Current status of imaging in nonalcoholic fatty liver disease

Table 1 Summary table for the value of conventional and elastographic imaging modalities in non-alcoholic fatty liver disease stratification

Modality	Steatosis assessment	Fibrosis assessment	SS / NASH differentiation
Conventional imaging
US	Not quantitative1[30]: Sensitivity 79.7%, Specificity 86.2%	No for fibrosis, but can detect cirrhosis with high sensitivity	No
CT	Quantitative2[38]: Sensitivity 82%, Specificity 100%	Semi-quantitative for fibrosis, but can detect cirrhosis with high sensitivity[39]	No
MRI	Quantitative3: Sensitivity 76.7%-90.0%, Specificity 87.1%-91%[40,41]	No for fibrosis, but can detect cirrhosis with high sensitivity	No
Elastographic imaging
TE / CAP	Sensitivity 82%, Specificity 91%4[42]	Advanced Fibrosis[43]: Sensitivity 91%, Specificity 75%	No
USE	-	Advanced Fibrosis[44]: Sensitivity 100%, Specificity 91%	No
MRE	Sensitivity 90%, Specificity 93.3%5[42]	Advanced Fibrosis[45]: Sensitivity100%, Specificity 92%	Yes5[46]: Sensitivity 94%, Specificity 73%

¹Gray-scale US detecting steatosis (more than 20% of hepatocytes involved in fat infiltration); ²Non-contrast CT detecting steatosis;

³MRI detecting liver histological steatosis; ⁴Evaluated by CAP based on TE; ⁵MRE discriminating steatosis from NASH using a threshold of 2.74 kPa. SS: Simple steatosis; NASH: Non-alcoholic steatohepatitis; US: Ultrasonography; CT: Computed tomography; MRI: Magnetic resonance imaging; TE: Transient elastography; CAP: Controlled attenuation parameter; USE: Ultrasound elastography; MRE: Magnetic resonance elastography.