A FibroScan® test is a quick (15-30- minute), painless, non-invasive examination of liver health, and provides a painless and reliable alternative to liver biopsy. The test measures liver health by measuring liver fibrosis or scar tissue in the liver, and additionally measures the amount of fat in the liver using the new Controlled Attenuation Parameter (CAP) assessment. Liver Wellness® is the first clinic in the private sector to offer the test to patients with the FibroScan® 530 device.
FibroScan® uses shear wave technology to measure the elasticity of the liver using a technique called Vibration-Controlled Transient Elastography (VCTE™). As the shear wave is propagated through the liver, the speed at which it travels is affected by the amount of scar tissue (fibrosis), and this is calibrated to give a liver stiffness value. Results are presented as a number in kilopascals (kPa). The higher the figure, the stiffer and more scarred the liver has become. In general, FibroScan®results of 12 kPa and higher raise concern that the liver has developed cirrhosis. Results from FibroScan® should not be confused with fibrosis scores measured on other scoring systems such as liver biopsies.
What is liver fibrosis
Liver fibrosis is a condition of scarring and stiffness of the liver and is caused by a variety of inflammatory and metabolic conditions. Liver fibrosis does not develop or progress at the same rate in everyone and some people are “fast fibrosers” meaning that cirrhosis may develop over 10-15 years while others are “slow fibrosers” meaning that cirrhosis may develop over 25-30 years. The most serious stage of fibrosis or scarring is cirrhosis, which means irreversible scarring of the liver. Causes of cirrhosis include hepatitis B and C, alcohol excess, iron overload (haemochromatosis), fatty liver disease and chronic exposure to some medications and toxins. Patients with cirrhosis are often well without any symptoms of disease (compensated cirrhosis), but over time, the liver may begin to fail, developing signs of liver failure such as intermittent confusion, swelling of the abdomen with fluid (ascites) – this is called decompensated cirrhosis. Patients with liver failure may need a liver transplant. Patients with cirrhosis also have a risk of developing liver cancer known as hepatocellular carcinoma.
Blood tests and clinical examination cannot reliably diagnose liver cirrhosis, and traditionally the only method to assess for liver scarring was a liver biopsy, which is invasive and can be associated with complications. Additionally, a liver biopsy requires hospital admission and several hours of bed rest after the biopsy. However, early detection of liver fibrosis is important as it allows both the patient and the doctor an opportunity to plan treatment and intervene before cirrhosis (irreversible liver scarring) has developed. Using the Fibroscan® 502 device, Liver Wellness™ can routinely provide this test to all patients who have chronic conditions of the liver, and can be repeated regularly (e.g. every 6-12 months) without any health risks. This provides very important information to both the patient and the doctor in monitoring the progression of a particular liver disease. For those patients who previously underwent treatment and want to determine that the liver is returning to a healthy state, Fibroscan® examination can provide information on how successful the treatment was.
What happens at the FibroScan® assessment
You will lie down on your back and with your right arm raised behind your head.
The doctor or liver nurse will apply a small amount of gel to your right side of your abdomen and place the probe with slight pressure against your skin.
Ten consecutive measurements will be made at the same location. The device will measure the state of the liver globally, as opposed to a biopsy, where only a very small sample is measured.
The test takes about 10 minutes, and the result is delivered immediately at the end. It will be a number between 1.5 and 75 kPa.
The doctor will evaluate and interpret the results and your report with recommendations will be completed within 72 hours and sent to you, your referring specialist or GP.
This includes the examination, performed by a specialist nurse, review of the results and reporting of the results with recommendations to the patient and the relevant health care practitioner by Prof. Suzanne Norris, consultant hepatologist.
When is a FibroScan® recommended
A FibroScan® is recommended for patients with:
abnormal liver blood tests
risk factors for chronic liver disease
staging of liver disease in patients with hepatitis C
staging of liver disease in patients with hepatitis B
patients with a diagnosis of fatty liver
family history of liver disease
patients who are worried they drink too much alcohol
patients who have type 2 diabetes
What happens during my FibroScan® visit
On your arrival to Liver Wellness™, you will be asked to fill in a form (name, address, referring doctor). You will be asked some medical questions regarding your liver condition. You will be examined with the FibroScan®. Your FibroScan® test results will be provided and interpreted by the consultant liver specialist and your report completed within 72 ours of your visit.
Do I have to get a referral from a doctor?
No you don’t need a referral. You can call us on 019108901 to book an appointment or book and pay securely on the website here.
Do I need to fast overnight before the FibroScan® test
There is no need for an overnight fast but do not eat or drink for 4 hours before the test.
Is this a painful test and are there needles involved
No needles are involved in this test and all you will feel is a gentle buzzing sensation on your skin.
Who will be conducting the FibroScan® test
The FibroScan® examination will be performed by expert medical and nursing staff who have been trained and certified to perform FibroScan® examination.
When are the results available
Although the results are known immediately after the test, they are first analysed by the Liver Wellness consultant before reports are issued to the patient and the patient’s chosen health care professional (by email or post) within 72 business hours following the FibroScan appointment.
I have already had a liver ultrasound. is this the same
No. An ultrasound examination can feel the same as a FibroScan® examination, but an ultrasound scan of the liver examines the liver structure (architecture), bile ducts, blood vessels going into and out from the liver, and also looks at other body organs near the liver such as the gallbladder. The FibroScan® examination measures liver fibrosis – an ultrasound cannot measure fibrosis. An FibroScan® examination can tell how much liver fibrosis is present and can confirm or rule out if the liver has developed cirrhosis.
I am pregnant. Can I still have a FibroScan® test
Yes, a FibroScan® test can be done if you are pregnant.
I have a pacemaker. Is it safe for me to have a FibroScan test
Yes, it is safe for you to have a FibroScan test even if you have a pacemaker or another implantable device.
Tests performed by EchoSens (the manufacturers of the FibroScan machine) have now been done and have confirmed that there is no interference between the FibroScan examination probes and implantable devices.