SpringerLink
Log in

Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: new trends and role of ultrasonography

  • Special Feature: Review Article
  • Diagnosis and assessment of nonalcoholic fatty liver disease / nonalcoholic steatohepatitis using ultrasound elastography
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Nonalcoholic fatty liver disease (NAFLD) is entering a new era in terms of diagnosis and conceptualization. The term NAFLD is considered to not reflect current knowledge. Metabolic dysfunction-associated fatty liver disease (MAFLD) has been suggested as a more appropriate overarching term by experts in this field. Regarding NAFLD progression, most patients die from non-liver-related diseases, even patients with advanced fibrosis. Liver biopsy is essential for the diagnosis of nonalcoholic steatohepatitis (NASH); it is the only procedure that reliably differentiates NAFLD from NASH. Recently, various noninvasive methods for diagnosing steatosis and fibrosis have been developed. Ultrasound attenuation measurements and proton density fat fraction with magnetic resonance imaging (MRI) have been developed as imaging tools for predicting steatosis. Fibrosis-4 index and NAFLD fibrosis score are complex scores for predicting fibrosis in patients with NAFLD. In addition, elastography based on ultrasound and MRI has been developed as an imaging tool for predicting fibrosis. There is a strong correlation between values from various real-time shear wave elastography devices and transient elastography, which is the gold standard for ultrasound-based measurements of liver stiffness. In conclusion, NAFLD is at a turning point in terms of its conceptualization, terminology, and diagnostics. It is now time to reconfirm the role of ultrasonography for the assessment of NAFLD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

HCC:

Hepatocellular carcinoma

NAFLD:

Nonalcoholic fatty liver disease

MAFLD:

Metabolic dysfunction-associated fatty liver disease

NASH:

Nonalcoholic steatohepatitis

PDFF:

Proton density fat fraction

FIB-4:

Fibrosis-4

HR:

Hazard ratio

CI:

Confidence interval

NFS:

NAFLD fibrosis score

MRI:

Magnetic resonance imaging

NAFL:

Nonalcoholic fatty liver

CAP:

Controlled attenuation parameter

AUROC:

Area under the receiver operating characteristic curve

ATI:

Attenuation imaging

UGAP:

Ultrasound-guided attenuation parameter

ATT:

Attenuation coefficient

TE:

Transient elastography

MRE:

Magnetic resonance elastography

SWE:

Shear wave elastography

References

  1. Tateishi R, Uchino K, Fujiwara N, et al. A nationwide survey on non-B, non-C hepatocellular carcinoma in Japan: 2011–2015 update. J Gastroenterol. 2019;54:367–76.

    Article  CAS  PubMed  Google Scholar 

  2. Eslam M, Newsome PN, Sarin SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease: an international expert consensus statement. J Hepatol. 2020;73:202–9.

    Article  PubMed  Google Scholar 

  3. Younossi Z, Stepanova M, Ong JP, et al. Nonalcoholic steatohepatitis is the fastest growing cause of hepatocellular carcinoma in liver transplant candidates. Clin Gastroenterol Hepatol. 2019;17:748–55.

    Article  PubMed  Google Scholar 

  4. Imajo K, Kessoku T, Honda Y, et al. Magnetic resonance imaging more accurately classifies steatosis and fibrosis in patients with nonalcoholic fatty liver disease than transient elastography. Gastroenterology. 2016;150:626–37.

    Article  PubMed  Google Scholar 

  5. Ratziu V, Bellentani S, Cortez-Pinto H, et al. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol. 2010;53:372–84.

    Article  PubMed  Google Scholar 

  6. Bellentani S, Saccoccio G, Masutti F, et al. Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med. 2000;132:112–7.

    Article  CAS  PubMed  Google Scholar 

  7. Eslam M, Sanyal JA, George J, et al. MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Gastroenterology. 2020;158:1999–2014.

    Article  CAS  PubMed  Google Scholar 

  8. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64:73–84.

    Article  PubMed  Google Scholar 

  9. Eguchi Y, Hyogo H, Ono M, et al. Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2009 to 2010 in Japan: a multicenter large retrospective study. J Gastroenterol. 2012;47:586–95.

