Noninvasive assessment of liver fibrosis

Hepatology. 2011 Jan;53(1):325-35. doi: 10.1002/hep.24013. Epub 2010 Nov 29.


Liver biopsy has long been an important tool for assessing the degree of liver fibrosis. Information on the presence and degree of liver fibrosis is useful before making therapeutic decisions or predicting disease outcomes. The need to stage liver fibrosis, however, should decrease as treatment options become more successful (as has occurred with viral hepatitis). In recent years, noninvasive tests have demonstrated a reasonable ability to identify significant fibrosis, cirrhosis in particular, nor is it surprising that liver disease specialists and patients favor a noninvasive approach. However, only those tests with the highest diagnostic accuracy, cost-effectiveness, and availability should be implemented. Apart from their diagnostic accuracy, the potential ability of these tests to predict disease outcomes (a more relevant endpoint) should be compared with that of liver biopsy. Indeed, the use of a standardized system to evaluate the utility of biomarkers would facilitate their implementation in clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / blood
  • Biopsy
  • Disease Progression
  • Elasticity Imaging Techniques
  • Fatty Liver / diagnosis
  • Hepatitis B, Chronic / diagnosis
  • Hepatitis C, Chronic / diagnosis
  • Humans
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / pathology*
  • Liver Diseases, Alcoholic / diagnosis
  • Non-alcoholic Fatty Liver Disease
  • Proteomics
  • Severity of Illness Index
  • Tomography, X-Ray Computed


  • Biomarkers