Moriyama K. Evaluation methods of hepatic steatosis: From conventional techniques to emerging biomarkers. World J Hepatol 2026; 18(1): 112821 [DOI: 10.4254/wjh.v18.i1.112821]
Corresponding Author of This Article
Kengo Moriyama, MD, PhD, Professor, Department of Clinical Health Science, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji 1920032, Tokyo, Japan. kengomoriyama@tokai.ac.jp
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Jan 27, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Hepatology
ISSN
1948-5182
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Moriyama K. Evaluation methods of hepatic steatosis: From conventional techniques to emerging biomarkers. World J Hepatol 2026; 18(1): 112821 [DOI: 10.4254/wjh.v18.i1.112821]
World J Hepatol. Jan 27, 2026; 18(1): 112821 Published online Jan 27, 2026. doi: 10.4254/wjh.v18.i1.112821
Evaluation methods of hepatic steatosis: From conventional techniques to emerging biomarkers
Kengo Moriyama
Kengo Moriyama, Department of Clinical Health Science, Tokai University School of Medicine, Hachioji 1920032, Tokyo, Japan
Author contributions: Moriyama K conceptualized, designed and wrote the review.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kengo Moriyama, MD, PhD, Professor, Department of Clinical Health Science, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji 1920032, Tokyo, Japan. kengomoriyama@tokai.ac.jp
Received: August 7, 2025 Revised: September 18, 2025 Accepted: December 2, 2025 Published online: January 27, 2026 Processing time: 173 Days and 8.5 Hours
Abstract
Accurate assessment of hepatic steatosis is essential for diagnosing, staging, and monitoring metabolic dysfunction-associated steatotic liver disease. This review comprehensively overviews conventional and emerging hepatic steatosis evaluation methods. Noninvasive imaging techniques such as ultrasound, controlled attenuation parameter, and magnetic resonance imaging-derived proton density fat fraction are discussed alongside invasive reference standards such as liver biopsy. The review also highlights the role of blood-based biomarkers, including fibroblast growth factor 21, cytokeratin-18, type III procollagen peptide, and Mac-2 binding protein glycosylation isomer, as well as novel approaches such as epigenetic markers, artificial intelligence–assisted imaging, and digital pathology. Each method is presented with consideration of its diagnostic performance, clinical utility, and limitations. By integrating these modalities into multimodal assessment strategies and incorporating dynamic endpoints such as magnetic resonance imaging-derived proton density fat fraction (known as magnetic resonance imaging-derived proton density fat fraction)-based fat reduction as a therapeutic response marker, clinicians can improve diagnostic accuracy, risk stratification, and therapeutic guidance.
Core Tip: This review provides a comprehensive overview of hepatic steatosis evaluation methods, ranging from conventional ultrasound and liver biopsy to advanced techniques such as magnetic resonance imaging-derived proton density fat fraction, attenuation-based ultrasound, and emerging blood-based and epigenetic biomarkers. By integrating multimodal diagnostic strategies, including artificial intelligence-assisted imaging and methylation profiling, clinicians can improve the diagnosis, risk stratification, and therapeutic monitoring of metabolic dysfunction-associated steatotic liver disease. The review also highlights the evolving role of steatosis quantification as a treatment response marker and future directions in precision hepatology.
