Imaging biomarkers of diffuse liver disease: current status
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SPECIAL SECTION: DIFFUSE LIVER DISEASE
Imaging biomarkers of diffuse liver disease: current status Bachir Taouli1,2 · Filipe Caseiro Alves3 Received: 26 April 2020 / Revised: 9 June 2020 / Accepted: 13 June 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract We are happy to introduce this special issue of Abdominal Radiology on “diffuse liver disease”. We have invited imaging experts to discuss various topics pertaining to diffuse liver disease, covering a vast array of imaging techniques including ultrasound (US), CT, MRI and new molecular imaging agents. Below, we briefly discussed the current status, limitations, and future directions of imaging biomarkers of diffuse liver disease. Chronic liver disease (CLD) is highly prevalent worldwide, with high morbidity and mortality. Globally, it was estimated that 1.5 billion persons had CLD in 2017, most commonly resulting from NAFLD (nonalcoholic fatty liver disease), chronic hepatitis B (CHB) and C (CHC) viral infections and alcoholic liver disease [1]. CLD and liver cirrhosis are responsible for approximately 44,000 deaths in the USA and 2 million deaths worldwide each year, in addition to a high rate of morbidity and healthcare costs [2]. The epidemiology of CLD is changing, with the implementation of large-scale CHB vaccination and efficient CHC treatment with direct acting antivirals, the increasing prevalence of obesity and metabolic syndrome, and alcohol use disorder [2]. Indeed, approximately 2 billion adults are obese or overweight and over 400 million have diabetes worldwide; both of which are risk factors for NAFLD, nonalcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC) [3]. Liver biopsy is the historical gold standard method to evaluate the degree of liver fibrosis, necroinflammation, fat and iron deposition, and to characterize unexplained etiologies of CLD (such as cholestatic disease) [4]. However, liver biopsy has major limitations, including invasiveness, risk of
* Bachir Taouli [email protected] 1
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine At Mount Sinai, 1470 Madison Avenue, New York, NY 10029, USA
2
BioMedical Engineering and Imaging Institute, Icahn School of Medicine At Mount Sinai, New York, NY, USA
3
Department of Radiology, University Hospital of Coimbra, Coimbra, Portugal
sampling and observer variability, and is difficult to repeat (for example in the context of drug trials) [5–7]. Over the last 15 years, the successful implementation of noninvasive tests such as transient elastography (TE) [8–11], more recently ARFI (Acoustic Radiation Force Impulse) methods [12–15] and magnetic resonance elastography (MRE) [16–18], as well as simple and proprietary serum markers [19–21] have significantly reduced the need for liver biopsy for fibrosis staging. Liver stiffness measured with elastography techniques is now considered a reliable imaging biomarker of liver fibrosis in a wide range of etiologies. It is used to predict the
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