Global Liver Institute

Going Beyond the Biopsy


Going Beyond the Biopsy

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Beyond the Biopsy Overview

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Biopsy Basics

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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, NASH, and other liver diseases.

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

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Alternatives to Biopsy

In some circumstances, a liver biopsy is extremely valuable, helpful, and perhaps even necessary, but in other circumstances non-invasive diagnostics can be used to avoid liver biopsy. These non-invasive alternatives potentially provide more information than biopsy, through their ability to assess changes throughout the liver, rather than only in the relatively small amount of liver tissue typically obtained from a liver biopsy.

From blood tests to imaging, alternatives to biopsy exist. Healthcare providers should increase the number of diagnoses and decrease the number of liver biopsies using non-invasive diagnostics.

What non-invasive diagnostics are there?

In the majority of circumstances, noninvasive diagnostics (such as blood tests and imaging tests) can be used to avoid liver biopsy. Ask your doctor which tests are appropriate in your case.

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Blood Tests

Different tests on the blood to calculate the amount of fat in the liver. They can be imprecise and not reflect the true degree of liver fibrosis. Specific blood tests include AST to Platelet Ratio Index (APRI), Fibrosis-4 Test (FIB-4), Enhanced Liver Fibrosis (ELF), and FibroTest.


Multiparametric Magnetic Resonance Imaging (LiverMultiScan)

Imaging technology that uses MRI to measure liver fat, iron, fibrosis and inflammation in a scan of up to 15 minutes.

Transient Elastography (Fibroscan)

Imaging device that uses ultrasound to measure liver stiffness

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Magnetic Resonance Elastography (MRE)

Imaging technology that combines MRI with sound waves to create a visual map (elastogram) to measure liver stiffness.
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Shear Wave Elastography

Imaging technology that uses ultrasound to measure liver stiffness.