    Article  CAS  PubMed  Google Scholar 

  10. Nishioji K, Sumida Y, Kamaguchi M, et al. Prevalence of and risk factors for non-alcoholic fatty liver disease in a non-obese Japanese population, 2011–2012. J Gastroenterol. 2015;50:95–108.

    Article  CAS  PubMed  Google Scholar 

  11. Farrell GC. Non-alcoholic steatohepatitis: what is it, and why is it important in the Asia-Pacific region? J Gastroenterol Hepatol. 2003;18:124–38.

    Article  PubMed  Google Scholar 

  12. Nayak NC, Vasdev N, Saigal S, et al. End-stage nonalcoholic fatty liver disease: evaluation of pathomorphologic features and relationship to cryptogenic cirrhosis from study of explant livers in a living donor liver transplant program. Hum Pathol. 2010;41:425–30.

    Article  PubMed  Google Scholar 

  13. Okanoue T, Umemura A, Yasui K, et al. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in Japan. J Gastroenterol Hepatol. 2011;26:153–62.

    Article  CAS  PubMed  Google Scholar 

  14. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55:2005–23.

    Article  PubMed  Google Scholar 

  15. Khan RS, Newsome PN. Non-alcoholic fatty liver disease and liver transplantation. Metabolism. 2016;65:1208–23.

    Article  CAS  PubMed  Google Scholar 

  16. Rinella ME, Sanyal AJ. Management of NAFLD: a stage-based approach. Nat Rev Gastroenterol Hepatol. 2016;13:196–205.

    Article  CAS  PubMed  Google Scholar 

  17. Sung K-C, Wild SH, Byrne CD. Development of new fatty liver, or resolution of existing fatty liver, over five years of follow-up, and risk of incident hypertension. J Hepatol. 2014;60:1040–5.

    Article  PubMed  Google Scholar 

  18. Tsuneto A, Hida A, Sera N, et al. Fatty liver incidence and predictive variables. Hypertens Res. 2010;33:638–43.

    Article  PubMed  Google Scholar 

  19. Tada T, Toyoda H, Sone Y, et al. Type 2 diabetes mellitus: a risk factor for progression of liver fibrosis in middle-aged patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol. 2019;34:2011–8.

    Article  CAS  PubMed  Google Scholar 

  20. Li J, Fan S, Li Y, et al. Incidence of obesity and its modifiable risk factors in Chinese adults aged 35–74 years: a prospective cohort study. Zhonghua Liu **ng Bing Xue Za Zhi. 2014;35:349–53.

    CAS  PubMed  Google Scholar 

  21. Matsushita Y, Takahashi Y, Mizoue T, et al. Overweight and obesity trends among Japanese adults: a 10-year follow-up of the JPHC Study. Int J Obes (Lond). 2008;32:1861–7.

    Article  CAS  Google Scholar 

  22. Chengfu Xu, Chaohui Yu, Ma H, et al. Prevalence and risk factors for the development of nonalcoholic fatty liver disease in a nonobese Chinese population: the Zhejiang Zhenhai Study. Am J Gastroenterol. 2013;108:1299–304.

    Article  Google Scholar 

  23. Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15:11–20.

    Article  PubMed  Google Scholar 

  24. Wong RJ, Aguilar M, Cheung R, et al. Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology. 2015;148:547–55.

    Article  PubMed  Google Scholar 

  25. Goldberg D, Ditah IC, Saeian K, et al. Changes in the prevalence of hepatitis C virus infection, nonalcoholic steatohepatitis, and alcoholic liver disease among patients with cirrhosis or liver failure on the waitlist for liver transplantation. Gastroenterology. 2017;152:1090–9.

    Article  PubMed  Google Scholar 

  26. Golabi P, Fukui N, de Avila L, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. J Hepatol. 2019;71:793–801.

    Article  PubMed  Google Scholar 

  27. Hossain N, Afendy A, Stepanova M, et al. Independent predictors of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7:1224–9.

    Article  CAS  PubMed  Google Scholar 

  28. Younossi ZM, Otgonsuren M, Venkatesan C, et al. In patients with non-alcoholic fatty liver disease, metabolically abnormal individuals are at a higher risk for mortality while metabolically normal individuals are not. Metabolism. 2013;62:352–60.

