Radiologic evaluation of nonalcoholic fatty liver disease

World Journal of Gastroenterology

Volumn 20, Issue 23, 2014, Pages 7392-7402

  Lee, Seung Soo ^a   Park, Seong Ho ^a  

^a University of Ulsan College of Medicine   (South Korea)

Author keywords

Computed tomography; Elastography; Liver steatosis; Magnetic resonance imaging; Magnetic resonance spectroscopy; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Ultrasonography

Indexed keywords

ARTICLE; CLINICAL TRIAL (TOPIC); COMPUTER ASSISTED TOMOGRAPHY; DISEASE SEVERITY; ECHOGRAPHY; ELASTOGRAPHY; FATTY LIVER; HEPATITIS; HISTOLOGY; HUMAN; IONIZING RADIATION; LIVER FIBROSIS; LIVER TRANSPLANTATION; METABOLIC SYNDROME X; NONALCOHOLIC FATTY LIVER; NONHUMAN; NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY; PROTON NUCLEAR MAGNETIC RESONANCE; RADIOLOGY; SENSITIVITY AND SPECIFICITY; SIGNAL NOISE RATIO; BIOPSY; DIAGNOSTIC IMAGING; LIVER; NUCLEAR MAGNETIC RESONANCE IMAGING; PATHOLOGY; PREDICTIVE VALUE; PROCEDURES; PROGNOSIS; RADIOGRAPHY; SEVERITY OF ILLNESS INDEX;

BIOPSY; DIAGNOSTIC IMAGING; ELASTICITY IMAGING TECHNIQUES; HUMANS; LIVER; MAGNETIC RESONANCE IMAGING; MAGNETIC RESONANCE SPECTROSCOPY; NON-ALCOHOLIC FATTY LIVER DISEASE; PREDICTIVE VALUE OF TESTS; PROGNOSIS; SEVERITY OF ILLNESS INDEX; TOMOGRAPHY, X-RAY COMPUTED;

EID: 84902651902     PISSN: 10079327     EISSN: 22192840     Source Type: Journal    
DOI: 10.3748/wjg.v20.i23.7392     Document Type: Article

References (82)

1. Szczepaniak LS, Nurenberg P, Leonard D, Browning JD, Reingold JS, Grundy S, Hobbs HH, Dobbins RL. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am J Physiol Endocrinol Metab 2005; 288: E462-E468 [PMID: 15339742 DOI: 10.1152/ajpendo.00064.2004]
2. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34: 274-285 [PMID: 21623852 DOI: 10.1111/j.1365-2036.2011.04724.x]
3. Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology 2006; 43: S99-S112 [PMID: 16447287 DOI: 10.1002/hep.20973]
4. de Alwis NM, Day CP. Non-alcoholic fatty liver disease: the mist gradually clears. J Hepatol 2008; 48 Suppl 1: S104-S112 [PMID: 18304679 DOI: 10.1016/j.jhep.2008.01.009]
5. Fierbinteanu-Braticevici C, Negreanu L, Tarantino G. Is fatty liver always benign and should not consequently be treated? J Physiol Pharmacol 2013; 64: 3-9 [PMID: 23568965]
6. Day CP. Natural history of NAFLD: remarkably benign in the absence of cirrhosis. Gastroenterology 2005; 129: 375-378 [PMID: 16012969 DOI: 10.1053/j.gastro/2005/05/041]
7. Wong VW, Wong GL, Choi PC, Chan AW, Li MK, Chan HY, Chim AM, Yu J, Sung JJ, Chan HL. Disease progression of non-alcoholic fatty liver disease: a prospective study with paired liver biopsies at 3 years. Gut 2010; 59: 969-974 [PMID: 20581244]
8. Tarantino G. What has the optimistic bias got to do with the need to differentiate fatty liver from nonalcoholic steatohepatitis? J Gastrointestin Liver Dis 2011; 20: 229-231 [PMID: 21961086]
9. Adams LA, Sanderson S, Lindor KD, Angulo P. The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies. J Hepatol 2005; 42: 132-138 [PMID: 15629518 DOI: 10.1016/ j.jhep.2004.09.012]
