Fibroscan: assess your liver

Your liver cleans your blood, assists your digestive system by producing bile and it helps your body store carbohydrates. Therefore, it's vital to make sure it's healthy and functioning as it should and one very safe and easy way to do this is with a FibroScan. Professor Aftab Ala, an expert in liver problems, explains all about this liver test.

What is a FibroScan?

FibroScan (or hepatic elastography) is a device that uses sound waves (ultrasound) to measure the hardness and elasticity of the liver and, depending on its state (the hardness and elasticity), enables the diagnosis of diseases such as scarring (fibrosis), fatty liver (steatosis) and liver cirrhosis. This technique is painless, avoids the need to perform a guided and invasive liver biopsy, which may be associated with side effects (such as pain and bleeding).

Who needs a FibroScan examination?

FibroScan may be suitable for you if you have:

• risk factors for fatty liver, such as type 2 diabetes or a raised body mass index
• a family history of liver disease
• relatively high consumption of alcohol
• hepatitis e.g. hepatitis B, C, autoimmune liver disease
• a history of medications (such as methotrexate, some chemotherapy agents) with the potential of liver injury

It can also form part of a general health check-up, to assess your risk of long-term illnesses such as diabetes and cardiovascular disease.

The test is not suitable if

• you are or might be pregnant
• you have implanted medical devices.

FibroScan can detect disease, but it can also be a useful preventative tool. If the doctor detects a risk of developing liver disease in the future, they can advise you on what lifestyle changes or medical treatments to make to reduce your risk.

What to expect

Make sure you don’t eat or drink anything at least three hours before the procedure. On the day, you should only drink clear fluids.

FibroScan is not painful and is free of complications. The test does not require admission nor does it have any abrasive or invasive side effects. You will lie on your back, with your right arm raised above your head. The doctor will apply a water-based gel to the skin and place the probe gently. The test should take around 5-10 minutes.

How the procedure works and what results mean

The technique consists of sending a mechanical pulse, which initiates an ultrasound wave that is transmitted by the liver. The heavier the liver tissue, the faster the wave diffuses and, therefore, tissue damage is greater. The result is expressed in kilopascals (kPa) and you'll be able to get your results immediately.

There are four possible phases of patient status:

1. If the value is less than 6-7 kPa, there is a low risk of progression of fibrosis and it is advised not to start treatment.

2. Between the values of 7 and 9.4 kPa, moderate fibrosis is indicated. It is advisable to test with FibroScan periodically, in order to evaluate the progression and the need for treatment.

3. If the margin is between 9.5 and 12 kPa, fibrosis is in an advanced state and medical treatment is necessary or advisable.

4. If the result exceeds 12-14 kPa, it means that fibrosis is severe and there is a high risk of cirrhosis, and future risk of liver cancer, so treatment is of an urgent nature.

Don't hesitate to check the health of your liver, particularly if you have any reason to be concerned. Book a consultation with Professor Aftab Ala via his profile.