Nonalcoholic steatohepatitis (NASH) is an aggressive form of nonalcoholic fatty liver disease (NAFLD) characterized by steatosis-associated inflammation and liver injury. Without effective treatment or management, NASH can have life-threatening outcomes. Evaluation and identification of NASH patients at risk for adverse outcomes are therefore important. Key issues in screening NASH patients are the assessment of advanced fibrosis, differentiation of NASH from simple steatosis, and monitoring of dynamic changes during follow-up and treatment. Currently, NASH staging and evaluation of the effectiveness for drugs still rely on pathological diagnosis, despite sample error issues and the subjectivity associated with liver biopsy. Optimizing the pathological assessment of liver biopsy samples and developing noninvasive surrogate methods for accessible, accurate, and safe evaluation are therefore critical. Although noninvasive methods including elastography, serum soluble biomarkers, and combined models have been implemented in the last decade, noninvasive diagnostic measurements are not widely applied in clinical practice. More work remains to be done in establishing cost-effective strategies both for screening for at-risk NASH patients and identifying changes in disease severity. In this review, we summarize the current state of noninvasive methods for detecting steatosis, steatohepatitis, and fibrosis in patients with NASH, and discuss noninvasive assessments for screening at-risk patients with a focus on the characteristics that should be monitored at follow-up.
Citations
Citations to this article as recorded by
Efficacy of Orlistat on Cardiometabolic Indices in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A GRADE-Assessed Systematic Review and Meta-Analysis of RCTs Mehdi Karimi, Seyed Morteza Ali Pourfaraji, Peyvand Parhizkar Roudsari, Samira Pirzad Current Therapeutic Research.2026; 104: 100822. CrossRef
MAP17 is a Novel NASH Progression Biomarker Associated with Macrophage Infiltration, Immunotherapy Response, and Oxidative Stress Zhiwei Huang, Jiatong Chen, Shenglu Liu, Xin Xiang, Yang Long, Peng Tan, Wenguang Fu Journal of Inflammation Research.2025; Volume 18: 601. CrossRef
A Novel Point-of-Care Prediction Model for Steatotic Liver Disease: Expected Role of Mass Screening in the Global Obesity Crisis Jeayeon Park, Goh Eun Chung, Yoosoo Chang, So Eun Kim, Won Sohn, Seungho Ryu, Yunmi Ko, Youngsu Park, Moon Haeng Hur, Yun Bin Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan Yoon, Yoon Jun Kim Gut and Liver.2025; 19(1): 126. CrossRef
Innovative nanomedicine approaches for the management of nonalcoholic fatty liver disease Limeng Li, Weiqi Gao, Fengyang Yao, Jiayi Li, Wei Sang, Ruiping Zhang Journal of Controlled Release.2025; 382: 113680. CrossRef
Multiparametric Quantitative Ultrasound as a Potential Imaging Biomarker for Noninvasive Detection of Nonalcoholic Steatohepatitis: A Clinical Feasibility Study Trina Chattopadhyay, Hsien-Jung Chan, Duy Chi Le, Chiao-Yin Wang, Dar-In Tai, Zhuhuang Zhou, Po-Hsiang Tsui Diagnostics.2025; 15(17): 2214. CrossRef
Agile 3+ and Metabolic Dysfunction-Associated Fatty Liver Disease:
Detecting Advanced Fibrosis based on Reported Liver Stiffness
Measurement in FibroScan and Laboratory Findings Mohammadjavad Sotoudeheian The International Journal of Gastroenterology and Hepatology Diseases.2024;[Epub] CrossRef
Hong Joo Kim, Soo Kyung Park, Hyo Joon Yang, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi
Clin Mol Hepatol 2016;22(3):350-358. Published online September 25, 2016
Background/Aims To analyze the effects of preexisting lamivudine (LAM) resistance and applying antiviral treatment (adefovir [ADV] add-on LAM combination treatment) on long-term treatment outcomes, and comparing the clinical outcomes of antiviral-naïve chronic hepatitis B patients receiving entecavir (ETV) monotherapy.
Methods This study enrolled 73 antiviral-naïve patients who received 0.5-mg ETV as an initial therapy and 54 patients who received ADV add-on LAM combination treatment as a rescue therapy from July 2006 to July 2010.
Results During 24-month treatments, the decreases in serum log10HBV-DNA values (copies/mL) were significantly greater in the antiviral-naïve patients treated with ETV than the patients receiving ADV add-on LAM combination treatment. The biochemical response rates for alanine aminotransferase normalization at 6 months (ETV) and 12 months (ADV add-on LAM) were 90.4% (66/73) and 77.8% (42/54), respectively (P=0.048). A Kaplan-Meier analysis indicated that the rates of serologic response, viral breakthrough, and emergence of genotypic resistance did not differ significantly between the two patient groups. There were also no significant intergroup differences in the rates of disease progression (PD) and new development of hepatocellular carcinoma (HCC).
Conclusions The long-term clinical outcomes of antiviral-naïve patients treated with ETV and LAM-resistant patients receiving ADV add-on LAM combination treatment were comparable in terms of the emergence of HCC and disease progression.
Citations
Citations to this article as recorded by
Efficacy and cost-effectiveness of antiviral regimens for entecavir-resistant hepatitis B: A systematic review and network meta-analysis Si-Si Yang, Cheng-Wei Cai, Xue-Qing Ma, Jia Xu, Cheng-Bo Yu Hepatobiliary & Pancreatic Diseases International.2020; 19(6): 507. CrossRef
First
Prev