10. Ekstedt M, Franzén LE, Mathiesen UL, Thorelius L, Holmqvist M, Bodemar G, Kechagias S. Long-term followup of patients with NAFLD and elevated liver enzymes. Hepatology 2006; 44: 865-873 [PMID: 17006923 DOI: 10.1002/ hep.21327]
11. Tarantino G. Is Assessing the Presence of NASH by Liver Histology or Surrogate Markers Always Advisable? Hepat Mon 2013; 13: e7560 [PMID: 23610586 DOI: 10.5812/hepatmon. 7560]
12. Ascha MS, Hanouneh IA, Lopez R, Tamimi TA, Feldstein AF, Zein NN. The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis. Hepatology 2010; 51: 1972-1978 [PMID: 20209604 DOI: 10.1002/hep.23527]
13. Juurinen L, Tiikkainen M, Häkkinen AM, Hakkarainen A, Yki-Järvinen H. Effects of insulin therapy on liver fat content and hepatic insulin sensitivity in patients with type 2 diabetes. Am J Physiol Endocrinol Metab 2007; 292: E829-E835 [PMID: 17090752 DOI: 10.1152/ajpendo.00133.2006]
14. Korenblat KM, Fabbrini E, Mohammed BS, Klein S. Liver, muscle, and adipose tissue insulin action is directly related to intrahepatic triglyceride content in obese subjects. Gastroenterology 2008; 134: 1369-1375 [PMID: 18355813 DOI: 10.1053/j.gastro.2008.01.075]
15. Cheung O, Sanyal AJ. Hepatitis C infection and nonalcoholic fatty liver disease. Clin Liver Dis 2008; 12: 573-585, viiiix [PMID: 18625429 DOI: 10.1016/j.cld.2008.03.005]
16. Marsman WA, Wiesner RH, Rodriguez L, Batts KP, Porayko MK, Hay JE, Gores GJ, Krom RA. Use of fatty donor liver is associated with diminished early patient and graft survival. Transplantation 1996; 62: 1246-1251 [PMID: 8932265 DOI: 10.1097/00007890-199611150-00011]
17. Ratziu V, Charlotte F, Heurtier A, Gombert S, Giral P, Bruckert E, Grimaldi A, Capron F, Poynard T. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 2005; 128: 1898-1906 [PMID: 15940625 DOI: 10.1053/j.gastro.2005.03.084]
18. Wai CT, Tan LH, Kaur M, Da Costa M, Quak SH, Tan KC. Pitfalls in interpreting liver biopsy results: the story of the blind men and the elephant. Liver Transpl 2002; 8: 1200-1201 [PMID: 12474163 DOI: 10.1053/jlts.2002.36843]
19. Lee SS, Park SH, Kim HJ, Kim SY, Kim MY, Kim DY, Suh DJ, Kim KM, Bae MH, Lee JY, Lee SG, Yu ES. Non-invasive assessment of hepatic steatosis: prospective comparison of the accuracy of imaging examinations. J Hepatol 2010; 52: 579-585 [PMID: 20185194 DOI: 10.1016/j.jhep.2010.01.008]
20. Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M, Mullen KD, Cooper JN, Sheridan MJ. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology 2002; 123: 745-750 [PMID: 12198701 DOI: 10.1053/gast.2002.35354]
21. van Werven JR, Marsman HA, Nederveen AJ, Smits NJ, ten Kate FJ, van Gulik TM, Stoker J. Assessment of hepatic steatosis in patients undergoing liver resection: comparison of US, CT, T1-weighted dual-echo MR imaging, and pointresolved 1H MR spectroscopy. Radiology 2010; 256: 159-168 [PMID: 20574093 DOI: 10.1148/radiol.10091790]
22. de Moura Almeida A, Cotrim HP, Barbosa DB, de Athayde LG, Santos AS, Bitencourt AG, de Freitas LA, Rios A, Alves E. Fatty liver disease in severe obese patients: diagnostic value of abdominal ultrasound. World J Gastroenterol 2008; 14: 1415-1418 [PMID: 18322958 DOI: 10.3748/wjg.14.1415]