    Article  CAS  PubMed  Google Scholar 

  29. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388–402.

    Google Scholar 

  30. Dulai PS, Singh S, Patel J, et al. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology. 2017;65:1557–65.

    Article  CAS  PubMed  Google Scholar 

  31. Younossi ZM, Stepanova M, Rafiq N, et al. Nonalcoholic steatofibrosis independently predicts mortality in nonalcoholic fatty liver disease. Hepatol Commun. 2017;1:421–8.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Tada T, Kumada T, Toyoda H, et al. Progression of liver fibrosis is associated with non-liver-related mortality in patients with nonalcoholic fatty liver disease. Hepatol Commun. 2017;1:899–910.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Barrera F, George J. The role of diet and nutritional intervention for the management of patients with NAFLD. Clin Liver Dis. 2014;18:91–112.

    Article  PubMed  Google Scholar 

  34. Chiu S, Sievenpiper JL, de Souza RJ, et al. Effect of fructose on markers of non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of controlled feeding trials. Eur J Clin Nutr. 2014;68:416–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Gerber L, Otgonsuren M, Mishra A, et al. Non-alcoholic fatty liver disease (NAFLD) is associated with low level of physical activity: a population-based study. Aliment Pharmacol Ther. 2012;36:772–81.

    Article  CAS  PubMed  Google Scholar 

  36. Anstee QM, Targher G, Day CP. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat Rev Gastroenterol Hepatol. 2013;10:330–44.

    Article  CAS  PubMed  Google Scholar 

  37. Valenti L, Al-Serri A, Daly AK, et al. Homozygosity for the patatin-like phospholipase-3/adiponutrin I148M polymorphism influences liver fibrosis in patients with nonalcoholic fatty liver disease. Hepatology. 2010;51:1209–17.

    Article  CAS  PubMed  Google Scholar 

  38. Liu YL, Patman GL, Leathart JB, et al. Carriage of the PNPLA3 rs738409 C >G polymorphism confers an increased risk of non-alcoholic fatty liver disease associated hepatocellular carcinoma. J Hepatol. 2014;61:75–81.

    Article  CAS  PubMed  Google Scholar 

  39. Liu YL, Reeves HL, Burt AD, et al. TM6SF2 rs58542926 influences hepatic fibrosis progression in patients with non-alcoholic fatty liver disease. Nat Commun. 2014;5:4309.

    Article  CAS  PubMed  Google Scholar 

  40. Dongiovanni P, Petta S, Maglio C, et al. Transmembrane 6 superfamily member 2 gene variant disentangles nonalcoholic steatohepatitis from cardiovascular disease. Hepatology. 2015;61:506–14.

    Article  CAS  PubMed  Google Scholar 

  41. Valenti L, Alisi A, Galmozzi E, et al. I148M patatin-like phospholipase domain-containing 3 gene variant and severity of pediatric nonalcoholic fatty liver disease. Hepatology. 2010;52:1274–80.

    Article  CAS  PubMed  Google Scholar 

  42. Nobili V, Donati B, Panera N, et al. A 4-polymorphism risk score predicts steatohepatitis in children with nonalcoholic fatty liver disease. J Pediatr Gastroenterol Nutr. 2014;58:632–6.

    Article  CAS  PubMed  Google Scholar 

  43. Younossi ZM, Otgonsuren M, Henry L, et al. Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009. Hepatology. 2015;62:1723–30.

    Article  CAS  PubMed  Google Scholar 

  44. Kawamura Y, Arase Y, Ikeda K, et al. Large-scale long-term follow-up study of Japanese patients with non-alcoholic Fatty liver disease for the onset of hepatocellular carcinoma. Am J Gastroenterol. 2012;107:253–61.

    Article  CAS  PubMed  Google Scholar 

  45. Leung JC, Loong TC, Wei JL, et al. Histological severity and clinical outcomes of nonalcoholic fatty liver disease in nonobese patients. Hepatology. 2017;65:54–64.

    Article  CAS  PubMed  Google Scholar 

  46. Wong VW, Wong GL, Yeung JC, et al. Long-term clinical outcomes after fatty liver screening in patients undergoing coronary angiogram: a prospective cohort study. Hepatology. 2016;63:754–63.

