Is liver biopsy still useful in the era of non-invasive tests?

The American Association for the Study of Liver Disease guidelines have suggested the following indications for liver biopsy [1], namely, diagnosis of parenchymal liver diseases, abnormal liver function tests of uncertain causes, fever of unknown origin, and abnormal findings on imaging studies; sta...

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Bibliographic Details
Published in:Clinical and molecular hepatology 2020, 26(3), , pp.302-304
Main Authors: Lim, Tae Seop, Kim, Ja Kyung
Format: Article
Language:English
Subjects:
Ascites
Biopsy
biopsy, needle
Cholangitis
Clinical medicine
Clinical practice guidelines
complications
Hepatitis B
Hepatology
Liver cancer
Liver cirrhosis
Liver diseases
Magnetic resonance imaging
Risk factors
Tomography
Ultrasonic imaging
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Summary:The American Association for the Study of Liver Disease guidelines have suggested the following indications for liver biopsy [1], namely, diagnosis of parenchymal liver diseases, abnormal liver function tests of uncertain causes, fever of unknown origin, and abnormal findings on imaging studies; staging of parenchymal liver diseases; and development of treatment plans based on histopathologic findings. Limitations to liver biopsy include invasive nature with possibility of complications, sampling variability and the subjective nature of the pathologist interpretation [5]. [...]non-invasive methods have recently replaced or supplemented a significant portion of liver biopsy. Patients suspected of cirrhosis in these scoring systems might be confirmed without liver biopsy by imaging based non-invasive methods such as ultrasonography based elastography such as transient elastography and two-dimensional shear wave elastography, and magnetic resonance elastography. Abbreviations APRI, aspartate transaminase to platelet ratio index; CT, computed tomography; FIB-4, fibrosis-4; MRI, magnetic resonance imaging; NAFLD, non-alcoholic fatty liver disease; NAS, NAFLD activity score; NASH, non-alcoholic steatohepatitis 1.
ISSN:2287-2728
2287-285X
DOI:10.3350/cmh.2020.0081