{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:48:50Z","timestamp":1788281330212,"version":"build-2803163510"},"reference-count":73,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Obesity is associated with significant comorbidities, including non-alcoholic fatty liver disease (NAFLD). Given its potential to progress to advanced liver disease, monitoring the extent and progress of liver fibrosis and assessing its fibrosis stage are essential. Although liver biopsy is considered to be the gold standard for liver fibrosis staging, it is an invasive procedure with risk of complications. Considering the rising prevalence of obesity and NAFLD globally, developing non-invasive diagnostic methods is a priority. Transient elastography (TE) is increasingly being used to assess the severity of liver disease. However, in the presence of severe obesity, the increased thickness of subcutaneous adipose tissue and changes in anatomy may affect its diagnostic accuracy. Two-dimensional shear wave elastography (2D-SWE) assesses the liver stiffness in real time along with simultaneous anatomic B-mode ultrasound imaging and allows selection of the region of interest. This would suggest that 2D-SWE has several advantages over TE in patients with severe obesity. The purpose of this review is to examine the current literature addressing the use of 2D-SWE in the assessment of liver fibrosis in patients with NAFLD. This review also examines the evidence on the use of 2D-SWE in patients with obesity and NAFLD and compares it to TE as a novel and non-invasive method of assessing liver fibrosis.<\/jats:p>","DOI":"10.3390\/jcm10010095","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T19:55:25Z","timestamp":1609271725000},"page":"95","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["The Use of Two-Dimensional Shear Wave Elastography in People with Obesity for the Assessment of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1121-2829","authenticated-orcid":false,"given":"Ritesh","family":"Chimoriya","sequence":"first","affiliation":[{"name":"School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-1168","authenticated-orcid":false,"given":"Milan K","family":"Piya","sequence":"additional","affiliation":[{"name":"School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0560-0761","authenticated-orcid":false,"given":"David","family":"Simmons","sequence":"additional","affiliation":[{"name":"School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0026-1457","authenticated-orcid":false,"given":"Golo","family":"Ahlenstiel","sequence":"additional","affiliation":[{"name":"School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"Storr Liver Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Blacktown Hospital, Blacktown, NSW 2148, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3127-2933","authenticated-orcid":false,"given":"Vincent","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1478-7954-10-22","article-title":"National, regional, and global trends in adult overweight and obesity prevalences","volume":"10","author":"Stevens","year":"2012","journal-title":"Popul. Health Metr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1038\/ijo.2008.102","article-title":"Global burden of obesity in 2005 and projections to 2030","volume":"32","author":"Kelly","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.1007\/s11695-019-03889-2","article-title":"Measurement of Liver Stiffness with 2D-Shear Wave Elastography (2D-SWE) in Bariatric Surgery Candidates Reveals Acceptable Diagnostic Yield Compared to Liver Biopsy","volume":"29","author":"Jamialahmadi","year":"2019","journal-title":"Obes. Surg."},{"key":"ref_5","unstructured":"Australian Institute of Health and Welfare (2019). Overweight and Obesity: An Interactive Insight. Cat. no. PHE 251."},{"key":"ref_6","unstructured":"Hales, C., Carroll, M., Fryar, C., and Ogden, C. (2020). Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017\u20132018. NCHS Data Brief, No 360."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/S0140-6736(09)60318-4","article-title":"Body-mass index and cause-specific mortality in 900,000 adults: Collaborative analyses of 57 prospective studies","volume":"373","author":"Whitlock","year":"2009","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Honda, Y., Yoneda, M., Imajo, K., and Nakajima, A. (2020). Elastography Techniques for the Assessment of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21114039"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"9330","DOI":"10.3748\/wjg.v20.i28.9330","article-title":"Non-alcoholic fatty liver disease and obesity: Biochemical, metabolic and clinical presentations","volume":"20","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"112","DOI":"10.7326\/0003-4819-132-2-200001180-00004","article-title":"Prevalence of and Risk Factors for Hepatic Steatosis in Northern Italy","volume":"132","author":"Bellentani","year":"2000","journal-title":"Ann. Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cld.2013.09.019","article-title":"Obesity and liver disease: The epidemic of the twenty-first century","volume":"18","author":"Corey","year":"2014","journal-title":"Clin. Liver Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.jhep.2018.10.033","article-title":"Non-alcoholic fatty liver disease\u2014A global public health perspective","volume":"70","author":"Younossi","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1053\/j.gastro.2010.09.038","article-title":"Prevalence of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Among a Largely Middle-Aged Population Utilizing Ultrasound and Liver Biopsy: A Prospective Study","volume":"140","author":"Williams","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"357","DOI":"10.2147\/DMSO.S182331","article-title":"Ethnic differences and heterogeneity in genetic and metabolic makeup contributing to nonalcoholic fatty liver disease","volume":"12","author":"Szanto","year":"2019","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease","volume":"158","author":"Eslam","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"16452","DOI":"10.3748\/wjg.v20.i44.16452","article-title":"Obesity, fatty liver disease and intestinal microbiota","volume":"20","author":"Arslan","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"G697","DOI":"10.1152\/ajpgi.00426.2010","article-title":"Obesity, diabetes mellitus, and liver fibrosis","volume":"300","author":"Chiang","year":"2011","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.trsl.2014.06.008","article-title":"Obesity and the liver: Nonalcoholic fatty liver disease","volume":"164","author":"Koppe","year":"2014","journal-title":"Transl. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1053\/jhep.2003.50161","article-title":"Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome","volume":"37","author":"Marchesini","year":"2003","journal-title":"Hepatology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1002\/hep.21327","article-title":"Long-term follow-up of patients with NAFLD and elevated liver enzymes","volume":"44","author":"Ekstedt","year":"2006","journal-title":"Hepatology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.cgh.2012.10.001","article-title":"Association Between Nonalcoholic Fatty Liver Disease and Risk for Hepatocellular Cancer, Based on Systematic Review","volume":"10","author":"White","year":"2012","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jhep.2005.12.008","article-title":"How to assess liver fibrosis and for what purpose?","volume":"44","author":"Beaugrand","year":"2006","journal-title":"J. Hepatol."},{"key":"ref_23","first-page":"107","article-title":"The clinical utility of FibroScan\u00ae as a noninvasive diagnostic test for liver disease","volume":"7","author":"Wilder","year":"2014","journal-title":"Med. Devices (Auckl.)"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1111\/apt.13711","article-title":"Liver stiffness measurement reliability and main determinants of point shear-wave elastography in patients with chronic liver disease","volume":"44","author":"Fraquelli","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1038\/nrgastro.2016.86","article-title":"Critical comparison of elastography methods to assess chronic liver disease","volume":"13","author":"Poynard","year":"2016","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1007\/s00330-014-3140-y","article-title":"Ultrasound point shear wave elastography assessment of liver and spleen stiffness: Effect of training on repeatability of measurements","volume":"24","author":"Ferraioli","year":"2014","journal-title":"Eur. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.jhep.2014.09.020","article-title":"Investigating liver stiffness and viscosity for fibrosis, steatosis and activity staging using shear wave elastography","volume":"62","author":"Deffieux","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tian\u2019an, J., Guo, T., Qiyu, Z., Dexing, K., Chao, C., Liyun, Z., and Lanjuan, L. (2016). Diagnostic Accuracy of 2D-Shear Wave Elastography for Liver Fibrosis Severity: A Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157219"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"W267","DOI":"10.2214\/AJR.13.11718","article-title":"A pilot study estimating liver fibrosis with ultrasound shear-wave elastography: Does the cause of liver disease or location of measurement affect performance?","volume":"203","author":"Beland","year":"2014","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2614","DOI":"10.1111\/j.1572-0241.2002.06038.x","article-title":"Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection","volume":"97","author":"Arie","year":"2002","journal-title":"Am. J. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/hep.510240201","article-title":"An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group","volume":"24","author":"Bedossa","year":"1996","journal-title":"Hepatology"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Brunt, E. (2016). Nonalcoholic Fatty Liver Disease: Pros and Cons of Histologic Systems of Evaluation. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17010097"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"11077","DOI":"10.3748\/wjg.v21.i39.11077","article-title":"Liver fibrosis in non-alcoholic fatty liver disease-diagnostic challenge with prognostic significance","volume":"21","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/hep.21496","article-title":"The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD","volume":"45","author":"Angulo","year":"2007","journal-title":"Hepatology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1002\/hep.24452","article-title":"Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: A meta-analysis","volume":"54","author":"Hernaez","year":"2011","journal-title":"Hepatology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"236","DOI":"10.35248\/2167-0889.19.8.236","article-title":"Liver Fibrosis Conventional and Molecular Imaging Diagnosis Update","volume":"8","author":"Li","year":"2019","journal-title":"J. Liver"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"W20","DOI":"10.2214\/AJR.19.21267","article-title":"Comparison of 2D Shear Wave Elastography, Transient Elastography, and MR Elastography for the Diagnosis of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease","volume":"214","author":"Furlan","year":"2019","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1148\/radiol.14140828","article-title":"Two-dimensional shear-wave elastography and conventional US: The optimal evaluation of liver fibrosis and cirrhosis","volume":"275","author":"Zheng","year":"2015","journal-title":"Radiology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4254\/wjh.v9.i1.38","article-title":"Ultrasound shear wave elastography and liver fibrosis: A Prospective Multicenter Study","volume":"9","author":"Sande","year":"2017","journal-title":"World J. Hepatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1055\/s-0033-1335375","article-title":"EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications","volume":"34","author":"Cosgrove","year":"2013","journal-title":"Ultraschall Med"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Mancini, M., Salomone Megna, A., Ragucci, M., De Luca, M., Marino Marsilia, G., Nardone, G., Coccoli, P., Prinster, A., Mannelli, L., and Vergara, E. (2017). Reproducibility of shear wave elastography (SWE) in patients with chronic liver disease. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0185391"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.diii.2015.11.001","article-title":"Shear wave elastography: An accurate technique to stage liver fibrosis in chronic liver diseases","volume":"97","author":"Guibal","year":"2016","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e325","DOI":"10.1016\/j.ejrad.2011.10.029","article-title":"Acoustic radiation force impulse-imaging and transient elastography for non-invasive assessment of liver fibrosis and steatosis in NAFLD","volume":"81","author":"Romen","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/hep.23312","article-title":"Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease","volume":"51","author":"Wong","year":"2010","journal-title":"Hepatology"},{"key":"ref_45","first-page":"828","article-title":"Pitfalls of liver stiffness measurement: A 5-year prospective study of 13,369 examinations","volume":"51","author":"Foucher","year":"2010","journal-title":"Hepatology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1097\/00042737-200604000-00015","article-title":"Prevalence and factors associated with failure of liver stiffness measurement using FibroScan in a prospective study of 2114 examinations","volume":"18","author":"Foucher","year":"2006","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.dld.2009.04.002","article-title":"Transient elastography for the assessment of liver fibrosis in patients with chronic viral hepatitis: The missing tool?","volume":"41","author":"Stasi","year":"2009","journal-title":"Dig. Liver Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1002\/hep.24624","article-title":"Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients","volume":"55","author":"Myers","year":"2012","journal-title":"Hepatology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.diii.2013.02.005","article-title":"Ultrasound elastography in liver","volume":"94","author":"Frulio","year":"2013","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1148\/radiol.14140839","article-title":"Shear-wave elastography for the estimation of liver fibrosis in chronic liver disease: Determining accuracy and ideal site for measurement","volume":"274","author":"Samir","year":"2015","journal-title":"Radiology"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1002\/hep.25936","article-title":"Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study","volume":"56","author":"Ferraioli","year":"2012","journal-title":"Hepatology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"281","DOI":"10.15557\/JoU.2016.0028","article-title":"Shear wave elastography with a new reliability indicator","volume":"16","author":"Dietrich","year":"2016","journal-title":"J. Ultrason."