23. Palmentieri B, de Sio I, La Mura V, Masarone M, Vecchione R, Bruno S, Torella R, Persico M. The role of bright liver echo pattern on ultrasound B-mode examination in the diagnosis of liver steatosis. Dig Liver Dis 2006; 38: 485-489 [PMID: 16716779 DOI: 10.1016/j.dld.2006.03.021]
24. Saverymuttu SH, Joseph AE, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J (Clin Res Ed) 1986; 292: 13-15 [PMID: 3080046]
25. Hepburn MJ, Vos JA, Fillman EP, Lawitz EJ. The accuracy of the report of hepatic steatosis on ultrasonography in patients infected with hepatitis C in a clinical setting: a retrospective observational study. BMC Gastroenterol 2005; 5: 14 [PMID: 15829009 DOI: 10.1186/1471-230X-5-14]
26. Strauss S, Gavish E, Gottlieb P, Katsnelson L. Interobserver and intraobserver variability in the sonographic assessment of fatty liver. AJR Am J Roentgenol 2007; 189: W320-W323 [PMID: 18029843 DOI: 10.2214/AJR.07.2123]
27. Kuroda H, Kakisaka K, Kamiyama N, Oikawa T, Onodera M, Sawara K, Oikawa K, Endo R, Takikawa Y, Suzuki K. Non-invasive determination of hepatic steatosis by acoustic structure quantification from ultrasound echo amplitude. World J Gastroenterol 2012; 18: 3889-3895 [PMID: 22876042 DOI: 10.3748/wjg.v18.i29.3889]
28. Webb M, Yeshua H, Zelber-Sagi S, Santo E, Brazowski E, Halpern Z, Oren R. Diagnostic value of a computerized hepatorenal index for sonographic quantification of liver steatosis. AJR Am J Roentgenol 2009; 192: 909-914 [PMID: 19304694 DOI: 10.2214/AJR.07.4016]
29. Borges VF, Diniz AL, Cotrim HP, Rocha HL, Andrade NB. Sonographic hepatorenal ratio: a noninvasive method to diagnose nonalcoholic steatosis. J Clin Ultrasound 2013; 41: 18-25 [PMID: 22997020 DOI: 10.1002/jcu.21994]
30. Tarantino G, Finelli C. What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome? World J Gastroenterol 2013; 19: 3375-3384 [PMID: 23801829 DOI: 10.3748/wjg.v19.i22.3375]
31. Lawrence DA, Oliva IB, Israel GM. Detection of hepatic steatosis on contrast-enhanced CT images: diagnostic accuracy of identification of areas of presumed focal fatty sparing. AJR Am J Roentgenol 2012; 199: 44-47 [PMID: 22733892 DOI: 10.2214/AJR.11.7838]
32. Kim DY, Park SH, Lee SS, Kim HJ, Kim SY, Kim MY, Lee Y, Kim TK, Khalili K, Bae MH, Lee JY, Lee SG, Yu ES. Contrast-enhanced computed tomography for the diagnosis of fatty liver: prospective study with same-day biopsy used as the reference standard. Eur Radiol 2010; 20: 359-366 [PMID: 19727755 DOI: 10.1007/s00330-009-1560-x]
33. Pickhardt PJ, Park SH, Hahn L, Lee SG, Bae KT, Yu ES. Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis. Eur Radiol 2012; 22: 1075-1082 [PMID: 22138733 DOI: 10.1007/s00330-011-2349-2]
34. Birnbaum BA, Hindman N, Lee J, Babb JS. Multi-detector row CT attenuation measurements: assessment of intraand interscanner variability with an anthropomorphic body CT phantom. Radiology 2007; 242: 109-119 [PMID: 17185663 DOI: 10.1148/radiol.2421052066]
35. Park SH, Kim PN, Kim KW, Lee SW, Yoon SE, Park SW, Ha HK, Lee MG, Hwang S, Lee SG, Yu ES, Cho EY. Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. Radiology 2006; 239: 105-112 [PMID: 16484355 DOI: 10.1148/radiol.2391050361]
