Noninvasive monitoring of hepatic steatosis: controlled attenuation parameter and magnetic resonance imaging-proton density fat fraction in patients with nonalcoholic fatty liver disease

Abstract

With an increase in the worldwide prevalence of obesity, the incidence ofnon-alcoholic fatty liver disease(NAFLD) has been on the rise, such that it has been recently considered to be a major public health concern. Traditional interventions, such as lifestyle modifications, regular exercise, and healthy diet, have been significant in improving NAFLD with reduction ofliverfat. Areas covered: Althoughliverbiopsy is still the gold standard for diagnosis of NAFLD, there is a need for non-invasive, quantitative assessments ofhepatic steatosis, especially in clinical trials of anti-steatotic medications or in the follow-up ofpatientsundergoing lifestyle modifications.Liverbiopsy has various shortcomings, such as invasive nature, risk of complications and possibility of sampling error. Therefore, it is impractical to useliverbiopsy routinely inpatientswith NAFLD, clearly indicating the need for non-invasive and accurate diagnostic methods. Recently,controlledattenuationparameter(CAP) andmagnetic resonanceimaging-protondensityfatfraction(MRI-PDFF) have been employed in various studies tomonitorthe dynamic changes ofhepatic steatosisin response to treatment inpatientswith NAFLD. Expert commentary: Although further validations are required, CAP and MRI-PDFF could be used as potential diagnostic andmonitoringtools in clinical setting.