An expert's guide to Fibroscan

Fibroscan is a modern technology used to evaluate liver health. In his latest article, renowned consultant gastroenterologist and hepatologist Professor Aftab Ala explains this new technology in detail. He explains the conditions it can detect, how it works and its advantages over a biopsy.

What diseases or conditions can Fibroscan detect?

Fibroscan technology is a key modern technology development in evaluating liver health, providing enormous benefits to patients as in many cases there are no signs or symptoms of moderate or severe liver disease. 

The following categories of patients may benefit from Fibroscan:
People with potential recognised risk factors for liver disease, such as a history of heavy alcohol intake or the presence of diabetes and/ or overweight/obesity
People who have evidence of a liver condition where there is a need to work out the severity, including:

• Non-alcoholic fatty liver disease
• Alcohol-related liver disease
• Abnormal liver tests of unknown cause
• Autoimmune liver disease and bile duct conditions such as primary biliary cholangitis, primary sclerosing cholangitis 
• Iron excess e.g., haemochromatosis 
• Monitoring the liver in patients taking medication which may potentially cause liver damage (e.g., methotrexate)

How does Fibroscan work?

Fibroscan specifically uses ultrasound to measure the speed of a vibration (shear wave) passing through the liver. That is, the faster that the wave passes through the liver, the stiffer the liver. The liver stiffness correlates with the degree of liver damage or "fibrosis". 

A Fibroscan is a rapid, painless, bedside procedure lasting approximately 15-20 minutes. It is carried out as an outpatient procedure with patients going home the same day. The liver scan will highlight any potential liver damage or disease, ending any unwarranted concern lifestyle may potentially impact on health.

What is a normal Fibroscan score?

A Fibroscan score is recorded as a numerical value. The stiffer the liver the higher the numerical value will be. The stiffness of the liver is an indicator that can be associated with a variety of causes. To ensure it is an effective result at least ten valid records must be taken.

A Fibroscan score is a numerical result between 2-75. A normal Fibroscan range is approximately between 2-7 with an average result being around 5. Scarring of the liver is measured by four stages:

• F0=no scarring
• F1=mild scarring
• F2=moderate fibrosis
• F3=severe fibrosis
• F4=advanced fibrosis or cirrhosis.

Your specialist will inform you of the result instantly and discuss the implications of the results 

What advantages does Fibroscan have over a liver biopsy?

A Fibroscan is a non-invasive, quick and painless bedside test to measure the elasticity of liver tissue (or liver scarring), referred to as fibrosis. Therefore, it’s an ideal tool to assess liver damage, performed at the time of a consultation with instant results. Moreover, due to its non-invasive assessment, it can be performed repeatedly to evaluate changes in the liver over time, be it liver fat or liver scarring.

How accurate is Fibroscan?

Fibroscan technology ensures accurate assessment of fatty liver and liver scarring from multiple causes that can damage the liver including excess alcohol, viral hepatitis, non-alcoholic/metabolic fatty liver disease and iron overload. 

Professor Ala Aftab is a leading gastroenterologist and hepatologist in Guildford & Farnham. If you would like to book a consultation with Professor Ala you can do so today via his Top Doctors profile.