Noninvasive Tests in the Assessment of NASH and NAFLD Fibrosis: Now and into the Future

Leon A. Adams, Wah Kheong Chan

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)


Noninvasive serum and imaging methods offer accessible, accurate, and safe assessment of fibrosis severity in nonalcoholic fatty liver disease. In contrast, current serum and imaging methods for the prediction of nonalcoholic steatohepatitis are not sufficiently accurate for routine clinical use. Serum fibrosis markers that incorporate direct measures of fibrogenesis (for example, hyaluronic acid) or fibrinolysis are generally more accurate than biomarkers not incorporating direct measures of fibrogenesis. Elastography methods are more accurate than serum markers for fibrosis assessment and particularly for the determination of cirrhosis, but have a significant failure and/or unreliability rate in obese individuals. To overcome this, combining serum and elastography methods in a sequential manner minimizes indeterminate results and maintains accuracy. The accuracy of current noninvasive methods for monitoring fibrosis response to treatment are limited; however, new tools derived from omic methodologies offer promise for the future.

Original languageEnglish
Pages (from-to)331-338
Number of pages8
JournalSeminars in Liver Disease
Issue number4
Publication statusPublished - 1 Nov 2020


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