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Chinese medical journal

Non-invasive tests for early-stage liver fibrosis: current advances and challenges

This review systematically evaluates established and emerging non-invasive tests for detecting early-stage liver fibrosis (F1–F2), spanning serum biomarkers, molecular imaging probes, AI-based analysis of conventional imaging, alternative biofluids such as urine, exhaled breath and saliva, gut microbiota-derived biomarkers, and multiomics-integrated models, concluding that these approaches show diagnostic promise but remain constrained by limited validation, absent standardization, and unclear integration into clinical pathways, and proposing a tiered diagnostic framework as a near-term implementation route.