Non-invasive diagnosis and monitoring of liver fibrosis and cirrhosis

The accurate staging of liver fibrosis in chronic liver diseases, especially the early diagnosis of liver cirrhosis, is crucial for prognostic assessment of the course of the disease. The histological evaluation of a liver biopsy cylinder is still the gold standard in assessing the stage of liver fibrosis. However, liver biopsy is an invasive procedure and carries the risk of complications. This has to be balanced against the information benefit of liver histology. To overcome this, non-invasive tests were developed assessing liver fibrosis based on combinations of laboratory markers or techniques measuring liver elasticity. In this review the current impact of the non invasive methods is discussed and weighted against liver biopsy. (C) 2009 Elsevier Ltd. All rights reserved.