What Ultrasound Operators Must Be Well Aware of in a World With Raising Burden of Non Alcoholic Fatty Liver Disease?

Non alcoholic fatty liver disease (NAFLD) is one of the manifestations of the metabolic syndrome. The latter is mainly determined by the presence of overweight and type 2 diabetes, whose prevalence is rapidly raising in developed Countries (almost 40 % in adult US Americans in 2013 – 2016) [1] in keeping with more food availability, cheap trash food, rich in fat, and soft drinks rich in sugar. The trend is even more worrisome, if one considers also the rapidly growing prevalence of children obesity. Given the magnitude of such a problem, expected to fully blow in the third decade of the third millennium, that we will be entering in less than 12 months, and the potential role of ultrasound in these patients a critical appraisal to this issue, as seen from the ultrasonographic standpoint, appears relevant.

• References

• 1 Hales CM, Fryar CD, Carroll MD. et al. Differences in Obesity Prevalence by Demographic Characteristics and Urbanization Level Among Adults in the United States, 2013–2016. JAMA 2018; 319: 2419-2429
• 2 European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 2016; 64: 1388-1402
• 3 Italian Association for the Study of the Liver (AISF). AISF position paper on nonalcoholic fatty liver disease (NAFLD): Updates and future directions. Dig Liver Dis 2017; 49: 471-483
• 4 Dietrich CF, Bamber J, Berzigotti A. et al. EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017. Ultraschall in Med 2017; 38: 377-394
• 5 Tana C, Schiavone C, Ticinesi A. et al. Hepatic artery resistive index as surrogate marker for fibrosis progression in NAFLD patients: A clinical perspective. Int J Immunopathol Pharmacol 2018; 32: 2058738418781373
• 6 Tana C, Tana M, Rossi S. et al. Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution. J Ultrasound 2016; 19: 183-189
• 7 Piscaglia F, Svegliati-Baroni G, Barchetti A. HCC-NAFLD Italian Study Group. et al. Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study. Hepatology 2016; 63: 827-838
• 8 Petta S, Maida M, Macaluso FS. et al. The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease. Hepatology 2015; 62: 1101-1110
• 9 Piscaglia F, Salvatore V, Mulazzani L. et al. Ultrasound Shear Wave Elastography for Liver Disease. A Critical Appraisal of the Many Actors on the Stage. Ultraschall in Med 2016; 37: 1-5
• 10 Petta S, Wong VW, Cammà C. et al. Improved noninvasive prediction of liver fibrosis by liver stiffness measurement in patients with nonalcoholic fatty liver disease accounting for controlled attenuation parameter values. Hepatology 2017; 65: 1145-1155
• 11 Cassinotto C, Boursier J, de Lédinghen V. et al. Liver stiffness in nonalcoholic fatty liver disease: A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology 2016; 63: 1817-1827
• 12 Younossi ZM, Lawitz EJ, Akhouri N. et al. Algorithms using noninvasive tests can accurately identify patients with advanced fibrosis due to NASH: data from the STELLAR clinical trials. Abstract presented at AASLD: The Liver Meeting 2018. Hepatology 2018 suppl1: LB-10