    Article  PubMed  Google Scholar 

  47. Kim D, Kim WR, Kim HJ, et al. Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States. Hepatology. 2013;57:1357–65.

    Article  CAS  PubMed  Google Scholar 

  48. Hang LW, Chen CF, Wang CB, et al. The association between continuous positive airway pressure therapy and liver disease development in obstructive sleep apnea/hypopnea syndrome patients: a nationwide population-based cohort study in Taiwan. Sleep Breath. 2017;21:461–7.

    Article  PubMed  Google Scholar 

  49. Wong VW, Wong GL, Tsang SW, et al. High prevalence of colorectal neoplasm in patients with non-alcoholic steatohepatitis. Gut. 2011;60:829–36.

    Article  PubMed  Google Scholar 

  50. Adams LA, Anstee QM, Tilg H, et al. Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases. Gut. 2017;66:1138–53.

    Article  PubMed  Google Scholar 

  51. Fan JG, Zhu J, Li XJ, et al. Prevalence of and risk factors for fatty liver in a general population of Shanghai. China J Hepatol. 2005;43:508–14.

    Article  PubMed  Google Scholar 

  52. Ratziu V, Charlotte F, Heurtier A, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology. 2005;128:1898–906.

    Article  PubMed  Google Scholar 

  53. Kleiner DE, Brunt EM. Nonalcoholic fatty liver disease: pathologic patterns and biopsy evaluation in clinical research. Semin Liver Dis. 2012;32:3–13.

    Article  CAS  PubMed  Google Scholar 

  54. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313–21.

    Article  PubMed  Google Scholar 

  55. Bedossa PFLIP Pathology Consortium. Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease. Hepatology. 2014;60:565–75.

    Article  CAS  Google Scholar 

  56. Ryan CK, Johnson LA, Germin BI, et al. One hundred consecutive hepatic biopsies in the workup of living donors for right lobe liver transplantation. Liver Transpl. 2002;8:1114–22.

    Article  PubMed  Google Scholar 

  57. Dasarathy S, Dasarathy J, Khiyami A, et al. Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study. J Hepatol. 2009;51:1061–7.

    Article  PubMed  PubMed Central  Google Scholar 

  58. de Lédinghen V, Vergniol J, Capdepont M, et al. Controlled attenuation parameter (CAP) for the diagnosis of steatosis: a prospective study of 5323 examinations. J Hepatol. 2014;60:1026–31.

    Article  PubMed  Google Scholar 

  59. Kwok R, Choi KC, Wong GL, et al. Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: a prospective cohort study. Gut. 2016;65:1359–68.

    Article  CAS  PubMed  Google Scholar 

  60. Sasso M, Beaugrand M, de Ledinghen V, et al. Controlled attenuation parameter (CAP): a novel VCTE guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol. 2010;36:1825–35.

    Article  PubMed  Google Scholar 

  61. Tada T, Iijima H, Kobayashi N, et al. Usefulness of attenuation imaging with an ultrasound scanner for the evaluation of hepatic steatosis. Ultrasound Med Biol. 2019;45:2679–87.

    Article  PubMed  Google Scholar 

  62. Ferraioli G, Maiocchi L, Raciti MV, et al. Detection of liver steatosis with a novel ultrasound-based technique: a pilot study using MRI-derived proton density fat fraction as the gold standard. Clin Transl Gastroenterol. 2019;10:e00081.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Jeon SK, Lee JM, Joo I, et al. Prospective evaluation of hepatic steatosis using ultrasound attenuation imaging in patients with chronic liver disease with magnetic resonance imaging proton density fat fraction as the reference standard. Ultrasound Med Biol. 2019;45:1407–16.

    Article  PubMed  Google Scholar 

  64. Bae JS, Lee DH, Lee JY, et al. Assessment of hepatic steatosis by using attenuation imaging: a quantitative, easy-to-perform ultrasound technique. Eur Radiol. 2019;29:6499–507.

    Article  PubMed  Google Scholar 

  65. Dioguardi Burgio M, Ronot M, Reizine E, et al. Quantification of hepatic steatosis with ultrasound: promising role of attenuation imaging coefficient in a biopsy-proven cohort. Eur Radiol. 2020;30:2293–301.

