FibroScan (Liver Elastrography)

What is it and why do I need it?

Various types of acute and chronic liver diseases (such as hepatitis B and C, and fatty liver disease) can lead to tissue damage and subsequent scar tissue formation. As the scar tissue accumulates, the liver loses some of its elasticity and becomes more stiff. Liver elastography involves the use of an external ultrasound probe that delivers a low frequency pulse, or sound wave, to a small volume of liver tissue under the rib cage. Transmission of the sound wave is measured and increases when the liver is scarred. The FibroScan device is approved for liver elastography measurements in patients with known chronic liver disease and particularly for patients with chronic hepatitis C. The test is simple, non-invasive and painless, and can help your doctor estimate the severity of fibrosis in your liver which may help with treatment and monitoring decisions.

Liver elastography procedures help your doctor determine the severity of hepatic fibrosis in patients with chronic liver disease. The FibroScan in particular can also help determine if a HCV patient does or does not have advanced fibrosis/cirrhosis, which can assist with treatment decisions regarding the need for oral antiviral therapy, liver cancer surveillance, etc. Some doctors also obtain serial liver elastography measurements once a year to see if the liver disease is improving or worsening over time.

FibroScan test results are always used in conjunction with other clinical data, laboratory test results, and liver imaging in managing individual patients.

The risks  

The FibroScan test is a completely non-invasive, simple and painless procedure that takes approximately 10 minutes to complete. Most patients with chronic liver disease can be assessed, but the test is not recommended or interpretable in patients with:
 
  • Fluid in the abdomen (i.e. ascites, variceal bleeding or hepatic encephalopathy)
  • Acute hepatitis
  • Right heart failure
  • Severe obesity
  • Small rib spaces
  • Inability to lie flat

The preparation    

Patients are asked to wear loose clothing and should be able to lie flat on an exam table for 10 minutes or more while the test is being performed. Patients are asked not to consume any liquids or solids for a minimum of 3 hours before the test to increase the likelihood of obtaining reliable test results. The scan typically takes 10 to 15 minutes to complete, but patients should plan on being here for 30 minutes to allow time for preparation.

The procedure

The liver is located in the right upper abdomen under the rib cage. Patients are asked to lie flat on an examination table. A technician places the FibroScan probe between the ribs on the right side of the lower chest wall. A series of painless pulses are then applied to the liver. The results are recorded on the equipment and an overall liver stiffness score is generated. This score is then interpreted by a qualified physician to predict the likelihood of advanced fibrosis or cirrhosis.

After the procedure 

It is not necessary to bring a driver for your liver elastography appointment. After the procedure, you will be immediately discharged from the procedure area and be able to leave without any restrictions. The doctor who completed and interpreted the procedure will send the test results to the doctor who ordered your procedure. FibroScan results will be available in about one to two weeks.