Non-biopsy methods to determine hepatic fibrosis.

The prognosis and clinical management of chronic liver diseases are highly dependent on the extent of liver fibrosis. Bigger the fibrosis, worse the prognosis; and bigger the risk of progression to cirrhosis. In current practice, liver biopsy is most frequently performed to assess the grade of inflammation and stage of fibrosis thereby providing prognostic information on which to base treatment decisions upon. Liver biopsy is becoming more and more useless in the management of chronic liver disease due to large sampling error, consistent inter-observer disagreement, high emotional cost of patient, enormous health care commitment in case of rare but possible severe complications, the fact that it is a snapshot of a process that is everything but a frozen one. Therefore, every methodology that avoids performing this invasive procedure is welcome. The purpose of this article is to present the noninvasive evaluation of patients with chronic liver disease as an alternative of liver biopsy in the assessment of hepatic structure and function.