Noninvasive tests for liver disease, fibrosis, and cirrhosis: Is liver biopsy obsolete?

Abstract

Liver biopsy has been used to diagnose chronic liver disease and to assess the degree of hepatic inflammation and fibrosis. However, it is an invasive test with many possible complications and the potential for sampling error. Noninvasive tests are increasingly precise in identifying the cause of many cases of liver disease and even the amount of liver injury (fibrosis). This review discusses the role of noninvasive tests to diagnose liver disease and to assess hepatic fibrosis and cirrhosis.

The Role of Liver Biopsy in the Non-Invasive Methods Era and Liver Stiffness Measurement Using Transient Elastography

“…However, most of the studies showed the significant difference between no or mild fibrosis group (F0-F1) and moderate-severe liver fibrosis group (F2-F4) or between F0-F2 vs. F3-F4 group. (6,7,8,9,10) When it comes to differentiate between F1 and F2, most of the studies showed unsatisfied result. Mostly have not very high sensitivity when it is used to differentiate between F1 and F2.…”

Karaciğer Fibrozisinin İnvazif Olmayan Dolaylı Biyokimyasal Belirteçleri

“…Konjenital nedenli olanlar (metabolik hastalıklar, hemakromatozis, Wilson hastalığı, α1 antitripsin eksikliği) çok nadir olmakla birlikte daha erken yaşta ortaya çıkmakta ve süreç daha hızlı ilerlediğinden indeks ve dolaylı belirteçlerle incelenme ve takip aşamasına gelmeden genellikle biyopsi ile tanı konmaktadır 1 . Kazanılmış fibrozis ise, bir dizi patojen ve toksik faktöre, farklı seviyelerde maruz kalma neticesinde ortaya çıkmaktadır.…”

Rethinking the Role of Liver Biopsy in the Era of Personalized Medicine

“…Its indications are decreasing because new therapeutical options for chronic viral hepatitis have improved [118]. Moreover, new non-invasive tests have been developed and their use may increase in the future, especially for long term management [119] (Table 7). …”