What is a fibroscan?

A FibroScan (also known as transient elastography) is a non-invasive method used to assess the amount of scarring (fibrosis) in the liver. It's particularly useful for diagnosing and monitoring liver diseases like chronic hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and alcoholic liver disease.

Here's a breakdown of key information:

How it works:

The FibroScan device uses a small probe placed on the skin over the abdomen. It emits vibrations that travel through the liver. The device measures how quickly these vibrations travel and how much they are attenuated (reduced in strength). This allows it to estimate the liver's stiffness, which is a key indicator of fibrosis. Higher stiffness values correlate with more advanced fibrosis and cirrhosis.

Advantages of FibroScan:

• Non-invasive: Unlike a liver biopsy (which involves inserting a needle into the liver), it's painless and doesn't require sedation.
• Quick and easy: The procedure takes only a few minutes.
• Repeatable: It can be repeated safely and easily to monitor disease progression or response to treatment.
• Relatively inexpensive: Compared to a liver biopsy, it's a more cost-effective option.
• Portable: The machine is portable, allowing for testing in various settings.

Disadvantages of FibroScan:

• Obesity: The accuracy of FibroScan can be reduced in obese individuals, as the vibrations may not penetrate the liver effectively.
• Ascites: The presence of excess fluid in the abdomen (ascites) can also interfere with accurate measurements.
• Not a definitive diagnosis: While it provides a valuable assessment of liver fibrosis, it doesn't replace a liver biopsy in all cases. A biopsy remains the gold standard for diagnosing liver disease definitively, especially when a decision about treatment needs to be very precise.
• Requires specific training: The test needs to be performed and interpreted by trained professionals.

What the results mean:

The FibroScan provides a Liver Stiffness Measurement (LSM) value expressed in kilopascals (kPa) and a Controlled Attenuation Parameter (CAP) value. These values are correlated with the different stages of liver fibrosis (F0-F4, with F4 being cirrhosis). The interpretation of these results requires medical expertise. The physician will consider the LSM and CAP values along with other clinical information to make a diagnosis and determine the appropriate course of treatment.

In summary, FibroScan is a valuable tool for assessing liver fibrosis, but it should be interpreted within the context of a patient's overall clinical picture and other test results. It's not a replacement for a liver biopsy in every situation, but it's a significant advancement in non-invasive liver disease assessment.