    Article  PubMed  Google Scholar 

  66. Tada T, Kumada T, Toyoda H, et al. Utility of attenuation coefficient measurement using an ultrasound-guided attenuation parameter for evaluation of hepatic steatosis: comparison with MRI-determined proton density fat fraction. AJR Am J Roentgenol. 2019;212:332–41.

    Article  PubMed  Google Scholar 

  67. Fujiwara Y, Kuroda H, Abe T, et al. The B-mode image-guided ultrasound attenuation parameter accurately detects hepatic steatosis in chronic liver disease. Ultrasound Med Biol. 2018;44:2223–32.

    Article  PubMed  Google Scholar 

  68. Tamaki N, Koizumi Y, Hirooka M, et al. Novel quantitative assessment system of liver steatosis using a newly developed attenuation measurement method. Hepatol Res. 2018;48:821–8.

    Article  PubMed  Google Scholar 

  69. Dulai PS, Sirlin CB, Loomba R. MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: clinical trials to clinical practice. J Hepatol. 2016;65:1006–16.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Reeder SB, Robson PM, Yu H, et al. Quantification of hepatic steatosis with MRI: the effects of accurate fat spectral modeling. J Magn Reson Imaging. 2009;29:1332–9.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Permutt Z, Le TA, Peterson MR, et al. Correlation between liver histology and novel magnetic resonance imaging in adult patients with non-alcoholic fatty liver disease—MRI accurately quantifies hepatic steatosis in NAFLD. Aliment Pharmacol Ther. 2012;36:22–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Yokoo T, Serai SD, Pirasteh A, RSNA-QIBAPDFF Biomarker Committee. Linearity, bias, and precision of hepatic proton density fat fraction measurements by using MR imaging: a meta-analysis. Radiology. 2018;286:486–8.

    Article  PubMed  Google Scholar 

  73. Tang A, Desai A, Hamilton G, et al. Accuracy of MR imaging-estimated proton density fat fraction for classification of dichotomized histologic steatosis grades in nonalcoholic fatty liver disease. Radiology. 2015;274:416–25.

    Article  PubMed  Google Scholar 

  74. Idilman IS, Aniktar H, Idilman R, et al. Hepatic steatosis: quantification by proton density fat fraction with MR imaging versus liver biopsy. Radiology. 2013;267:767–75.

    Article  PubMed  Google Scholar 

  75. Ekstedt M, Hagstrom H, Nasr P, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61:1547–54.

    Article  CAS  PubMed  Google Scholar 

  76. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67:328–57.

    Article  PubMed  Google Scholar 

  77. Kanwal F, Kramer JR, Mapakshi S, et al. Risk of hepatocellular cancer in patients with non-alcoholic fatty liver disease. Gastroenterology. 2018;155:1828–37.

    Article  PubMed  Google Scholar 

  78. Sumida Y, Shima T, Mitsumoto Y, et al. Epidemiology, pathogenesis, and diagnostic strategyof diabetic liver disease in Japan. Int J Mol Sci. 2020;21:4337.

    Article  CAS  PubMed Central  Google Scholar 

  79. Yoneda M, Imajo K, Takahashi H, et al. Clinical strategy of diagnosing and following patients with nonalcoholic fatty liver disease based on invasive and noninvasive methods. J Gastroenterol. 2018;53:181–96.

    Article  CAS  PubMed  Google Scholar 

  80. Chan WK, Treeprasertsuk S, Goh GB, et al. Optimizing use of nonalcoholic fatty liver disease fibrosis score, fibrosis-4 score, and liver stiffness measurement to identify patients with advanced fibrosis. Clin Gastroenterol Hepatol. 2019;17:2570–80.

    Article  PubMed  Google Scholar 

  81. Sumida Y, Yoneda M, Hyogo H, et al. Validation of the FIB4 index in a Japanese nonalcoholic fatty liver disease population. BMC Gastroenterol. 2012;12:2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Shah AG, Lydecker A, Murray K, et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7:1104–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. McPherson S, Hardy T, Dufour JF, et al. Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis. Am J Gastroenterol. 2017;112:740–51.

