What is Fibroscan?
Similar to an ultrasound used during pregnancy, Fibroscan is a specialised ultrasound machine that measuressteatosis (fatty change) and fibrosis (scarring) in your liver. It can be used on its own or along with other tests such as imagine scans or blood tests that also helps measure the scarring or fatty changes in your liver.
Fibroscan helps specialists to learn more about your liver, and give a more complete assessment of your liver health.
How is the scan done?
It is a non-invasive, painless and quick procedure that involves a probe being placed on your abdominal wall. The probe will emit a vibration wave in pulses, and 10 reading will be taken minimally to ensure an accurate result. It should take approximately 5 to 10 minutes to perform and you can resume your normal activities afterwards. To prepare for the scan, you will be advised not to consume any food or drink for two hours before the procedure.
Your Fibroscan result
On your next appointment, your gastroenterology specialist will talk to you about your results. Fibroscan calculates the median liver stiffness measurement (LSM) reading and measures the amount of scarring in your liver, giving you your fibrosis result.
The result is measured in kilopascals (kPa) and it is typically between 2 to 6 kPa. A normal liver should also result in a low median LSM. For those with liver disease(s), they can have a result that is higher than the normal range.
Fibrosis score ranges from F0 to F4.
F0 to F1: No liver scarring or mild liver scarring
F2: Liver scarring is moderate
F3: Liver scarring is severe
F4: Liver scarring is more advanced (cirrhosis)
What type of liver diseases can Fibroscan help with?
Because it is principally used to estimate the degree of liver scarring present, the scan is useful to assess patients with the following conditions:
- Non-alcoholic fatty liver disease
- Alcoholic liver disease
- Viral hepatitis B and C
- Hepatitis C and HIV co-infection
- Other liver diseases
The liver stiffness reading can also be used to monitor disease progression or regression through a series of measurements, as well as provide prognosis and further management including treatment.
Pitfalls of Fibroscan
There may also be incidences of false elevations such as an over-estimated fibrosis results due to several reasons. As such, liver stiffness readings require careful interpretations with considerations to the following potential factors.
Possible reasons for an over-estimation of fibrosis
- Benign or cancerous tumours in the liver
- Liver inflammation (caused by a recent liver illness or alcohol consumption)
- Liver congestion, typically caused by heart failure
Inaccurate or unreliable readings can also be commonly seen in patients with:
- Obesity – a body mass index (BMI) higher than 30 – 35
- Presence of build-up of fluid in the abdomen, known as ascites
- Biliary obstruction – too little bile flowing out of the liver
- Features of metabolic syndrome (hypertension, type 2 diabetes, increased waist circumference)
Regardless, the interpretation of the Fibroscan results is best performed by a gastroenterology specialist who is experienced in managing chronic liver diseases and in conjunction with other tests.