prospective study of 5323 examinations. J Hepatol 2014;60:1026–31.

    OpenUrlCrossRefPubMed
23. 23.↵
    1. Kumar R,
    2. Rout G,
    3. Kumar R,
    4. et al

    . Body mass index-based controlled attenuation parameter cut-offs for assessment of hepatic steatosis in non-alcoholic fatty liver disease. Indian J Gastroenterol 2020;39:32–41.

    OpenUrlPubMed
24. 24.↵
    1. Ciardullo S,
    2. Pizzi M,
    3. Pizzi P,
    4. Oltolini A,
    5. Muraca E,
    6. Perseghin G

    . Prevalence of elevated liver stiffness among potential candidates for bariatric surgery in the United States. Obes Surg 2022;32:712–9.

    OpenUrlPubMed
25. 25.↵
    1. de Lédinghen V,
    2. Hiriart JB,
    3. Vergniol J,
    4. Merrouche W,
    5. Bedossa P,
    6. Paradis V

    . Controlled attenuation parameter (CAP) with the XL probe of the Fibroscan(®): a comparative study with the M probe and liver biopsy. Dig Dis Sci 2017;62:2569–77.

    OpenUrlPubMed
26. 26.↵
    1. Chan WK,
    2. Nik Mustapha NR,
    3. Mahadeva S,
    4. Wong VW,
    5. Cheng JY,
    6. Wong GL

    . Can the same controlled attenuation parameter cut-offs be used for M and XL probes for diagnosing hepatic steatosis? J Gastroenterol Hepatol 2018;33:1787–94.

    OpenUrlPubMed
27. 27.↵
    1. Naveau S,
    2. Voican CS,
    3. Lebrun A,
    4. et al

    . Controlled attenuation parameter for diagnosing steatosis in bariatric surgery candidates with suspected nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2017;29:1022–30.

    OpenUrlPubMed
28. 28.↵
    1. Garg H,
    2. Aggarwal S,
    3. Yadav R,
    4. et al

    . Utility of transient elastography (Fibroscan) and impact of bariatric surgery on nonalcoholic fatty liver disease (MASLD) in morbidly obese patients. Surg Obes Relat Dis 2018;14:81–91.

    OpenUrlPubMed
29. 29.↵
    1. Somda S,
    2. Lebrun A,
    3. Tranchart H,
    4. et al

    . Adaptation of controlled attenuation parameter (CAP) measurement depth in morbidly obese patients addressed for bariatric surgery. PLoS One 2019;14:e0217093.

    OpenUrlPubMed
30. 30.↵
    1. Wong VW,
    2. Vergniol J,
    3. Wong GL,
    4. et al

    . Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 2010;51:454–62.

    OpenUrlCrossRefPubMedWeb of Science
31. 31.↵
    1. Agarwal L,
    2. Aggarwal S,
    3. Yadav R,
    4. et al

    . Bariatric surgery in nonalcoholic fatty liver disease (MASLD): impact assessment using paired liver biopsy and Fibroscan. Obes Surg 2021;31:617–26.

    OpenUrlPubMed
32. 32.↵
    1. Mahadeva S,
    2. Mahfudz AS,
    3. Vijayanathan A,
    4. Goh KL,
    5. Kulenthran A,
    6. Cheah PL

    . Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease. J Dig Dis 2013;14:604–10.

    OpenUrlPubMed
33. 33.↵
    1. Myers RP,
    2. Pomier-Layrargues G,
    3. Kirsch R,
    4. et al

    . Discordance in fibrosis staging between liver biopsy and transient elastography using the FibroScan XL probe. J Hepatol 2012;56:564–70.

    OpenUrlCrossRefPubMed
34. 34.↵
    1. Myers RP,
    2. Pomier-Layrargues G,
    3. Kirsch R,
    4. et al

    . Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients. Hepatology 2012;55:199–208.

    OpenUrlCrossRefPubMedWeb of Science
35. 35.↵
    1. Chan WK,
    2. Treeprasertsuk S,
    3. Goh GB,
    4. et al

    . Optimizing use of nonalcoholic fatty liver disease fibrosis score, fibrosis-4 score, and liver stiffness measurement to identify patients with advanced fibrosis. Clin Gastroenterol Hepatol 2019;17:2570–80.e37.

    OpenUrlPubMed
36. 36.↵
    1. Chan WK,
    2. Nik Mustapha NR,
    3. Mahadeva S

    . A novel 2-step approach combining the MASLD fibrosis score and liver stiffness measurement for predicting advanced fibrosis. Hepatol Int 2015;9:594–602.

