THE ROLE OF RADIOLOGICAL IMAGING IN PREVENTING THE PROGRESSION OF CHRONIC HEPATITIS TO LIVER CIRRHOSIS

Abstract

Abstract: Chronic viral hepatitis caused by hepatitis B virus (HBV) and hepatitis C virus (HCV) remains one of the most significant global health challenges, with an estimated 296 million and 58 million people affected, respectively. Without timely diagnosis and intervention, a substantial proportion of these patients progress to liver fibrosis and ultimately to cirrhosis, a state associated with major morbidity, portal hypertension, and hepatocellular carcinoma. Liver biopsy has historically served as the reference standard for fibrosis staging; however, its invasiveness, sampling error, and patient discomfort have driven the development of noninvasive imaging alternatives. This narrative review examines the established and emerging roles of ultrasonography, transient elastography (FibroScan), shear wave elastography, magnetic resonance elastography (MRE), diffusion-weighted magnetic resonance imaging (DW-MRI), and computed tomography (CT) in the early detection and staging of liver fibrosis in patients with chronic hepatitis. Evidence from the reviewed literature consistently demonstrates that imaging-based modalities can accurately identify significant fibrosis and cirrhosis, enabling timely therapeutic decisions that may halt or reverse disease progression. In particular, MRE exhibits area under the receiver-operating characteristic curve (AUC) values of up to 0.92 for advanced fibrosis, while DW-MRI achieves sensitivity of 88% and specificity of 81% for cirrhosis. Integration of these modalities into routine surveillance protocols offers a clinically practical pathway to prevent cirrhosis-related complications.