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1055\/s-0033-1335205","article-title":"EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology","volume":"34","author":"Bamber","year":"2013","journal-title":"Ultraschall Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.7150\/thno.18650","article-title":"Ultrasound Elastography: Review of Techniques and Clinical Applications","volume":"7","author":"Sigrist","year":"2017","journal-title":"Theranostics"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1002\/jum.14217","article-title":"Challenges and Considerations When Using Shear Wave Elastography to Evaluate the Transplanted Kidney, With Pictorial Review","volume":"36","author":"Early","year":"2017","journal-title":"J. Ultrasound Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.diii.2013.01.022","article-title":"Ultrasound elastography: Principles and techniques","volume":"94","author":"Gennisson","year":"2013","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1109\/TUFFC.2004.1295425","article-title":"Supersonic shear imaging: A new technique for soft tissue elasticity mapping","volume":"51","author":"Bercoff","year":"2004","journal-title":"IEEE Trans. Ultrason. Ferroelectr. Freq. Control"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s00261-018-1475-6","article-title":"Principles of ultrasound elastography","volume":"43","author":"Ozturk","year":"2018","journal-title":"Abdom. Radiol."},{"key":"ref_59","unstructured":"Koninklijke Philips N.V. (2019). ElastQ Imaging-Liver Elastography Overview. EPIQ Elite Release 4.0, Koninklijke Philips N.V."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12880-020-0414-5","article-title":"Accuracy of real-time shear wave elastography in staging hepatic fibrosis: A meta-analysis","volume":"20","author":"Fu","year":"2020","journal-title":"BMC Med. Imaging"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s10396-017-0840-3","article-title":"Liver fibrosis: Noninvasive assessment using supersonic shear imaging and FIB4 index in patients with non-alcoholic fatty liver disease","volume":"45","author":"Takeuchi","year":"2018","journal-title":"J. Med. Ultrason."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1002\/hep.29179","article-title":"Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis","volume":"67","author":"Herrmann","year":"2018","journal-title":"Hepatology"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1097\/MEG.0000000000000686","article-title":"Reliability and applicability of two-dimensional shear-wave elastography for the evaluation of liver stiffness","volume":"28","author":"Varbobitis","year":"2016","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Lupsor Platon, M. (2018). Noninvasive Evaluation of Fibrosis and Steatosis in Nonalcoholic Fatty Liver Disease by Elastographic Methods. Non-Alcoholic Fatty Liver Disease\u2014Molecular Bases, Prevention and Treatment, IntechOpen.","DOI":"10.5772\/intechopen.71161"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Poynard, T., Pham, T., Perazzo, H., Munteanu, M., Luckina, E., Elaribi, D., Ngo, Y., Bonyhay, L., Seurat, N., and Legroux, M. (2016). Real-Time Shear Wave versus Transient Elastography for Predicting Fibrosis: Applicability, and Impact of Inflammation and Steatosis. A Non-Invasive Comparison. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0163276"},{"key":"ref_66","unstructured":"Lee, D.H., Cho, E.J., Bae, J.S., Lee, J.Y., Yu, S.J., Kim, H., Lee, K.B., Han, J.K., and Choi, B.I. (2020). Accuracy of Two-Dimensional Shear Wave Elastography and Attenuation Imaging for Evaluation of Patients With Nonalcoholic Steatohepatitis. Clin. Gastroenterol. Hepatol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1148\/radiol.2020192665","article-title":"The Role of Multiparametric US of the Liver for the Evaluation of Nonalcoholic Steatohepatitis","volume":"296","author":"Sugimoto","year":"2020","journal-title":"Radiology"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO) (2016). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J. Hepatol., 64, 1388\u20131402.","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1002\/hep.28394","article-title":"Liver stiffness in nonalcoholic fatty liver disease: A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy","volume":"63","author":"Cassinotto","year":"2016","journal-title":"Hepatology"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Cassinotto, C., Boursier, J., Paisant, A., Guiu, B., Irles-Depe, M., Canivet, C., Aube, C., and de Ledinghen, V. (2020). Transient Versus 2-Dimensional Shear-Wave Elastography in a Multistep Strategy to Detect Advanced Fibrosis in NAFLD. Hepatology.","DOI":"10.1002\/hep.31655"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1053\/j.gastro.2015.11.048","article-title":"Magnetic Resonance Imaging More Accurately Classifies Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease Than Transient Elastography","volume":"150","author":"Imajo","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/apt.13710","article-title":"Liver stiffness measurement using acoustic radiation force impulse elastography in overweight and obese patients","volume":"44","author":"Attia","year":"2016","journal-title":"Aliment. Pharmacol. Ther."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/1\/95\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:47:40Z","timestamp":1760179660000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/1\/95"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,29]]},"references-count":73,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1]]}},"alternative-id":["jcm10010095"],"URL":"https:\/\/doi.org\/10.3390\/jcm10010095","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,29]]}}}