    OpenUrlCrossRefPubMed
37. 37.↵
    1. Drolz A,
    2. Wehmeyer M,
    3. Diedrich T,
    4. Piecha F,
    5. Schulze Zur Wiesch J,
    6. Kluwe J

    . [Combination of MASLD Fibrosis Score and liver stiffness measurement for identification of moderate fibrosis stages (II & III) in non-alcoholic fatty liver disease (Kombination von NAFLD Fibrosis Score und transienter Elastografie zur Identifikation mittelgradiger Fibrosestadien (II/III) bei nicht-alkoholischer Fettlebererkrankung)]. Z Gastroenterol 2018;56:43–50.

    OpenUrlPubMed
38. 38.↵
    1. Anstee QM,
    2. Lawitz EJ,
    3. Alkhouri N,
    4. et al

    . Noninvasive tests accurately identify advanced fibrosis due to MASH: baseline data from the STELLAR trials. Hepatology 2019;70:1521–30.

    OpenUrlPubMed
39. 39.↵
    1. Chow JC,
    2. Wong GL,
    3. Chan AW,
    4. et al

    . Repeating measurements by transient elastography in non-alcoholic fatty liver disease patients with high liver stiffness. J Gastroenterol Hepatol 2019;34:241–8.

    OpenUrlPubMed
40. 40.↵
    1. Vuppalanchi R,
    2. Siddiqui MS,
    3. Van Natta ML

    , MASH Clinical Research Networket al. Performance characteristics of vibration-controlled transient elastography for evaluation of nonalcoholic fatty liver disease. Hepatology 2018;67:134–44.

    OpenUrlCrossRefPubMed
41. 41.↵
    1. Harrison SA,
    2. Ratziu V,
    3. Boursier J,
    4. et al

    . A blood-based biomarker panel (NIS4) for non-invasive diagnosis of non-alcoholic steatohepatitis and liver fibrosis: a prospective derivation and global validation study. Lancet Gastroenterol Hepatol 2020;5:970–85.

    OpenUrlPubMed
42. 42.↵
    1. Cichoż-Lach H,
    2. Celiński K,
    3. Prozorow-Król B,
    4. Swatek J,
    5. Słomka M,
    6. Lach T

    . The BARD score and the MASLD fibrosis score in the assessment of advanced liver fibrosis in nonalcoholic fatty liver disease. Med Sci Monit 2012;18:Cr735–40.

    OpenUrlPubMed
43. 43.↵
    1. Fujii H,
    2. Enomoto M,
    3. Fukushima W,
    4. Tamori A,
    5. Sakaguchi H,
    6. Kawada N

    . Applicability of BARD score to Japanese patients with MASLD. Gut 2009;58:1566–7; author reply 1567.

    OpenUrlFREE Full Text
44. 44.↵
    1. McPherson S,
    2. Stewart SF,
    3. Henderson E,
    4. Burt AD,
    5. Day CP

    . Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut 2010;59:1265–9.

    OpenUrlAbstract/FREE Full Text
45. 45.↵
    1. Raszeja-Wyszomirska J,
    2. Szymanik B,
    3. Ławniczak M,
    4. et al

    . Validation of the BARD scoring system in Polish patients with nonalcoholic fatty liver disease (MASLD). BMC Gastroenterol 2010;10:67.

    OpenUrlCrossRefPubMed
46. 46.↵
    1. Ruffillo G,
    2. Fassio E,
    3. Alvarez E,
    4. et al

    . Comparison of MASLD fibrosis score and BARD score in predicting fibrosis in nonalcoholic fatty liver disease. J Hepatol 2011;54:160–3.

    OpenUrlPubMed
47. 47.↵
    1. Ratziu V,
    2. Giral P,
    3. Charlotte F,
    4. et al

    . Liver fibrosis in overweight patients. Gastroenterology 2000;118:1117–23.

    OpenUrlCrossRefPubMedWeb of Science
48. 48.↵
    1. Calès P,
    2. Boursier J,
    3. Chaigneau J,
    4. et al

    . Diagnosis of different liver fibrosis characteristics by blood tests in non-alcoholic fatty liver disease. Liver Int 2010;30:1346–54.

    OpenUrlCrossRefPubMedWeb of Science
49. 49.↵
    1. Loaeza-del-Castillo A,
    2. Paz-Pineda F,
    3. Oviedo-Cárdenas E,
    4. Sánchez-Avila F,
    5. Vargas-Vorácková F

    . AST to platelet ratio index (APRI) for the noninvasive evaluation of liver fibrosis. Ann Hepatol 2008;7:350–7.

