1. What is Liver Shearwave Elastography (FibroScan)?
Liver Shearwave Elastography, also known as FibroScan, is a non-invasive diagnostic test that measures liver stiffness and fat content. It is used to detect liver fibrosis (scarring) and fatty liver disease without requiring a biopsy.
2. Why is FibroScan performed?
FibroScan is used to:
- Detect liver fibrosis caused by conditions such as hepatitis B or C, fatty liver disease, and alcohol-related liver disease.
- Monitor liver health and the effectiveness of treatments for chronic liver diseases.
- Help identify the risk of complications like cirrhosis or liver failure.
3. How does FibroScan work?
FibroScan uses ultrasound waves to emit painless vibrations into the liver, creating shear waves. The speed of these waves correlates with liver stiffness, while another parameter measures fat content.
4. How should I prepare for the test?
- Fasting: Avoid eating, drinking, or smoking for at least 5–6 hours before the test, as it can influence results.
- Clothing: Wear loose-fitting clothes for easy access to your upper abdomen.
5. Is FibroScan painful?
No, FibroScan is completely painless and non-invasive. You may feel gentle vibrations or tapping on your abdomen during the procedure.
6. How long does the procedure take?
The scan itself takes about 5–10 minutes, with the entire appointment, including preparation and discussion, lasting up to 30 minutes.
7. What liver conditions can FibroScan detect?
FibroScan can detect and monitor:
- Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).
- Alcoholic liver disease.
- Chronic hepatitis B or C.
- Cirrhosis (advanced liver fibrosis).
- Autoimmune liver diseases, such as primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC).
8. How are FibroScan results interpreted?
FibroScan results focus primarily on the Liver Stiffness Measurement (LSM), which is expressed in kilopascals (kPa). These results help determine the extent of liver fibrosis (scarring) and are categorized into stages from F0 to F4. Here’s how the results are interpreted:
Liver Stiffness (Fibrosis Staging)
- F0-F1 (0–7.1 kPa):
- Normal to mild fibrosis.
- Indicates a healthy liver or minimal damage.
- F2 (7.2–9.4 kPa):
- Moderate fibrosis.
- Suggests noticeable scarring but not advanced enough to cause significant functional impairment.
- F3 (9.5–12.4 kPa):
- Severe fibrosis.
- A significant level of scarring that may start to impact liver function.
- F4 (≥12.5 kPa):
- Cirrhosis (advanced fibrosis).
- Indicates a high risk of complications, including liver failure or portal hypertension.
Additional Factors
- Higher stiffness values (>20 kPa): Often associated with advanced cirrhosis and may suggest portal hypertension. Further clinical evaluation is necessary.
- Your doctor may correlate these values with your medical history, blood tests, and imaging results to determine the best course of action.
What Do High Values Mean?
- High kPa values suggest that the liver has become stiff due to extensive fibrosis or cirrhosis.
- Conditions that can elevate stiffness values include hepatitis, fatty liver disease, or long-term alcohol use.
What Do Low Values Mean?
- Low kPa values generally indicate a healthy liver with no or minimal scarring. However, normal values don’t rule out the need for lifestyle adjustments or further tests if other risk factors are present.
Key Notes on Interpretation
Your doctor may recommend further investigations, such as blood tests, imaging, or even a liver biopsy, if the results are unclear or inconsistent with your overall health picture.
FibroScan results are not definitive for all conditions. For example, transient inflammation or liver congestion (due to heart failure or other conditions) can temporarily increase liver stiffness.
9. Can FibroScan replace a liver biopsy?
FibroScan can replace a biopsy for assessing fibrosis in most cases. However, a biopsy might still be required for conditions like:
- Autoimmune diseases.
- Suspected liver cancer.
- Rare liver disorders requiring microscopic analysis.
10. What are the benefits of Liver Shearwave Elastography?
- Non-invasive and painless: No needles or recovery time required.
- Quick and convenient: Results are immediate.
- Accurate: Detects and stages fibrosis and fat accumulation effectively.
