Non-Invasive Testing in Metabolic Dysfunction Associated Fatty Liver Disease

Since the introduction of non-alcoholic steatohepatitis into the medical nomenclature, liver biopsy has been the best option for diagnosis, despite multiple limitations. Due to this inaccurate gold standard, there has been a need to develop non invasive testing for this disease to better diagnose and stage this condition. With the development of new terminology in 2020 of metabolic-dysfunction associated fatty liver disease providing a positive diagnostic criterion followed by metabolic-dysfunction associated steatotic liver disease, there has been extensive work to transition existing biomarkers into these new conditions. Despite this, there remains current gaps in biomarker development to meet the needs of this condition, particularly in view of its worldwide increasing prevalence. In this narrative review, we summarise the current concepts of non-invasive testing, review the available biomarkers and their accuracy in steatosis, steatohepatitis, and fibrosis, and discuss future concepts of biomarker development.