    OpenUrlPubMed
50. 50.↵
    1. Sterling RK,
    2. Lissen E,
    3. Clumeck N

    , APRICOT Clinical Investigatorset al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006;43:1317–25.

    OpenUrlCrossRefPubMedWeb of Science
51. 51.↵
    1. Shah AG,
    2. Lydecker A,
    3. Murray K,
    4. Tetri BN,
    5. Contos MJ,
    6. Sanyal AJ

    , Nash Clinical Research Network. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2009;7:1104–12.

    OpenUrlCrossRefPubMed
52. 52.↵
    1. Calès P,
    2. Lainé F,
    3. Boursier J,
    4. et al

    . Comparison of blood tests for liver fibrosis specific or not to MASLD. J Hepatol 2009;50:165–73.

    OpenUrlCrossRefPubMedWeb of Science
53. 53.↵
    1. Angulo P,
    2. Hui JM,
    3. Marchesini G,
    4. et al

    . The MASLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with MASLD. Hepatology 2007;45:846–54.

    OpenUrlCrossRefPubMedWeb of Science
54. 54.↵
    1. Qureshi K,
    2. Clements RH,
    3. Abrams GA

    . The utility of the “MASLD fibrosis score” in morbidly obese subjects with MASLD. Obes Surg 2008;18:264–70.

    OpenUrlCrossRefPubMed
55. 55.↵
    1. Sebastiani G,
    2. Alshaalan R,
    3. Wong P,
    4. et al

    . Prognostic value of non-invasive fibrosis and steatosis tools, hepatic venous pressure gradient (HVPG) and histology in nonalcoholic steatohepatitis. PLoS One 2015;10:e0128774.

    OpenUrlPubMed
56. 56.↵
    1. Parkes J,
    2. Roderick P,
    3. Harris S,
    4. et al

    . Enhanced liver fibrosis test can predict clinical outcomes in patients with chronic liver disease. Gut 2010;59:1245–51.

    OpenUrlAbstract/FREE Full Text
57. 57.↵
    1. Vali Y,
    2. Lee J,
    3. Boursier J

    , LITMUS systematic review teamet al. Enhanced liver fibrosis test for the non-invasive diagnosis of fibrosis in patients with MASLD: a systematic review and meta-analysis. J Hepatol 2020;73:252–62.

    OpenUrlPubMed
58. 58.↵
    1. Fagan KJ,
    2. Pretorius CJ,
    3. Horsfall LU,
    4. et al

    . ELF score ≥9.8 indicates advanced hepatic fibrosis and is influenced by age, steatosis and histological activity. Liver Int 2015;35:1673–81.

    OpenUrlPubMed
59. 59.↵
    1. Guéchot J

    . Non-invasive evaluation of liver fibrosis: more well-validated tests available for patient management. Liver Int 2015;35:1643–5.

    OpenUrlPubMed
60. 60.↵
    1. Poynard T,
    2. Lassailly G,
    3. Diaz E

    , FLIP consortiumet al. Performance of biomarkers FibroTest, ActiTest, SteatoTest, and NashTest in patients with severe obesity: meta analysis of individual patient data. PLoS One 2012;7:e30325.

    OpenUrlCrossRefPubMed
61. 61.↵
    1. Crossan C,
    2. Tsochatzis EA,
    3. Longworth L,
    4. et al

    . Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation. Health Technol Assess 2015;19:1–409, v-vi.

    OpenUrlCrossRefPubMed
62. 62.↵
    1. Tapper EB,
    2. Sengupta N,
    3. Hunink MG,
    4. Afdhal NH,
    5. Lai M

    . Cost-Effective evaluation of nonalcoholic fatty liver disease with MASLD fibrosis score and vibration controlled transient elastography. Am J Gastroenterol 2015;110:1298–304.

    OpenUrlCrossRefPubMed
63. 63.↵
    1. Poynard T,
    2. Peta V,
    3. Munteanu M

    , FLIP consortium, the FibroFrance-CPAM group, the FibroFrance-Obese group, and the Selonsertib groupet al. The diagnostic performance of a simplified blood test (SteatoTest-2) for the prediction of liver steatosis. Eur J Gastroenterol Hepatol 2019;31:393–402.

    OpenUrlPubMed
64. 64.↵
    1. Bedogni G,
    2. Kahn HS,
    3. Bellentani S,
    4. Tiribelli C

    . A simple index of lipid overaccumulation is a good marker of liver steatosis. BMC Gastroenterol 2010;10:98.

