#Faqt score 79 manual#

Other limitations of liver biopsy include the subjective nature of pathologic assessment of hepatic steatosis, the ordinal rather than continuous scale of assessment, and the fact that histologic assessment relies on manual counting of the number of affected hepatocytes, rather than quantifying the relative volume of lipid within a sample. However, the limitations of biopsy include that biopsy is an invasive procedure with potential risks of pain, bleeding, infection, and rarely, death 11. This threshold has provided a reference standard for evaluating non-invasive quantitative methods. Hepatic steatosis is diagnosed when more than 5% of steatotic hepatocytes are microscopically seen in a liver tissue section. Non-targeted liver biopsy remains the gold standard for diagnosis and grading of hepatic steatosis, fibrosis, and inflammation 10. Other patient subgroups such as those undergoing chemotherapy or bariatric surgery are at risk of development of fatty liver and may also benefit from monitoring of hepatic fat fraction.

Moreover, NASH is associated with higher risk of cardiovascular-related death 8, 9.Įarly detection of NAFLD, continuous monitoring, and early therapeutic intervention, such as lifestyle modifications as well as treatment with pharmaceutical agents (currently in clinical trials) can improve overall patient outcomes and potentially decrease the economic burden on healthcare costs. This risk further increases with decompensated cirrhosis. Patients with NASH are at increased risk of liver-related death with an estimated rate of 2-5% every 10 years. In fact, NASH is expected to become the most common etiology for liver transplantation in the next 10-20 years 7, 8.

Though NAFL and early-stage NASH may be reversible, hepatic cirrhosis is irreversible and may progress to decompensated liver cirrhosis 6. NASH is further subclassified based on varying degrees of fibrosis which progress to frank cirrhosis. Nonalcoholic fatty liver includes early stages of hepatic steatosis with or without mild lobular inflammation, while the hallmark of NASH is coexisting hepatic inflammation. Nonalcoholic fatty liver disease ranges from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) based on histologic analysis. A recent study in 43,166 patients in Korea showed that NAFLD was strongly associated with increased risk of type 2 diabetes mellitus in euglycemic patients 5. The prevalence of NAFLD is estimated to be 30% in Western populations and up to 90% in patients with insulin resistance, obesity, dyslipidemia, hypertension, and genetic predispositions 4. It refers to a broad spectrum of disease defined by excessive and abnormal accumulation of fat in hepatic cells in the absence of clinically significant alcohol intake, viral infection, or other etiologies that can lead to hepatic steatosis 3. Nonalcoholic fatty liver disease is the most common subtype of hepatic steatosis and the most common chronic liver disease in the Western world. Nonalcoholic fatty liver disease (NAFLD) is considered to be the hepatic manifestation of metabolic syndrome and is dramatically increasing in prevalence, paralleling the global obesity epidemic 1, 2. We also briefly summarize other clinically available imaging modalities for evaluating hepatic steatosis such as MRI, CT, and serum analysis.

Here we review several different emerging quantitative ultrasound-based approaches used for detection and quantification of hepatic steatosis in patients at risk for nonalcoholic fatty liver disease. In addition, quantitative ultrasound-based imaging techniques are less operator dependent than traditional ultrasound. These newer ultrasound techniques possess many inherent advantages similar to conventional ultrasound such as universal availability, real-time capability, and relatively low cost along with quantitative rather than a qualitative assessment of liver fat. Recently, quantitative ultrasound-based imaging techniques have dramatically improved the ability of ultrasound to detect and quantify hepatic steatosis. Nonalcoholic fatty liver disease is a major global health concern with increasing prevalence, associated with obesity and metabolic syndrome.

Faqt score 79