FibroScan for Fatty Liver Disease Evaluation and Grading

Liver disease is a major health concern in India. According to the Indian Council of Medical Research (ICMR), approximately 32% of the Indian population suffers from liver issues. Prolonged liver problems can lead to liver fibrosis and cirrhosis, a severe condition in which the liver does not function properly. Cirrhosis kills over 2 lakh people in India each year, making it one of the top ten causes of mortality worldwide. Furthermore, India accounts for one out of every five cirrhosis-related fatalities worldwide. 

The liver is the largest organ in your body. It helps your body digest food, store energy, and eliminate toxins. Fatty liver occurs when your liver contains an excessive amount of fat. The liver is the body's primary organ for digesting food and waste products.

A healthy liver contains little or no fat. If you consume too much alcohol or eat too much food, your body converts part of the calories to fat. This fat is stored in your liver's cells.A fatty liver is one in which fat accounts for more than 5% of the total weight of the liver. Over time, fatty liver might progress to cirrhosis (scarring). 

There are 2 main types of fatty liver disease:

• Metabolically associated fatty liver disease (MAFLD): Metabolic dysfunction-associated fatty liver disease (MAFLD), now more commonly known as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), is a condition in which excess fat develops in the liver as a result of metabolic dysregulation rather than alcohol. A diagnosis needs liver fat and at least one metabolic risk factor. The management focuses on lifestyle adjustments to prevent cirrhosis and cardiovascular consequences. 

• Alcohol-related fatty liver disease: Alcoholic fatty liver disease is caused by excessive alcohol use. The majority of the alcohol you consume is broken down by your liver and then eliminated from your body. However, the act of breaking it down might produce toxic compounds. These drugs can harm liver cells, cause inflammation, and reduce your body's natural defences. The more alcohol you consume, the more you harm your liver. Alcoholic fatty liver disease is the first stage of alcohol-related liver disease. The subsequent stages include alcoholic hepatitis and cirrhosis. 

Given the asymptomatic nature of early liver illness and the limitations of liver function tests in detecting fibrosis or cirrhosis, sophisticated diagnostic technologies such as Fibroscan are essential. Early detection enables immediate medical intervention, lifestyle changes, and focused treatment to halt the progression of liver disease. Fibroscan is a non-invasive, cost-effective method for early diagnosis, increased survival rates, and improved quality of life for patients with liver disease.

With Fibroscan, the necessity for a costly, invasive liver biopsy is greatly minimised. Early detection and personalised therapy can help patients avoid serious consequences of liver disease and improve survival rates. 

What is Fibro Scan?

FibroScan is the name of a medical gadget used to assess the health of your liver. The word FibroScan, which is frequently misinterpreted as "fiber scan," "fibro scan," or even "fibro liver scan," also refers to the FibroScan liver test itself. If your doctor recommends a liver fibroscan, it will most likely check your liver's health and identify liver fibrosis, which can suggest the presence and severity of liver damage or liver disease. FibroScan measures liver stiffness with advanced ultrasound technology known as transient elastography. It is a useful tool and a quick, simple, noninvasive assessment that allows you and your doctor to determine the state of your liver health. 

Is a FibroScan the same as an Ultrasound?

When you get a FibroScan of the liver, you are basically getting an ultrasound of the liver. If you're wondering if you should get a FibroScan or an ultrasound, it's more like "FibroScan as your ultrasound." That's because liver FibroScan employs transient elastography, an ultrasound-based modality that is an improved version of ultrasound.

This should be reassuring to many patients who are unfamiliar with FibroScan. Many of us have had ultrasounds before, and we found them to be relatively short and comfortable. 

How should I prepare for my FibroScan?

FibroScan preparation is easy and straightforward. Do not eat or drink anything for three hours prior to your operation. You should dress comfortably (e.g., a shirt or a loose dress) so that the nurse can inspect your right upper abdomen. Please refrain from wearing any tight attire to your appointment. You may also be asked to relax on the examination bed for a few minutes before the exam, as measurements must be collected while your body is at rest. 

What is the procedure for FibroScan?

If you've ever had an ultrasound, the FibroScan technique will seem familiar. You lie on your back with your right arm raised over your head, allowing access to your right rib cage for liver scanning. Gel is administered to the area, and the FibroScan instrument is positioned on the skin between your ribs. You may experience a tiny vibration while the device sends energy pulses to your liver to collect readings.

Before FibroScan technology became accessible in the United States in 2013, doctors had to do liver biopsies to obtain the same information as a FibroScan, so we can be happy for this painless technique. You might be thinking, "How long does a FibroScan take?" More good news: the normal exam lasts only 5-10 minutes. 

What is a normal FibroScan test result?