    OpenUrlCrossRefPubMed
65. 65.↵
    1. Marie S,
    2. Tripp DKK,
    3. Cherrington NJ

    . Strategies to diagnose nonalcoholic steatohepatitis: a novel approach to take advantage of pharmacokinetic alterations. Drug Metab Dispos 2022;50:492–9.

    OpenUrlAbstract/FREE Full Text
66. 66.↵
    1. Newsome PN,
    2. Sasso M,
    3. Deeks JJ,
    4. et al

    . FibroScan-AST (FAST) score for the non-invasive identification of patients with non-alcoholic steatohepatitis with significant activity and fibrosis: a prospective derivation and global validation study. Lancet Gastroenterol Hepatol 2020;5:362–73.

    OpenUrlPubMed
67. 67.↵
    1. Liebig S,
    2. Stoeckmann N,
    3. Geier A,
    4. et al

    . Multicenter validation study of a diagnostic algorithm to detect MASH and fibrosis in MASLD patients with low MASLD fibrosis score or liver stiffness. Clin Transl Gastroenterol 2019;10:e00066.

    OpenUrl
68. 68.↵
    1. Mózes FE,
    2. Lee JA,
    3. Selvaraj EA

    , LITMUS Investigatorset al. Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with MASLD: an individual patient data meta-analysis. Gut 2022;71:1006–19.

    OpenUrlAbstract/FREE Full Text
69. 69.↵
    1. Petta S,
    2. Wai-Sun Wong V,
    3. Bugianesi E,
    4. et al

    . Impact of obesity and alanine aminotransferase levels on the diagnostic accuracy for advanced liver fibrosis of noninvasive tools in patients with nonalcoholic fatty liver disease. Am J Gastroenterol 2019;114:916–28.

    OpenUrlPubMed
70. 70.↵
    1. Petta S,
    2. Wong VW,
    3. Cammà C,
    4. et al

    . Serial combination of non-invasive tools improves the diagnostic accuracy of severe liver fibrosis in patients with MASLD. Aliment Pharmacol Ther 2017;46:617–27.

    OpenUrlCrossRefPubMed
71. 71.↵
    1. Hagström H,
    2. Talbäck M,
    3. Andreasson A,
    4. Walldius G,
    5. Hammar N

    . Repeated FIB-4 measurements can help identify individuals at risk of severe liver disease. J Hepatol 2020;73:1023–9.

    OpenUrlPubMed
72. 72.↵
    1. Balkhed W,
    2. Åberg FO,
    3. Nasr P,
    4. Ekstedt M,
    5. Kechagias S

    . Repeated measurements of non-invasive fibrosis tests to monitor the progression of non-alcoholic fatty liver disease: a long-term follow-up study. Liver Int 2022;42:1545–56.

    OpenUrlPubMed
73. 73.↵
    1. Ciardullo S,
    2. Muraca E,
    3. Perra S,
    4. et al

    . Screening for non-alcoholic fatty liver disease in type 2 diabetes using non-invasive scores and association with diabetic complications. BMJ Open Diabetes Res Care 2020;8.
74. 74.↵
    1. Lee J,
    2. Vali Y,
    3. Boursier J,
    4. et al

    . Prognostic accuracy of FIB-4, MASLD fibrosis score and APRI for MASLD-related events: a systematic review. Liver Int 2021;41:261–70.

    OpenUrlCrossRefPubMed
75. 75.↵
    1. Lee HW,
    2. Ahn SH

    . How do genetic variants affect our interpretation of non-invasive tests for non-alcoholic fatty liver disease? J Gastroenterol Hepatol 2020;35:915–6.

    OpenUrlPubMed
76. 76.↵
    1. Castera L,
    2. Friedrich-Rust M,
    3. Loomba R

    . Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease. Gastroenterology 2019;156:1264–81.e4.

    OpenUrlCrossRefPubMed
77. 77.↵
    1. De Silva S,
    2. Li W,
    3. Kemos P,
    4. et al

    . Non-invasive markers of liver fibrosis in fatty liver disease are unreliable in people of South Asian descent. Frontline Gastroenterol 2018;9:115–21.

    OpenUrlAbstract/FREE Full Text
78. 78.↵
    1. Fu C,
    2. Wai JW,
    3. Nik Mustapha NR,
    4. et al

    . Performance of simple fibrosis scores in nonobese patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2020;18:2843–5.e2.

