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Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective

Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis and cirrhosis. Accurate assessment of liver fibrosis is important for predicting disease outcomes and assessing therapeutic response in clinical practice and clinical trials. Although noninv...

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Autores principales: Soon, Gwyneth, Wee, Aileen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820194/
https://www.ncbi.nlm.nih.gov/pubmed/33207115
http://dx.doi.org/10.3350/cmh.2020.0181
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author Soon, Gwyneth
Wee, Aileen
author_facet Soon, Gwyneth
Wee, Aileen
author_sort Soon, Gwyneth
collection PubMed
description Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis and cirrhosis. Accurate assessment of liver fibrosis is important for predicting disease outcomes and assessing therapeutic response in clinical practice and clinical trials. Although noninvasive tests such as transient elastography and magnetic resonance elastography are preferred where possible, histological assessment of liver fibrosis via semiquantitative scoring systems remains the current gold standard. Collagen proportionate area provides more granularity by measuring the percentage of fibrosis on a continuous scale, but is limited by the absence of architectural input. Although not yet used in routine clinical practice, advances in second harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy imaging show great promise in characterising architectural features of fibrosis at the individual collagen fiber level. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g., qFibrosis, q-FPs), which have been validated against fibrosis stage in NAFLD. Artificial intelligence is being explored to further refine and develop quantitative fibrosis scoring methods. SHG-microscopy shows promise as the new gold standard for the quantitative measurement of liver fibrosis. This has reaffirmed the pivotal role of the liver biopsy in fibrosis assessment in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials; this approach may improve the outcomes of the trials evaluating therapeutic response to antifibrotic drugs.
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spelling pubmed-78201942021-01-27 Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective Soon, Gwyneth Wee, Aileen Clin Mol Hepatol Review Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis and cirrhosis. Accurate assessment of liver fibrosis is important for predicting disease outcomes and assessing therapeutic response in clinical practice and clinical trials. Although noninvasive tests such as transient elastography and magnetic resonance elastography are preferred where possible, histological assessment of liver fibrosis via semiquantitative scoring systems remains the current gold standard. Collagen proportionate area provides more granularity by measuring the percentage of fibrosis on a continuous scale, but is limited by the absence of architectural input. Although not yet used in routine clinical practice, advances in second harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy imaging show great promise in characterising architectural features of fibrosis at the individual collagen fiber level. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g., qFibrosis, q-FPs), which have been validated against fibrosis stage in NAFLD. Artificial intelligence is being explored to further refine and develop quantitative fibrosis scoring methods. SHG-microscopy shows promise as the new gold standard for the quantitative measurement of liver fibrosis. This has reaffirmed the pivotal role of the liver biopsy in fibrosis assessment in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials; this approach may improve the outcomes of the trials evaluating therapeutic response to antifibrotic drugs. The Korean Association for the Study of the Liver 2021-01 2020-11-19 /pmc/articles/PMC7820194/ /pubmed/33207115 http://dx.doi.org/10.3350/cmh.2020.0181 Text en Copyright © 2021 by The Korean Association for the Study of the Liver This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Soon, Gwyneth
Wee, Aileen
Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective
title Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective
title_full Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective
title_fullStr Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective
title_full_unstemmed Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective
title_short Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective
title_sort updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: histological perspective
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820194/
https://www.ncbi.nlm.nih.gov/pubmed/33207115
http://dx.doi.org/10.3350/cmh.2020.0181
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