Personalized management of cirrhosis by non-invasive tests of liver fibrosis

Abstract

Owing to the high prevalence of various chronic liver diseases, cirrhosis is one of the leading causes of morbidity and mortality worldwide. In recent years, the development of non-invasive tests of fibrosis allows accurate diagnosis of cirrhosis and reduces the need for liver biopsy. In this review, we discuss the application of these non-invasive tests beyond the diagnosis of cirrhosis. In particular, their role in the selection of patients for hepatocellular carcinoma surveillance and varices screening is highlighted.

Liver resection for cancer: New developments in prediction, prevention and management of postresectional liver failure

“…AST) reflect activity of fibrogenesis, whereas class II biomarkers (e.g. APRI) correlate with fibrosis [80]. TE is the most applied technique, but shows low accuracy in patients with obesity or ascites [81].…”

Validation of the Baveno VI and the expanded Baveno VI criteria to identify patients who could avoid screening endoscopy

“…Liver biopsy is the reference method for diagnosing cirrhosis; however, because of its invasiveness and potential complications, it is not widely used in clinical practice . In this regard, non‐invasive varix prediction is a reasonable approach to stratify patients based on their risk for varices . Currently, the most widely used and accepted criteria is the Baveno VI consensus, which recommends liver stiffness measurement (LSM) using transient elastography (TE) and platelet count to determine which patients can safely avoid screening endoscopies .…”

Non‐invasive tests for liver disease severity and the hepatocellular carcinoma risk in chronic hepatitis B patients with low‐level viremia

“…As a consequence, measurement error in the exposure variables in this study likely resulted in an underestimation of the association. Fibrosis can be assessed non‐invasively by fibroscan and has shown its potential to identify patients at risk for HCC . In our cohort, fibroscan data were lacking, so added value of fibroscan over APRI and FIB‐4 could not be assessed.…”