    OpenUrlPubMed
79. 79.↵
    1. Pitisuttithum P,
    2. Chan WK,
    3. Piyachaturawat P,
    4. et al

    . Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty liver disease: the GOASIA study. BMC Gastroenterol 2020;20:88.

    OpenUrlPubMed
80. 80.↵
    1. Boursier J,
    2. de Ledinghen V,
    3. Leroy V,
    4. et al

    . A stepwise algorithm using an at-a-glance first-line test for the non-invasive diagnosis of advanced liver fibrosis and cirrhosis. J Hepatol 2017;66:1158–65.

    OpenUrlPubMed
81. 81.↵
    1. Armstrong MJ,
    2. Schmidt-Martin D,
    3. Rowe IA,
    4. Newsome PN

    . Caution in using non-invasive scoring systems in MASLD beyond highly selected study populations. Am J Gastroenterol 2017;112:653–4.

    OpenUrlPubMed
82. 82.↵
    1. McPherson S,
    2. Hardy T,
    3. Dufour JF,
    4. et al

    . Age as a confounding factor for the accurate non-invasive diagnosis of advanced MASLD fibrosis. Am J Gastroenterol 2017;112:740–51.

    OpenUrlCrossRefPubMed
83. 83.↵
    1. Stine JG,
    2. Rinella ME

    . Age and non-invasive markers of fibrosis in patients with nonalcoholic fatty liver disease: time to adjust the clock? Am J Gastroenterol 2017;112:752–4.

    OpenUrlPubMed
84. 84.↵
    1. Bayrak M

    . Non-invasive diagnosis of nonalcoholic fatty liver disease: impact of age and other risk factors. Aging Male 2020;23:1275–82.

    OpenUrlPubMed
85. 85.↵
    1. Brandman D,
    2. Boyle M,
    3. McPherson S,
    4. et al

    . Letter: non-invasive prediction models to exclude cirrhosis in MASLD-not everyone fits the mould. Authors' reply. Aliment Pharmacol Ther 2022;56:182–3.

    OpenUrlPubMed
86. 86.↵
    1. Giri S,
    2. Agrawal D,
    3. Afzalpurkar S

    . Letter: non-invasive prediction models to exclude cirrhosis in MASLD - not everyone fits the mould. Aliment Pharmacol Ther 2022;56:180–1.

    OpenUrlPubMed
87. 87.↵
    1. Sebastiani G,
    2. Alberti A

    . Non invasive fibrosis biomarkers reduce but do not substitute the need for liver biopsy. World J Gastroenterol 2006;12:3682–94.

    OpenUrlCrossRefPubMedWeb of Science
88. 88.↵
    1. Wai JW,
    2. Fu C,
    3. Wong VW

    . Confounding factors of non-invasive tests for nonalcoholic fatty liver disease. J Gastroenterol 2020;55:731–41.

    OpenUrlPubMed
89. 89.↵
    1. Pérez-Gutiérrez OZ,
    2. Hernández-Rocha C,
    3. Candia-Balboa RA,
    4. et al

    . Validation study of systems for noninvasive diagnosis of fibrosis in nonalcoholic fatty liver disease in Latin population. Ann Hepatol 2013;12:416–24.

    OpenUrlPubMed
90. 90.↵
    1. Nalbantoglu IL,
    2. Brunt EM

    . Role of liver biopsy in nonalcoholic fatty liver disease. World J Gastroenterol 2014;20:9026–37.

    OpenUrlPubMed
91. 91.↵
    1. Brunt EM

    . Non-alcoholic fatty liver disease: what's new under the microscope? Gut 2011;60:1152–8.

    OpenUrlAbstract/FREE Full Text
92. 92.↵
    1. Patel K,
    2. Sebastiani G

    . Limitations of non-invasive tests for assessment of liver fibrosis. JHEP Rep 2020;2:100067.

    OpenUrlPubMed
93. 93.↵
    1. Brunetti E,
    2. Silini E,
    3. Pistorio A,
    4. et al

    . Coarse vs. fine needle aspiration biopsy for the assessment of diffuse liver disease from hepatitis C virus-related chronic hepatitis. J Hepatol 2004;40:501–6.

    OpenUrlCrossRefPubMed
94. 94.↵
    1. Kleiner DE,
    2. Brunt EM

    . Nonalcoholic fatty liver disease: pathologic patterns and biopsy evaluation in clinical research. Semin Liver Dis 2012;32:3–13.

    OpenUrlCrossRefPubMedWeb of Science
95. 95.↵
    1. Brunt EM

    . Nonalcoholic fatty liver disease: pros and cons of histologic systems of evaluation. Int J Mol Sci 2016;17.
96. 96.↵
    1. Kleiner DE,
    2. Brunt EM,
    3. Van Natta M

    , Nonalcoholic Steatohepatitis Clinical Research Networket al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005;41:1313–21.

