Non-invasive assessment of liver fibrosis and steatosis

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Wai-Kay Seto

The University of Hong Kong, Hong Kong

: J Liver Disease Transplant

Abstract

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Liver biopsy has long been an imperfect gold standard for the assessment of liver fibrosis. While liver biopsy is still widely considered in the disease assessment of viral hepatitis and non-alcoholic steatohepatitis, its invasive nature means it is seldom used to assess treatment response in stable and asymptomatic patients. Non-invasive methods of liver fibrosis are gradually emerging. Serumbased markers e.g. enhanced liver fibrosis score have been shown to correlate strongly with actual histology for multiple chronic liver diseases. Another method of assessing is liver stiffness measurements via transient elastography, a non-invasive ultrasoundbased method that is easily performed with high reproducibility. Liver stiffness measurements have been well-validated in chronic hepatitis B, chronic hepatitis C and non-alcoholic fatty liver disease. In addition, liver stiffness measurements have been shown to have prognostic value on the development of cirrhotic complications, hepatocellular carcinoma and all-cause mortality. Evidence on the role of liver stiffness measurement in the clinical monitoring of treatment response is also emerging. Transient elastography also allows the measurement of controlled attenuation parameter, a quantitative marker of steatosis. Transient elastography is now recommended by multiple international guidelines as an assessment tool for chronic liver diseases. There are also other methods of liver fibrosis assessment, e.g. magnetic resonance imaging-based methods that are currently in development.

Biography

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Wai-Kay Seto completed his Medical degree in 2003 and Doctor of Medicine in 2012. He is currently a Clinical Associate Professor in Department of Medicine at University of Hong Kong. He is also a fellow in Gastroenterology and Hepatology and Consultant of Medicine at University of Hong Kong-Shenzhen Hospital, Shenzhen, China. He has published more than 100 peer-reviewed articles in high-impact peer-reviewed journals, including first-authored articles in Journal of Clinical Oncology, Gut, Hepatology, Journal of Hepatology and American Journal of Gastroenterology. He has been awarded numerous research awards by Hong Kong College of Physicians.