Global Liver Institute

Going Beyond the Biopsy

GLOBAL LIVER INSTITUTE

Going Beyond the Biopsy

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Beyond the Biopsy Overview

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Going Beyond the Biopsy

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Non-invasive alternatives are necessary to respond to the growing incidence of NAFLD/MASLD, NASH/MASH, and other liver diseases.

The symptoms of NASH/MASH are hard to recognize, as such, it remains under diagnosed. Newer noninvasive screening and diagnostic tools are now being used, offering a safer and more thorough examination of the liver.

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Several effective noninvasive diagnostics currently assess liver fibrosis, including:

  • Multiparametric Magnetic Resonance Imaging (MMRI)
  • Ultrasound
  • Transient Elastography
  • Magnetic Resonance Elastography (MRE)
  • Shear Wave Elastography
  • Blood tests (AST to Platelet Ratio Index (APRI), Fibrosis-4 Test (FIB-4), Enhanced Liver Fibrosis (ELF))

Noninvasive diagnostics lead to fewer patient visits, quicker diagnoses, and improved cost-effectiveness, all with minimal procedural risks. It is essential for patients to appreciate the value of these noninvasive options and their positive impact on health outcomes. Similarly, clinicians, policymakers, and payors must recognize the importance of noninvasive diagnostics in improving liver health care.

Liver biopsy has long been a key tool for diagnosing liver disease and remains commonly  used in clinical trials.

While biopsies have value, noninvasive diagnostics are increasingly viable in clinical practice. Noninvasive options, such as blood tests and imaging, offer several advantages: they carry no procedural risks, avoid patient discomfort, and can sometimes yield broader insights into liver health beyond the small sample obtained from a biopsy. In most cases, these noninvasive diagnostics can effectively replace the need for a liver biopsy, supporting a shift towards safer, more comprehensive diagnostic approaches.

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Complications of Biopsy

While complications from liver biopsy are rare, they can occur and include:

  • 8Bleeding
  • 8Pneumothorax (lung collapse from air leakage)
  • 8Hemothorax (blood buildup around lungs, causing chest pain)
  • 8Perforation of adjacent organs
  • 8Accidental biopsy of the kidney
  • 8Bile peritonitis (bile leakage in the abdomen, causing pain)
  • 8Infection (bacteremia, abscess, sepsis)
  • 8Hemobilia (bleeding in the bile ducts, causing pain and/or jaundice)
  • 8Death

Ask Your Doctor Before the Biopsy

  • What is the reason for doing the biopsy?
  • What are the noninvasive alternatives?
  • What are the processes for minimizing pain and discomfort?
  • How is the risk of bleeding minimized?
  • How soon will I get the results?