Transient elastography in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a relevant issue in public health owing to its epidemiological burden. It represents the most common chronic liver disease in the general population and is expected to increase in future as a result of an ageing population. Liver biopsy is still considered the "gold standard" for distinguishing the broad range of NAFLD. However, liver biopsy is often not recommended in the NAFLD patients, because of its cost, the potential risk of bleeding and the absence of consensus regarding the histopathological criteria that firmly differentiate between the NAFLD entities. Due to the remarkable increase in the prevalence of NAFLD and the concomitant efforts in developing novel therapies, a non-invasive, simple and reproducible technique is needed in the clinical practice. Transient elastography is a non-invasive technique for liver stiffness measurement (LSM) as a function of the extent of hepatic fibrosis. This review focuses on practical issues in the use of LSM in the NAFLD patients and suggests areas for further research and development.