36. Park YS, Park SH, Lee SS, Kim DY, Shin YM, Lee W, Lee SG, Yu ES. Biopsy-proven nonsteatotic liver in adults: estimation of reference range for difference in attenuation between the liver and the spleen at nonenhanced CT. Radiology 2011; 258: 760-766 [PMID: 21212369 DOI: 10.1148/radiol. 10101233]
37. Patrick D, White FE, Adams PC. Long-term amiodarone therapy: a cause of increased hepatic attenuation on CT. Br J Radiol 1984; 57: 573-576 [PMID: 6733404 DOI: 10.1259/0007-1285-57-679-573]
38. Artz NS, Hines CD, Brunner ST, Agni RM, Kühn JP, Roldan-Alzate A, Chen GH, Reeder SB. Quantification of hepatic steatosis with dual-energy computed tomography: comparison with tissue reference standards and quantitative magnetic resonance imaging in the ob/ob mouse. Invest Radiol 2012; 47: 603-610 [PMID: 22836309 DOI: 10.1097/ RLI.0b013e318261fad0]
39. Mendler MH, Bouillet P, Le Sidaner A, Lavoine E, Labrousse F, Sautereau D, Pillegand B. Dual-energy CT in the diagnosis and quantification of fatty liver: limited clinical value in comparison to ultrasound scan and single-energy CT, with special reference to iron overload. J Hepatol 1998; 28: 785-794 [PMID: 9625313 DOI: 10.1016/S0168-8278(98)80228-6]
40. Gholam PM, Flancbaum L, Machan JT, Charney DA, Kotler DP. Nonalcoholic fatty liver disease in severely obese subjects. Am J Gastroenterol 2007; 102: 399-408 [PMID: 17311652 DOI: 10.1111/j.1572-0241.2006.01041.x]
41. Lee SW, Park SH, Kim KW, Choi EK, Shin YM, Kim PN, Lee KH, Yu ES, Hwang S, Lee SG. Unenhanced CT for assessment of macrovesicular hepatic steatosis in living liver donors: comparison of visual grading with liver attenuation index. Radiology 2007; 244: 479-485 [PMID: 17641368 DOI: 10.1148/radiol.2442061177]
42. Lim S, Kwon SY, Yoon JW, Kim SY, Choi SH, Park YJ, Yoon HI, Chang YS, Lee JH, Lee CT, Kim KW, Park KS, Jang HC. Association between body composition and pulmonary function in elderly people: the Korean Longitudinal Study on Health and Aging. Obesity (Silver Spring) 2011; 19: 631-638 [PMID: 20706206 DOI: 10.1038/oby.2010.167]
43. Ross R. Advances in the application of imaging methods in applied and clinical physiology. Acta Diabetol 2003; 40 Suppl 1: S45-S50 [PMID: 14618432 DOI: 10.1007/s00592-003-0025-y]
44. Hamilton G, Middleton MS, Bydder M, Yokoo T, Schwimmer JB, Kono Y, Patton HM, Lavine JE, Sirlin CB. Effect of PRESS and STEAM sequences on magnetic resonance spectroscopic liver fat quantification. J Magn Reson Imaging 2009; 30: 145-152 [PMID: 19557733 DOI: 10.1002/jmri.21809]
45. Reeder SB, Cruite I, Hamilton G, Sirlin CB. Quantitative Assessment of Liver Fat with Magnetic Resonance Imaging and Spectroscopy. J Magn Reson Imaging 2011; 34: spcone [PMID: 22025886]
46. Cassidy FH, Yokoo T, Aganovic L, Hanna RF, Bydder M, Middleton MS, Hamilton G, Chavez AD, Schwimmer JB, Sirlin CB. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis. Radiographics 2009; 29: 231-260 [PMID: 19168847 DOI: 10.1148/rg.291075123]
47. Kang BK, Yu ES, Lee SS, Lee Y, Kim N, Sirlin CB, Cho EY, Yeom SK, Byun JH, Park SH, Lee MG. Hepatic fat quantification: a prospective comparison of magnetic resonance spectroscopy and analysis methods for chemical-shift gradient echo magnetic resonance imaging with histologic assessment as the reference standard. Invest Radiol 2012; 47: 368-375 [PMID: 22543969 DOI: 10.1097/RLI.0b013e31824baff3]