    OpenUrlCrossRefPubMedWeb of Science
97. 97.↵
    1. Abdi W,
    2. Millan JC,
    3. Mezey E

    . Sampling variability on percutaneous liver biopsy. Arch Intern Med 1979;139:667–9.

    OpenUrlCrossRefPubMedWeb of Science
98. 98.↵
    1. Sookoian S,
    2. Pirola CJ

    . Systematic review with meta-analysis: the significance of histological disease severity in lean patients with nonalcoholic fatty liver disease. Aliment Pharmacol Ther 2018;47:16–25.

    OpenUrlPubMed
99. 99.↵
    1. Zeng Y,
    2. He H,
    3. An Z

    . Advance of serum biomarkers and combined diagnostic panels in nonalcoholic fatty liver disease. Dis Markers 2022;2022:1254014.

    OpenUrlPubMed
100. 100.↵
     1. Sahebkar A,
     2. Sancho E,
     3. Abelló D,
     4. Camps J,
     5. Joven J

     . Novel circulating biomarkers for non-alcoholic fatty liver disease: a systematic review. J Cell Physiol 2018;233:849–55.

     OpenUrlPubMed
101. 101.↵
     1. Gomez-Torres O,
     2. Amatya S,
     3. Kamberov L,
     4. et al

     . SLAMF1 is expressed and secreted by hepatocytes and the liver in nonalcoholic fatty liver disease. Am J Physiol Gastrointest Liver Physiol 2022;323:G177–g187.

     OpenUrlPubMed
102. 102.↵
     1. Chien Y,
     2. Tsai PH,
     3. Lai YH,
     4. et al

     . CircularRNA as novel biomarkers in liver diseases. J Chin Med Assoc 2020;83:15–7.

     OpenUrlPubMed
103. 103.↵
     1. Ahmed AE,
     2. Ibrahim WA,
     3. Nabil ZM,
     4. Mansour KA,
     5. Mansour AMF,
     6. ElGhandour AM

     . Role of thymosin beta 4 in the diagnosis of nonalcoholic fatty liver and its relation to metabolic syndrome in Egyptian patients. Egypt J Immunol 2022;29:76–86.

     OpenUrlPubMed
104. 104.↵
     1. Banasch M,
     2. Ellrichmann M,
     3. Tannapfel A,
     4. Schmidt WE,
     5. Goetze O

     . The non-invasive (13)C-methionine breath test detects hepatic mitochondrial dysfunction as a marker of disease activity in non-alcoholic steatohepatitis. Eur J Med Res 2011;16:258–64.

     OpenUrlCrossRefPubMed
105. 105.↵
     1. Brennan P,
     2. Clare K,
     3. George J,
     4. Dillon JF

     . Determining the role for uric acid in non-alcoholic steatohepatitis development and the utility of urate metabolites in diagnosis: an opinion review. World J Gastroenterol 2020;26:1683–90.

     OpenUrlPubMed
106. 106.↵
     1. Cengiz M,
     2. Yilmaz G,
     3. Ozenirler S

     . Serum biglycan as a diagnostic marker for non-alcoholic steatohepatitis and liver fibrosis. Clin Lab 2021;67.
107. 107.↵
     1. Ishiba H,
     2. Sumida Y,
     3. Seko Y

     , Japan Study Group of MASLDet al. Type IV collagen 7S is the most accurate test for identifying advanced fibrosis in MASLD with type 2 diabetes. Hepatol Commun 2021;5:559–72.

     OpenUrlPubMed
108. 108.↵
     1. Fan W,
     2. Torok NJ

     . Noninvasive fibrosis biomarkers in patients with MASH with diabetes. Hepatol Commun 2021;5:553–5.

     OpenUrlPubMed
109. 109.↵
     1. Lee DH

     . Imaging evaluation of non-alcoholic fatty liver disease: focused on quantification. Clin Mol Hepatol 2017;23:290–301.

     OpenUrlPubMed
110. 110.↵
     1. Ataseven H,
     2. Yildirim MH,
     3. Yalniz M,
     4. Bahcecioglu IH,
     5. Celebi S,
     6. Ozercan IH

     . The value of ultrasonography and computerized tomography in estimating the histopathological severity of nonalcoholic steatohepatitis. Acta Gastroenterol Belg 2005;68:221–5.

