Non-invasive tests for evaluation of the severity and prognosis of liver diseases

Liver fibrosis is part of the structural and functional alterations in chronic liver diseases, and it is the most important prognostic factor of the risk of developing cirrhosis, liver-related complications and mortality. Although liver biopsy has traditionally been considered as the (gold standard) reference method for evaluation of fibrosis, owing to its invasiveness, sampling variability, and the static nature of information it yields, non-invasive fibrosis markers became alternatives for assessment of the severity and outcome of liver diseases during the last two decades. Serum biochemical tests, elastographies and imaging methods are available for the diagnosis and staging of fibrosis. The present paper reviews the advantages and disadvantages of these tests in hepatopathy of different etiologies, and in compensated advanced chronic liver disease, on the ground of clinical experiences and the newest international guidelines.