- Safe: No radiation or harmful side effects.
- Cost-effective: Reduces the need for invasive and expensive procedures.
11. How often should FibroScan be repeated?
For chronic liver conditions, FibroScan is typically repeated every 6–12 months to monitor changes. The frequency depends on your condition and treatment plan.
12. What are the symptoms of liver disease?
Common symptoms include:
- Fatigue and weakness.
- Yellowing of the skin and eyes (jaundice).
- Abdominal pain or swelling.
- Dark urine and pale stools.
- Unexplained weight loss.
- Nausea or vomiting. If you experience these symptoms, a liver scan like FibroScan can help assess your liver health.
13. Can I have FibroScan if I have other health conditions?
Yes, FibroScan is safe for most individuals. However, it might not be suitable for:
- Pregnant women due to limited safety data.
- Patients with fluid buildup in the abdomen (ascites), as it can affect accuracy.
- People with electronic implants like pacemakers, as the device may interfere.
14. Can lifestyle changes improve liver health?
Absolutely. Lifestyle changes can improve liver health and FibroScan results:
- Eat a balanced diet low in sugar and saturated fats.
- Exercise regularly to reduce fat buildup in the liver.
- Avoid alcohol or drink in moderation.
- Manage underlying conditions like diabetes or high cholesterol.
- Maintain a healthy weight.
15. Where can I get a FibroScan?
FibroScan is available at hospitals, diagnostic centers, and private clinics specializing in liver health. For services in London:
- Phoenix Ultrasound – Central London Branch: 1 Portpool Lane, London, EC1N 7UU.
- Surrey Branch: 63 Nork Way, Banstead, SM7 1HL.
- Phone: 020 3318 1373.
- Email: [email protected].
Schema for FibroScan Results Interpretation
1. Measurement Parameter
- Liver Stiffness Measurement (LSM)
- Unit: Kilopascals (kPa)
- Purpose: Indicates the degree of liver fibrosis.
2. Fibrosis Stages and LSM Range
| Fibrosis Stage | LSM Range (kPa) | Description | Clinical Significance |
|---|---|---|---|
| F0-F1 | 0–7.1 | Normal to mild fibrosis. | No or minimal liver scarring. Liver is functioning well. |
| F2 | 7.2–9.4 | Moderate fibrosis. | Noticeable scarring. Disease may progress without treatment. |
| F3 | 9.5–12.4 | Severe fibrosis. | Significant damage. Liver function may start to decline. |
| F4 | ≥12.5 | Advanced fibrosis (Cirrhosis). | High risk of complications such as liver failure or portal hypertension. |
3. Interpretation Guide
| Result Range (kPa) | Possible Causes | Next Steps |
|---|---|---|
| 0–7.1 | Normal liver, minimal scarring. | Routine monitoring and preventive measures (e.g., healthy diet, exercise). |
| 7.2–12.4 | Moderate to severe fibrosis. | Evaluate liver function and consider medical intervention or lifestyle changes. |
| ≥12.5 | Cirrhosis or advanced fibrosis. | Assess for complications; additional tests (e.g., imaging, blood tests) may be needed. |
4. Notes on High and Low LSM Values
- High LSM Values (>20 kPa):
- May indicate advanced cirrhosis or portal hypertension. Further evaluation is essential.
- Low LSM Values (<7.1 kPa):
- Normal liver stiffness, but other factors (e.g., fat content or inflammation) might still need assessment.
5. Factors Influencing LSM Accuracy
| Factor | Impact | Adjustment |
|---|---|---|
| Inflammation (e.g., hepatitis) | May temporarily increase stiffness values. | Correlate with blood tests or repeat scan after inflammation subsides. |
| Ascites (abdominal fluid) | Reduces accuracy of measurements. | Consider alternative diagnostic tools. |
| Obesity | May cause variability in results. | Use additional imaging methods for confirmation. |
This schema provides a concise yet comprehensive overview of FibroScan results interpretation, suitable for both medical professionals and patients seeking clarity on their results.