48. Meisamy S, Hines CD, Hamilton G, Sirlin CB, McKenzie CA, Yu H, Brittain JH, Reeder SB. Quantification of hepatic steatosis with T1-independent, T2-corrected MR imaging with spectral modeling of fat: blinded comparison with MR spectroscopy. Radiology 2011; 258: 767-775 [PMID: 21248233 DOI: 10.1148/radiol.10100708]
49. Pineda N, Sharma P, Xu Q, Hu X, Vos M, Martin DR. Measurement of hepatic lipid: high-speed T2-corrected multiecho acquisition at 1H MR spectroscopy--a rapid and accurate technique. Radiology 2009; 252: 568-576 [PMID: 19546430 DOI: 10.1148/radiol.2523082084]
50. Yokoo T, Bydder M, Hamilton G, Middleton MS, Gamst AC, Wolfson T, Hassanein T, Patton HM, Lavine JE, Schwimmer JB, Sirlin CB. Nonalcoholic fatty liver disease: diagnostic and fat-grading accuracy of low-flip-angle multiecho gradient-recalled-echo MR imaging at 1.5 T. Radiology 2009; 251: 67-76 [PMID: 19221054 DOI: 10.1148/radiol.2511080666]
51. Yokoo T, Shiehmorteza M, Hamilton G, Wolfson T, Schroeder ME, Middleton MS, Bydder M, Gamst AC, Kono Y, Kuo A, Patton HM, Horgan S, Lavine JE, Schwimmer JB, Sirlin CB. Estimation of hepatic proton-density fat fraction by using MR imaging at 3.0 T. Radiology 2011; 258: 749-759 [PMID: 21212366 DOI: 10.1148/radiol.10100659]
52. Lee SS, Lee Y, Kim N, Kim SW, Byun JH, Park SH, Lee MG, Ha HK. Hepatic fat quantification using chemical shift MR imaging and MR spectroscopy in the presence of hepatic iron deposition: validation in phantoms and in patients with chronic liver disease. J Magn Reson Imaging 2011; 33: 1390-1398 [PMID: 21591008 DOI: 10.1002/jmri.22583]
53. Cotler SJ, Guzman G, Layden-Almer J, Mazzone T, Layden TJ, Zhou XJ. Measurement of liver fat content using selective saturation at 3.0 T. J Magn Reson Imaging 2007; 25: 743-748 [PMID: 17347995 DOI: 10.1002/jmri.20865]
54. Qayyum A, Goh JS, Kakar S, Yeh BM, Merriman RB, Coakley FV. Accuracy of liver fat quantification at MR imaging: comparison of out-of-phase gradient-echo and fat-saturated fast spin-echo techniques--initial experience. Radiology 2005; 237: 507-511 [PMID: 16244259 DOI: 10.1148/radiol. 2372040539]
55. Dixon WT. Simple proton spectroscopic imaging. Radiology 1984; 153: 189-194 [PMID: 6089263]
56. McPherson S, Jonsson JR, Cowin GJ, O'Rourke P, Clouston AD, Volp A, Horsfall L, Jothimani D, Fawcett J, Galloway GJ, Benson M, Powell EE. Magnetic resonance imaging and spectroscopy accurately estimate the severity of steatosis provided the stage of fibrosis is considered. J Hepatol 2009; 51: 389-397 [PMID: 19505740 DOI: 10.1016/ j.jhep.2009.04.012]
57. Westphalen AC, Qayyum A, Yeh BM, Merriman RB, Lee JA, Lamba A, Lu Y, Coakley FV. Liver fat: effect of hepatic iron deposition on evaluation with opposed-phase MR imaging. Radiology 2007; 242: 450-455 [PMID: 17255416 DOI: 10.1148/radiol.2422052024]
58. Guiu B, Petit JM, Loffroy R, Ben Salem D, Aho S, Masson D, Hillon P, Krause D, Cercueil JP. Quantification of liver fat content: comparison of triple-echo chemical shift gradientecho imaging and in vivo proton MR spectroscopy. Radiology 2009; 250: 95-102 [PMID: 19092092 DOI: 10.1148/radiol. 2493080217]
