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Noninvasive Markers to Assess Liver Fibrosis

Czul, Frank MD; Bhamidimarri, Kalyan R. MD

Journal of Clinical Gastroenterology: July 2016 - Volume 50 - Issue 6 - p 445–457
doi: 10.1097/MCG.0000000000000534
Clinical Review

Chronic liver disease represents a major public health problem, accounting for significant morbidity and mortality worldwide. Their prognosis and management greatly depends on the amount and progression of liver fibrosis with time and the risk of development of cirrhosis. Historically, liver biopsy was considered to be the gold standard for the detection of fibrosis. Nevertheless, liver biopsy is an invasive procedure that has limitations in terms of patient acceptance, risk-benefit ratio, cost-effectiveness, and its availability in various geographic regions. Moreover, it is a questionable gold standard due to significant sampling error and intraobserver and interobserver variability. These limitations have led to the development of noninvasive techniques for assessing the presence and the degree of liver fibrosis. This review aims to revise the most recent data from the literature about noninvasive methods useful in the evaluation of liver fibrosis.

University of Miami Miller School of Medicine, Miami, FL

The authors declare that they have nothing to disclose.

Reprints: Frank Czul, MD, University of Miami Miller School of Medicine, 1500 NW, 12th Avenue, Suite 1101, Miami, FL 33136 (e-mail:

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