    Article  PubMed  Google Scholar 

  84. Ishiba H, Sumida Y, Tanaka S, Japan Study Group of Non-Alcoholic Fatty Liver Disease (JSG-NAFLD). The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study. J Gastroenterol. 2018;53:1216–24.

    Article  PubMed  Google Scholar 

  85. Srivastava A, Gailer R, Tanwar S, et al. Prospective evaluation of a primary care referral pathway for patients with non-alcoholic fatty liver disease. J Hepatol. 2019;71:371–8.

    Article  PubMed  Google Scholar 

  86. Inadomi C, Takahashi H, Ogawa Y, et al. Accuracy of the enhanced liver fibrosis test, and combination of the enhanced liver fibrosis and non-invasive tests for the diagnosis of advanced liver fibrosis in patients with non-alcoholic fatty liver disease. Hepatol Res. 2020;50:682–92.

    Article  CAS  PubMed  Google Scholar 

  87. Ogawa Y, Honda Y, Kessoku T, et al. Wisteria floribunda agglutinin-positive Mac-2-binding protein and type 4 collagen 7S: useful markers for the diagnosis of significant fibrosis in patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol. 2018;33:1795–803.

    Article  CAS  PubMed  Google Scholar 

  88. Okanoue T, Ebise H, Kai T, et al. A simple scoring system using type IV collagen 7s and aspartate aminotransferase for diagnosing nonalcoholic steatohepatitis and related fibrosis. J Gastroenterol. 2018;53:129–39.

    Article  CAS  PubMed  Google Scholar 

  89. Seko Y, Sumida Y, Tanaka S, et al. Predictors of malignancies and overall mortality in Japanese patients with biopsy-proven non-alcoholic fatty liver disease. Hepatol Res. 2015;45:728–38.

    Article  CAS  PubMed  Google Scholar 

  90. Bercoff J, Tanter M, Fink M. Supersonic shear imaging: a new technique for soft tissue elasticity map**. IEEE Trans Ultrason Ferroelectr Freq Control. 2004;51:396–409.

    Article  PubMed  Google Scholar 

  91. Tada T, Kumada T, Toyoda H, et al. Utility of real-time shear wave elastography for assessing liver fibrosis in patients with chronic hepatitis C infection without cirrhosis: comparison of liver fibrosis indices. Hepatol Res. 2015;45:E122–9.

    Article  CAS  PubMed  Google Scholar 

  92. Aoki T, Iijima H, Tada T, et al. Prediction of development of hepatocellular carcinoma using a new scoring system involving virtual touch quantification in patients with chronic liver diseases. J Gastroenterol. 2017;52:104–12.

    Article  PubMed  Google Scholar 

  93. Iijima T, Tada T, Kumada T, et al. Comparison of liver stiffness assessment by transient elastography and shear wave elastography using six ultrasound devices. Hepatol Res. 2019;49:676–86.

    Article  PubMed  Google Scholar 

  94. Yin M, Glaser KJ, Talwalkar JA, et al. Hepatic MR elastography: clinical performance in a series of 1377 consecutive examinations. Radiology. 2016;278:114–24.

    Article  PubMed  Google Scholar 

  95. Serai SD, Obuchowski NA, Venkatesh SK, et al. Repeatability of MR elastography of liver: a meta-analysis. Radiology. 2017;285:92–100.

    Article  PubMed  Google Scholar 

Download references

Funding

There was no grant support or other financial support for this study.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji, Hyogo, 670-8540, Japan

    Toshifumi Tada

  2. Department of Gastroenterology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

    Toshifumi Tada, Takashi Nishimura & Hiroko Iijima

  3. Ultrasound Imaging Center, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

    Toshifumi Tada, Takashi Nishimura, Masahiro Yoshida & Hiroko Iijima

Authors
  1. Toshifumi Tada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takashi Nishimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiro Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroko Iijima
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toshifumi Tada.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tada, T., Nishimura, T., Yoshida, M. et al. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: new trends and role of ultrasonography. J Med Ultrasonics 47, 511–520 (2020). https://doi.org/10.1007/s10396-020-01058-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10396-020-01058-y

Keywords

Search

Navigation