An expert's guide to Fibroscan

Written by: PROFESSOR AFTAB ALA

 

Fibroscan is a modern bedside technology used to accurately evaluate liver health. Internationally recognised consultant gastroenterologist and hepatologist Professor Aftab Ala explains this new technology. He explains the conditions it can detect, how it works and its advantages over a standard liver biopsy.

A Fibroscan is a non-invasive, quick and painless bedside test to measure the elasticity of liver tissue, referred to as fibrosis or cirrhosis. It’s an ideal tool to assess liver damage without the need for an invasive liver biopsy. It is able to detect liver damage before symptoms develop providing an opportunity to identify damage before it becomes irreversible.

It can be performed repeatedly to evaluate changes in the liver over time, be it liver fat or liver scarring.

 

Which patients may benefit from a Fibroscan?

People with potential recognised risk factors for liver disease including :

• Heavy alcohol intake

• Type 2 diabetes

• 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 or Metabolic associated fatty liver disease (MAFLD)

• 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 uses an ultrasound probe 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". During the examination there is a very slight vibration on the skin at the tip of the probe.

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.

 

What is a normal Fibroscan score?

A Fibroscan score is recorded as a numerical value 2-75. The stiffer the liver the higher the numerical value will be. 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.

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Look At Your Liver Health Assessment