59. O'Regan DP, Callaghan MF, Wylezinska-Arridge M, Fitzpatrick J, Naoumova RP, Hajnal JV, Schmitz SA. Liver fat content and T2*: simultaneous measurement by using breath-hold multiecho MR imaging at 3.0 T--feasibility. Radiology 2008; 247: 550-557 [PMID: 18349314 DOI: 10.1148/radiol. 2472070880]
60. Hines CD, Yu H, Shimakawa A, McKenzie CA, Brittain JH, Reeder SB. T1 independent, T2* corrected MRI with accurate spectral modeling for quantification of fat: validation in a fat-water-SPIO phantom. J Magn Reson Imaging 2009; 30: 1215-1222 [PMID: 19856457 DOI: 10.1002/jmri.21957]
61. Reeder SB, Robson PM, Yu H, Shimakawa A, Hines CD, McKenzie CA, Brittain JH. Quantification of hepatic steatosis with MRI: the effects of accurate fat spectral modeling. J Magn Reson Imaging 2009; 29: 1332-1339 [PMID: 19472390 DOI: 10.1002/jmri.21751]
62. Yu H, Shimakawa A, McKenzie CA, Brodsky E, Brittain JH, Reeder SB. Multiecho water-fat separation and simultaneous R2* estimation with multifrequency fat spectrum modeling. Magn Reson Med 2008; 60: 1122-1134 [PMID: 18956464 DOI: 10.1002/mrm.21737]
63. Borra RJ, Salo S, Dean K, Lautamäki R, Nuutila P, Komu M, Parkkola R. Nonalcoholic fatty liver disease: rapid evaluation of liver fat content with in-phase and out-of-phase MR imaging. Radiology 2009; 250: 130-136 [PMID: 19017926 DOI: 10.1148/radiol.2501071934]
64. Tang A, Tan J, Sun M, Hamilton G, Bydder M, Wolfson T, Gamst AC, Middleton M, Brunt EM, Loomba R, Lavine JE, Schwimmer JB, Sirlin CB. Nonalcoholic fatty liver disease: MR imaging of liver proton density fat fraction to assess hepatic steatosis. Radiology 2013; 267: 422-431 [PMID: 23382291 DOI: 10.1148/radiol.12120896]
65. Kang GH, Cruite I, Shiehmorteza M, Wolfson T, Gamst AC, Hamilton G, Bydder M, Middleton MS, Sirlin CB. Reproducibility of MRI-determined proton density fat fraction across two different MR scanner platforms. J Magn Reson Imaging 2011; 34: 928-934 [PMID: 21769986 DOI: 10.1002/jmri.22701]
66. Urdzik J, Bjerner T, Wanders A, Weis J, Duraj F, Haglund U, Norén A. The value of pre-operative magnetic resonance spectroscopy in the assessment of steatohepatitis in patients with colorectal liver metastasis. J Hepatol 2012; 56: 640-646 [PMID: 22027576 DOI: 10.1016/j.jhep.2011.10.006]
67. Roldan-Valadez E, Favila R, Martínez-López M, Uribe M, Ríos C, Méndez-Sánchez N. In vivo 3T spectroscopic quantification of liver fat content in nonalcoholic fatty liver disease: Correlation with biochemical method and morphometry. J Hepatol 2010; 53: 732-737 [PMID: 20594607 DOI: 10.1016/ j.jhep.2010.04.018]
68. Raptis DA, Fischer MA, Graf R, Nanz D, Weber A, Moritz W, Tian Y, Oberkofler CE, Clavien PA. MRI: the new reference standard in quantifying hepatic steatosis? Gut 2012; 61: 117-127 [PMID: 21997548 DOI: 10.1136/gutjnl-2011-300155]
69. Wong VW, Chan RS, Wong GL, Cheung BH, Chu WC, Yeung DK, Chim AM, Lai JW, Li LS, Sea MM, Chan FK, Sung JJ, Woo J, Chan HL. Community-based lifestyle modification programme for non-alcoholic fatty liver disease: a randomized controlled trial. J Hepatol 2013; 59: 536-542 [PMID: 23623998 DOI: 10.1016/j.jhep.2013.04.013]
