Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis/cirrhosis and liver-related mortality. Despite emergence of noninvasive tests, liver biopsy remains the mainstay for the diagnosis and assessment of disease severity and chronicity. Accurate...

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Autores principales:	Gwyneth Shook Ting Soon, Aileen Wee
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	liver biopsy liver fibrosis nonalcoholic fatty liver disease quantification Pathology RB1-214 Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/86e35ff04b0b4afda29654ecb13f3e75
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spelling	oai:doaj.org-article:86e35ff04b0b4afda29654ecb13f3e752021-12-02T17:28:22ZLiver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease0377-492910.4103/IJPM.IJPM_947_20https://doaj.org/article/86e35ff04b0b4afda29654ecb13f3e752021-01-01T00:00:00Zhttp://www.ijpmonline.org/article.asp?issn=0377-4929;year=2021;volume=64;issue=5;spage=104;epage=111;aulast=Tinghttps://doaj.org/toc/0377-4929Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis/cirrhosis and liver-related mortality. Despite emergence of noninvasive tests, liver biopsy remains the mainstay for the diagnosis and assessment of disease severity and chronicity. Accurate detection and quantification of liver fibrosis with architectural localization are essential for assessing the severity of NAFLD and its response to antifibrotic therapy in clinical trials. Conventional histological scoring systems for liver fibrosis are semiquantitative. Collagen proportionate area is morphometric by measuring the percentage of fibrosis on a continuous scale but is limited by the absence of architectural input. Ultra-fast laser microscopy, e.g., second harmonic generation (SHG) imaging, has enabled in-depth analysis of fibrillary collagen based on intrinsic optical signals. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g. qFibrosis, q-FPs) in NAFLD. Artificial intelligence is being explored to further develop quantitative fibrosis scoring methods. SHG microscopy should be considered the new gold standard for the quantitative assessment of liver fibrosis, reaffirming the pivotal role of the liver biopsy in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials. The current decrease by 1-point or more in fibrosis stage may not be realistic for the evaluation of therapeutic response to antifibrotic drugs in relatively short-term trials.Gwyneth Shook Ting SoonAileen WeeWolters Kluwer Medknow Publicationsarticleliver biopsyliver fibrosisnonalcoholic fatty liver diseasequantificationPathologyRB1-214MicrobiologyQR1-502ENIndian Journal of Pathology and Microbiology, Vol 64, Iss 5, Pp 104-111 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	liver biopsy liver fibrosis nonalcoholic fatty liver disease quantification Pathology RB1-214 Microbiology QR1-502
spellingShingle	liver biopsy liver fibrosis nonalcoholic fatty liver disease quantification Pathology RB1-214 Microbiology QR1-502 Gwyneth Shook Ting Soon Aileen Wee Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease
description	Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis/cirrhosis and liver-related mortality. Despite emergence of noninvasive tests, liver biopsy remains the mainstay for the diagnosis and assessment of disease severity and chronicity. Accurate detection and quantification of liver fibrosis with architectural localization are essential for assessing the severity of NAFLD and its response to antifibrotic therapy in clinical trials. Conventional histological scoring systems for liver fibrosis are semiquantitative. Collagen proportionate area is morphometric by measuring the percentage of fibrosis on a continuous scale but is limited by the absence of architectural input. Ultra-fast laser microscopy, e.g., second harmonic generation (SHG) imaging, has enabled in-depth analysis of fibrillary collagen based on intrinsic optical signals. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g. qFibrosis, q-FPs) in NAFLD. Artificial intelligence is being explored to further develop quantitative fibrosis scoring methods. SHG microscopy should be considered the new gold standard for the quantitative assessment of liver fibrosis, reaffirming the pivotal role of the liver biopsy in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials. The current decrease by 1-point or more in fibrosis stage may not be realistic for the evaluation of therapeutic response to antifibrotic drugs in relatively short-term trials.
format	article
author	Gwyneth Shook Ting Soon Aileen Wee
author_facet	Gwyneth Shook Ting Soon Aileen Wee
author_sort	Gwyneth Shook Ting Soon
title	Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease
title_short	Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease
title_full	Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease
title_fullStr	Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease
title_full_unstemmed	Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease
title_sort	liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/86e35ff04b0b4afda29654ecb13f3e75
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Liver biopsy in the quantitative assessment of liver fibrosis in nonalcoholic fatty liver disease

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