     OpenUrlPubMed
111. 111.↵
     1. Grąt K,
     2. Grąt M,
     3. Rowiński O

     . Usefulness of different imaging modalities in evaluation of patients with non-alcoholic fatty liver disease. Biomedicines 2020;8.
112. 112.↵
     1. Seneviratne N,
     2. Fang C,
     3. Sidhu PS

     . Ultrasound-based hepatic fat quantification: current status and future directions. Clin Radiol 2023;78:187–200.

     OpenUrlPubMed
113. 113.↵
     1. Poynard T,
     2. Pham T,
     3. Perazzo H

     , FIBROFRANCE-HECAMet al. Real-time shear wave versus transient elastography for predicting fibrosis: applicability, and impact of inflammation and steatosis. A non-invasive comparison. PLoS One 2016;11:e0163276.

     OpenUrlPubMed
114. 114.↵
     1. Ozturk A,
     2. Olson MC,
     3. Samir AE,
     4. Venkatesh SK

     . Liver fibrosis assessment: MR and US elastography. Abdom Radiol (NY) 2022;47:3037–50.

     OpenUrlPubMed
115. 115.↵
     1. Dioguardi Burgio M,
     2. Ronot M,
     3. Reizine E,
     4. et al

     . Quantification of hepatic steatosis with ultrasound: promising role of attenuation imaging coefficient in a biopsy-proven cohort. Eur Radiol 2020;30:2293–301.

     OpenUrlPubMed
116. 116.↵
     1. Jeon SK,
     2. Lee JM,
     3. Joo I,
     4. et al

     . Prospective evaluation of hepatic steatosis using ultrasound attenuation imaging in patients with chronic liver disease with magnetic resonance imaging proton density fat fraction as the reference standard. Ultrasound Med Biol 2019;45:1407–16.

     OpenUrlPubMed
117. 117.↵
     1. Khani V,
     2. Momeni Moghaddam A,
     3. Hatami B

     . Comparison of hepatic steatosis index as noninvasive diagnostic tool and liver ultrasound for non-alcoholic steatosis in the adult population. Gastroenterol Hepatol Bed Bench 2022;15:360–5.

     OpenUrlPubMed
118. 118.↵
     1. Lu S,
     2. Archard R,
     3. McLeod L,
     4. et al

     . Portal Venous Pulsatility Index as a predictor of fibrosis in patients with non-alcoholic fatty liver disease. Australas J Ultrasound Med 2022;25:36–41.

     OpenUrlPubMed
119. 119.↵
     1. Kim JW,
     2. Lee CH,
     3. Kim BH,
     4. et al

     . Ultrasonographic index for the diagnosis of non-alcoholic steatohepatitis in patients with non-alcoholic fatty liver disease. Quant Imaging Med Surg 2022;12:1815–29.

     OpenUrlPubMed
120. 120.↵
     1. Audière S,
     2. Labourdette A,
     3. Miette V,
     4. et al

     . Improved ultrasound attenuation measurement method for the non-invasive evaluation of hepatic steatosis using FibroScan. Ultrasound Med Biol 2021;47:3181–95.

     OpenUrlPubMed
121. 121.↵
     1. Pickhardt PJ,
     2. Park SH,
     3. Hahn L,
     4. Lee SG,
     5. Bae KT,
     6. Yu ES

     . Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis. Eur Radiol 2012;22:1075–82.

     OpenUrlCrossRefPubMed
122. 122.↵
     1. Shores NJ,
     2. Link K,
     3. Fernandez A,
     4. et al

     . Non-contrasted computed tomography for the accurate measurement of liver steatosis in obese patients. Dig Dis Sci 2011;56:2145–51.

     OpenUrlCrossRefPubMed
123. 123.↵
     1. Park HJ,
     2. Kim KW,
     3. Kwon HJ,
     4. et al

     . CT-based visual grading system for assessment of hepatic steatosis: diagnostic performance and interobserver agreement. Hepatol Int 2022;16:1075–84.

     OpenUrlPubMed
124. 124.↵
     1. Ahn Y,
     2. Yun SC,
     3. Lee SS,
     4. et al

     . Development and validation of a simple index based on non-enhanced CT and clinical factors for prediction of non-alcoholic fatty liver disease. Korean J Radiol 2020;21:413–21.

     OpenUrlPubMed
125. 125.↵
     1. Bamburowicz-Klimkowska M,
     2. Ruzycka-Ayoush M,
     3. Cieszanowski A,
     4. et al

     . New insights into MASLD based on preclinical MRI studies. Chem Phys Lipids 2022;244:105192.