70. Ryan MC, Itsiopoulos C, Thodis T, Ward G, Trost N, Hofferberth S, O'Dea K, Desmond PV, Johnson NA, Wilson AM. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol 2013; 59: 138-143 [PMID: 23485520 DOI: 10.1016/j.jhep.2013.02.012]
71. Noureddin M, Lam J, Peterson MR, Middleton M, Hamilton G, Le TA, Bettencourt R, Changchien C, Brenner DA, Sirlin C, Loomba R. Utility of magnetic resonance imaging versus histology for quantifying changes in liver fat in nonalcoholic fatty liver disease trials. Hepatology 2013; 58: 1930-1940 [PMID: 23696515 DOI: 10.1002/hep.26455]
72. Le TA, Chen J, Changchien C, Peterson MR, Kono Y, Patton H, Cohen BL, Brenner D, Sirlin C, Loomba R. Effect of colesevelam on liver fat quantified by magnetic resonance in nonalcoholic steatohepatitis: a randomized controlled trial. Hepatology 2012; 56: 922-932 [PMID: 22431131 DOI: 10.1002/ hep.25731]
73. Machann J, Thamer C, Stefan N, Schwenzer NF, Kantartzis K, Häring HU, Claussen CD, Fritsche A, Schick F. Followup whole-body assessment of adipose tissue compartments during a lifestyle intervention in a large cohort at increased risk for type 2 diabetes. Radiology 2010; 257: 353-363 [PMID: 20713612 DOI: 10.1148/radiol.10092284]
74. Johnson NA, Sachinwalla T, Walton DW, Smith K, Armstrong A, Thompson MW, George J. Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology 2009; 50: 1105-1112 [PMID: 19637289 DOI: 10.1002/hep.23129]
75. Angulo P. Long-term mortality in nonalcoholic fatty liver disease: is liver histology of any prognostic significance? Hepatology 2010; 51: 373-375 [PMID: 20101746 DOI: 10.1002/ hep.23521]
76. Ochi H, Hirooka M, Koizumi Y, Miyake T, Tokumoto Y, Soga Y, Tada F, Abe M, Hiasa Y, Onji M. Real-time tissue elastography for evaluation of hepatic fibrosis and portal hypertension in nonalcoholic fatty liver diseases. Hepatology 2012; 56: 1271-1278 [PMID: 22488593 DOI: 10.1002/hep.25756]
77. Nobili V, Vizzutti F, Arena U, Abraldes JG, Marra F, Pietrobattista A, Fruhwirth R, Marcellini M, Pinzani M. Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis. Hepatology 2008; 48: 442-448 [PMID: 18563842 DOI: 10.1002/ hep.22376]
78. Orlacchio A, Bolacchi F, Antonicoli M, Coco I, Costanzo E, Tosti D, Francioso S, Angelico M, Simonetti G. Liver elasticity in NASH patients evaluated with real-time elastography (RTE). Ultrasound Med Biol 2012; 38: 537-544 [PMID: 22341049 DOI: 10.1016/j.ultrasmedbio.2011.12.023]
79. Wong VW, Vergniol J, Wong GL, Foucher J, Chan HL, Le Bail B, Choi PC, Kowo M, Chan AW, Merrouche W, Sung JJ, de Lédinghen V. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 2010; 51: 454-462 [PMID: 20101745 DOI: 10.1002/hep.23312]
80. Palmeri ML, Wang MH, Rouze NC, Abdelmalek MF, Guy CD, Moser B, Diehl AM, Nightingale KR. Noninvasive evaluation of hepatic fibrosis using acoustic radiation forcebased shear stiffness in patients with nonalcoholic fatty liver disease. J Hepatol 2011; 55: 666-672 [PMID: 21256907 DOI: 10.1016/j.jhep.2010.12.019]
81. Chen J, Talwalkar JA, Yin M, Glaser KJ, Sanderson SO, Ehman RL. Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology 2011; 259: 749-756 [PMID: 21460032 DOI: 10.1148/radiol.11101942]
82. 1H MR spectrum. NMR Biomed 2011; 24: 784-790 [PMID: 21834002 DOI: 10.1002/nbm.1622]