Non-Alcoholic Fatty Liver Disease and Non-Invasive Methods of Diagnosis

Non-alcoholic fatty liver disease (NAFLD) is widely recognized as the hepatic manifestation of the metabolic syndrome, characterized by the accumulation of triglycerides in the hepatocyte cytoplasm. With a global prevalence estimated at 25%, NAFLD stands as the most common chronic liver disease. While the majority of NAFLD patients may never experience liver-related complications, a notable 5–10% face the risk of progression to cirrhosis, end-stage liver disease, or hepatocellular carcinoma. NAFLD patients with advanced fibrosis are at the highest risk of developing cardiovascular, renal, and cirrhosis-related complications. Liver biopsy is currently considered the reference method for evaluating liver steatosis and fibrosis stages. However, due to their limitations in large-scale screening, non-invasive tests (NIT) have gained prominence in evaluating steatosis and fibrosis stages in NAFLD patients. These NIT methods encompass serum-based algorithms as well as ultrasound- and magnetic resonance-based techniques. This review explores the advantages and limitations of NIT for identifying steatosis and advanced fibrosis in NAFLD.