If you have any questions regarding your FibroScan results, you should speak with your doctor. In general, however, the FibroScan will provide you with: 

• Cap Score: The amount of fatty change in your liver is assessed in decibels per meter (dB/m) and correlates to your steatosis grade (S1, S2, or S3). The lower the percentage of your liver with fatty change, the healthier your liver is, as are your FibroScan CAP score and steatosis grade. A CAP score of 5% or below suggests a healthy liver, but a CAP score of 5% to 33% and a steatosis grade of S1 indicates a mild fatty liver. Higher CAP scores and steatosis grades suggest that the liver has moderate to severe fat content and is damaged. 

• The amount of scarring in your liver, measured in kilopascals (kPa), will determine your fibrosis score. The lower the score, the less scarring and healthier your liver is. A normal result ranges between 2 and 6 kPa. A fibrosis score ranging from F0 to F1 shows no or mild liver scarring. F4, the highest possible score, shows severe liver scarring, also known as cirrhosis.

Depending on your specific health scenario, your FibroScan result may not be enough to provide a complete picture of your liver function. In some circumstances, your doctor may administer additional testing, such as blood tests, imaging scans, or biopsies, in addition to the FibroScan. 

Regarding your liver stiffness result.

Your liver stiffness level is measured in kilopascals (kPa). Normal findings range between 2 and 7 kPa. If you have liver disease, your test results may be greater than normal. The maximum achievable result is 75 kPa.

Using your liver stiffness result to determine your fibrosis score

Your healthcare professional will calculate your fibrosis score based on your liver stiffness results and medical history. Your results may range from normal to advanced. 

• Normal: This indicates that your liver has no or rather minor scarring.
• Moderate to severe: This is liver scarring that can be restored (undone) by treating your liver condition. Good nutrition and lifestyle modifications can help slow or reverse the progression of scarring in your liver. You may not have any symptoms of moderate liver scarring.
• Cirrhosis (seh-ROH-sis) is a late stage of severe liver scarring. This occurs over time in chronic (long-term) liver illness. 

Fibroscan risk or complications

The Fibroscan liver test is a straightforward, painless, and quick procedure. Fibroscan, unlike an invasive biopsy, does not require incisions or tissue sample removal. Patients can have the test performed without anaesthesia or sedation, making it a safe and low-risk treatment. Most patients suffer no adverse effects, and the surgery is generally tolerated by people of all ages. 

Conclusion

A Fibroscan liver test is a noninvasive imaging procedure that uses ultrasound to evaluate liver health and detect fibrosis. Unlike a liver biopsy, the Fibroscan test is painless, rapid, and has no recovery period. The treatment only takes 15 minutes, and patients can return home the same day.

Fibroscan technology for the diagnosis of liver disease is available at City X-Ray Scan and Clinic. Ou can book your Fibroscan test at affordable price for the detection of liver disease. It delivers an instant, non-invasive, and painless evaluation of liver health, making it a critical tool for patients with liver diseases. 

Frequently Asked Questions

Is the FibroScan test performed on an empty stomach?

Yes, it is recommended that you avoid eating or drinking considerable amounts of fluids for at least 3 hours prior to the Fibroscan test to ensure reliable findings.

Is Fibroscan painful?

No, the Fibroscan test isn't painful. It is a short, non-invasive process that results in a pleasant tapping sensation on the skin. 

Can a FibroScan replace a liver biopsy?

In many cases, FibroScan can replace a liver biopsy since it gives reliable results without the need for an invasive procedure. However, in certain circumstances, a biopsy may still be required.

Is FibroScan safe for everyone?

Yes, FibroScan is a safe and non-invasive procedure that is appropriate for the majority of patients. It does not use radiation, making it an ideal solution for patients who require regular monitoring of their liver function. If you have any special health issues, speak with your doctor before scheduling a FibroScan. 

How can I minimise my Fibroscan score?

To lower your Fibroscan score, you should restrict your alcohol use, eat a balanced diet, exercise regularly, and control your blood sugar and cholesterol levels.

Will I receive the findings of my FibroScan test immediately?

You may receive preliminary findings right after your test. However, your doctor will make the ultimate interpretation after reviewing the sub-specialised radiologist's report. Your doctor will discuss the results with you during your follow-up appointment. 

How do you examine a Fibroscan report?

A Fibroscan report contains two crucial parameters that assist in determining the health of your liver:

• Liver stiffness (kPa): This value indicates the degree of fibrosis (scarring) in the liver. Higher numbers suggest more severe scarring, which could be related to illnesses such as cirrhosis.
• The CAP Score (dB/m) assesses the amount of fat in the liver, which aids in the detection of fatty liver disease (NAFLD). A higher CAP score suggests a bigger amount of fat in the liver.