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Table 1 Noninvasive imaging assessment of NAFLD and advanced fibrosis

From: Nonalcoholic fatty liver disease and type 2 diabetes: where do Diabetologists stand?

Diagnostic modality Advantages Disadvantages
USa • Noninvasive
• Inexpensive
• Widely available
• Fair accuracy in moderate to severe hepatic steatosis (≥ S2)a
• ↓sensitivity when hepatic steatosis < 20–33%a
• Operator-dependent
• ↓accuracy in patients with chronic liver disease or obesity
VCTE (CAPa & LSMb) • Noninvasive
• Inexpensive
• Widely available
• Reproducible
• Advanced fibrosis stagingb
• Technical limitations in patients with ascites, morbid obesity, or ↑chest wall fat
• Measurement failure
MRI-PDFFa & MREb • Noninvasive
• Quantification of hepatic steatosisa (helpful in patients with ↓grade hepatic steatosis)
• Excellent reproducibility
• Advanced fibrosis stagingb
• Expensive
• Small sample volume/not convenient for patients with uneven fatty changesa
  1. asteatosis assessment. b fibrosis assessment
  2. Abbreviations: US Ultrasonography, VCTE Vibration-controlled transient elastography, CAP Controlled attenuation parameter, LSM liver Stiffness measurement, MRI-PDFF Magnetic resonance imaging-proton density fat fraction, MRE Magnetic resonance elastography