Recommendation ID

Non-invasive tests for diagnosing NAFLD in adults:- Which non-invasive tests are most accurate and cost-effective in identifying non-alcoholic fatty liver disease (NAFLD) in adults with risk factors, type 2 diabetes and metabolic syndrome?

Any explanatory notes
(if applicable)

Why this is important:- Non-alcoholic fatty liver disease (NAFLD) is present in over 50% of adults with type 2 diabetes mellitus or metabolic syndrome. Untreated it can progress to fibrosis, cirrhosis and hepatocellular cancer. In most patients NAFLD is asymptomatic and is only detected incidentally when liver blood tests or abdominal ultrasound are performed for some other reason. Even then, more than 80% of patients with NAFLD have normal routine liver blood tests. There is an urgent need for a simple, accessible, cost-effective, non-invasive test capable of case-finding NAFLD in the huge numbers of people at risk.
The 'gold standard' for diagnosis is liver biopsy. It is not feasible to perform liver biopsy in large numbers of at risk patients, so magnetic resonance based techniques are increasingly used as the comparison in studies assessing non-invasive tests for NAFLD. These demonstrate high diagnostic accuracy but are impractical or too expensive for large scale case finding.

Source guidance details

Comes from guidance
Non-alcoholic fatty liver disease (NAFLD): assessment and management
Date issued
July 2016

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/07/2016