Noninvasive assessment of liver fibrosis†

Hepatology
Volume 53, Issue 1, pages 325–335, January 2011
Stella M. Martínez, Gonzalo Crespo, Miquel Navasa, Xavier Forns,‡

Article first published online: 29 NOV 2010
DOI: 10.1002/hep.24013
Copyright © 2010 American Association for the Study of Liver Diseases

Author Information
Liver Unit, Hospital Clínic, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer) and CIBERehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas), Barcelona, Spain

Email: Xavier Forns (xforns@clinic.ub.es)
*Correspondence: Xavier Forns, Liver Unit,Villarroel 170, Hospital Clinic, Barcelona 08036, Spain
†Potential conflict of interest: Nothing to report.
‡fax: (34)-93-451-55-22

Abstract

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. (HEPATOLOGY 2011.)

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