Fatty liver, also known as hepatic steatosis, is a condition in which excess fat accumulates in the liver cells. This condition commonly affects people of all ages and backgrounds. While a small amount of fat in the liver is normal, too much of it can cause inflammation and damage to the liver. Fatty liver can be caused by a variety of factors including obesity, diabetes, high cholesterol, and excessive alcohol consumption. In some cases, it can lead to highly serious liver diseases such as cirrhosis and liver cancer. With the rise in obesity and metabolic disorders, the fatty liver disease incidence has increased in recent years, becoming a clinically significant illness, owing to its rising incidence, improved knowledge of its pathophysiology, and rapid development of its associated therapeutics [3]. This article examines the imaging approaches for NAFLD screening, diagnosis, and risk stratification, with an emphasis on diagnostic accuracy, limits, and practical relevance [4].

Fatty liver disease is divided into two types: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD) [5]. AFLD is caused by an excessive alcohol consumption [6], [7], whereas NAFLD is associated with obesity, insulin resistance, and other metabolic disorders [8]. NAFLD is one of the most common liver diseases in the world, affecting millions of people globally. In NAFLD, the liver becomes enlarged and inflamed, leading to liver damage and sometimes liver failure [9]. This condition can progress silently for years, without any noticeable symptoms, until it has reached an advanced stage. Therefore, early detection and management are essential to prevent disease progression.

NAFLD is a persistent condition of the liver characterized by the presence of abnormal fat build up (>5% of the liver’s cross-sectional area) in the absence of any secondary cause for hepatic fat accumulation. These causes may include use of alcohol, steatogenic medication, and hereditary disorders. NAFLD is a significant health concern, as it can lead to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Diagnosing NAFLD often involves imaging techniques, such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). An early identification and management of NAFLD can help prevent its progression and associated complications [10]. Depending upon the research population and diagnostic criteria utilized, its global prevalence is estimated to range from 20% to 46%. NAFLD is thought to impact about 30% (100 million) of population in the United States [11]. Its frequency is significantly higher in those who are obese (70%) and diabetic (90%). By 2020, it is anticipated that NAFLD-related liver damage will predominate among causes of end-stage liver disease necessitating transplantation in the United States.

The disease is associated with obesity, type 2 diabetes, and high cholesterol levels [12], which are all quite common in today’s sedentary and unhealthy lifestyles [13]. Unhealthy diets, lack of physical activity, and increased stress levels contribute to the development of fatty liver disease [14], [15]. Additionally, fatty liver disease is associated with excessive alcohol consumption, which has become a common issue in modern societies. If left untreated, it can lead to severe liver damage, cirrhosis, and even liver cancer. Therefore, making lifestyle changes is crucial for preventing or managing fatty liver disease.

NAFLD, a global growing health concern has been associated with modern lifestyle habits such as a sedentary lifestyle, unhealthy diet, and excessive alcohol consumption [16]. The primary cause of fatty liver is the accumulation of fat in the liver cells, which can be caused by an unhealthy diet that is high in calories, unhealthy fats, and sugar. Sedentary lifestyle habits such as prolonged sitting and lack of physical activity also contributes to the development of fatty liver [17]. Excessive alcohol consumption is another leading cause of fatty liver as it can directly damage liver cells, leading to the accumulation of fat in the liver [18].

The symptoms of fatty liver are usually mild and can go unnoticed. However, in some cases, the disease can cause fatigue, abdominal pain, swelling, and jaundice. In extreme circumstances, it can cause liver damage and liver failure [19]. Type 2 diabetes, obesity, high blood pressure, and high cholesterol are all risk factors for fatty liver. All these prevalent health problems are linked to current lifestyle choices [20]. Fatty liver diagnosis can be done through blood tests [21], imaging studies such as ultrasound [22], CT scan, and MRI. The diagnosis is usually made when there is an abnormal accumulation of fat in the liver. It is crucial to get regular health check-ups to monitor the liver’s health, especially if you have any of the risk factors for fatty liver [23].

It is possible to prevent fatty liver disease by adopting a healthy lifestyle, which includes regular exercise, a balanced and healthy diet, limiting alcohol consumption, and maintaining healthy weight. Regular health check-ups and monitoring liver health can also help prevent fatty liver development [24].