     OpenUrl
126. 126.↵
     1. Garnov N,
     2. Linder N,
     3. Schaudinn A,
     4. et al

     . Comparison of T1 relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI. NMR Biomed 2014;27:1123–8.

     OpenUrlPubMed
127. 127.↵
     1. Banerjee R,
     2. Pavlides M,
     3. Tunnicliffe EM,
     4. et al

     . Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease. J Hepatol 2014;60:69–77.

     OpenUrlCrossRefPubMedWeb of Science
128. 128.↵
     1. Kim JW,
     2. Lee YS,
     3. Park YS,
     4. et al

     . Multiparametric MR index for the diagnosis of non-alcoholic steatohepatitis in patients with non-alcoholic fatty liver disease. Sci Rep 2020;10:2671.

     OpenUrlPubMed
129. 129.↵
     1. Catania R,
     2. Furlan A,
     3. Smith AD,
     4. Behari J,
     5. Tublin ME,
     6. Borhani AA

     . Diagnostic value of MRI-derived liver surface nodularity score for the non-invasive quantification of hepatic fibrosis in non-alcoholic fatty liver disease. Eur Radiol 2021;31:256–63.

     OpenUrlPubMed
130. 130.↵
     1. Cui J,
     2. Ang B,
     3. Haufe W,
     4. et al

     . Comparative diagnostic accuracy of magnetic resonance elastography vs. eight clinical prediction rules for non-invasive diagnosis of advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease: a prospective study. Aliment Pharmacol Ther 2015;41:1271–80.

     OpenUrlCrossRefPubMed
131. 131.↵
     1. Lee YS,
     2. Lee JE,
     3. Yi HS,
     4. et al

     . MRE-based MASH score for diagnosis of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease. Hepatol Int 2022;16:316–24.

     OpenUrlPubMed
132. 132.↵
     1. Alsaqal S,
     2. Hockings P,
     3. Ahlström H,
     4. et al

     . The combination of MR elastography and proton density fat fraction improves diagnosis of nonalcoholic steatohepatitis. J Magn Reson Imaging 2022;56:368–79.

     OpenUrlPubMed
133. 133.↵
     1. Jung J,
     2. Loomba RR,
     3. Imajo K,
     4. et al

     . MRE combined with FIB-4 (MEFIB) index in detection of candidates for pharmacological treatment of MASH-related fibrosis. Gut 2021;70:1946–53.

     OpenUrlAbstract/FREE Full Text
134. 134.↵
     1. Hájek M,
     2. Dezortová M,
     3. Wagnerová D,
     4. et al

     . MR spectroscopy as a tool for in vivo determination of steatosis in liver transplant recipients. Magma 2011;24:297–304.

     OpenUrlPubMed
135. 135.↵
     1. Lăpădat AM,
     2. Florescu LM,
     3. Manea NC,
     4. et al

     . MR spectroscopy of the liver - a reliable non-invasive alternative for evaluating non-alcoholic fatty liver disease. Rom J Morphol Embryol 2020;61:73–80.

     OpenUrlPubMed
136. 136.↵
     1. Hayashi T,
     2. Saitoh S,
     3. Takahashi J,
     4. et al

     . Hepatic fat quantification using the two-point Dixon method and fat color maps based on non-alcoholic fatty liver disease activity score. Hepatol Res 2017;47:455–64.

     OpenUrlPubMed
137. 137.↵
     1. Yurdaisik I,
     2. Nurili F

     . Accuracy of multi-echo dixon sequence in quantification of hepatic steatosis. Cureus 2020;12:e7103.

     OpenUrl
138. 138.↵
     1. Rodge GA,
     2. Goenka MK,
     3. Goenka U,
     4. Afzalpurkar S,
     5. Shah BB

     . Quantification of liver fat by MRI-PDFF imaging in patients with suspected non-alcoholic fatty liver disease and its correlation with metabolic syndrome, liver function test and ultrasonography. J Clin Exp Hepatol 2021;11:586–91.

     OpenUrlPubMed
139. 139.↵
     1. Stine JG,
     2. Munaganuru N,
     3. Barnard A,
     4. et al

     . Change in MRI-PDFF and histologic response in patients with nonalcoholic steatohepatitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2021;19:2274–83.e5.

     OpenUrlCrossRefPubMed
140. 140.↵
     1. Ando Y,
     2. Jou JH

     . Nonalcoholic fatty liver disease and recent guideline updates. Clin Liver Dis (Hoboken) 2021;17:23–8.

     OpenUrlPubMed