KASL clinical practice guidelines: management of nonalcoholic fatty liver disease

2013 Clinical and Molecular Hepatology 19, 4 (325-348)

DIAGNOSIS
Diagnosis of and screening for NAFLD
Non-invasive testing in NASH and advanced fibrosis
Transient elastography
Several studies using transient elastography (TE, Fibroscan) to evaluate fibrosis have been performed in NAFLD patients. In a recent meta-analysis, TE showed high sensitivity and specificity in the assessment of hepatic fibrosis in NAFLD. However, in cases of obesity (body mass index [BMI] ?30 kg/m2), which commonly occurs in patients with NAFLD, the accuracy of TE decreased, and performance of the test may not be possible in some cases (5-13%). The recently introduced Controlled Attenuation Parameter (CAP) is known to relatively accurately evaluate the degree of fatty infiltration, and a large number of clinical studies are anticipated to report meaningful results
Recommendations
NAFLD fibrosis score, transient elastography, and magnetic resonance elastography could be helpful in the estimation of advanced liver fibrosis in NAFLD. (B1)

Pubmed : 24459637