A liver biopsy (removing a piece of tissue or a sample of cells from your body and testing it in a laboratory) is usually the gold standard for diagnosing and determining the severity of the liver disease. 

However, it is a painful, risky, and invasive procedure which is why a newer technology known as FibroScan (Ultrasound Elastography) has gained a lot of attention in the last few years. It is not only risk-free and inexpensive but is also faster, more precise, and can be done multiple times to evaluate the liver status and its response to treatment. 

FibroScan: The Technology That Has Been Tried And Tested

Ultrasound technology has been used for decades in the observation and diagnosis of a variety of medical conditions including a gestation or dating scan (done to see a growing baby in the womb). 

How Does FibroScan Work?

FibroScan is a non-invasive device that can be used to assess the ‘stiffness’ or ‘hardness’ of the liver via vibration controlled transient elastography (VCTE) method. Here, liver stiffness is evaluated by measuring the velocity of the vibration or shear wave generated on the skin. 

The vibration wave velocity is determined by measuring the time the wave takes to travel to a particular depth inside the liver. 

Because fibrous or damaged tissue is harder than normal liver, the degree of liver damage (also known as hepatic fibrosis) can be inferred from this test. To improve test reliability, a minimum of 10 valid readings, with at least a 60% success rate are needed.

FibroScan can measure up to 3 cubic cm of liver tissue, which is approximately 100 times the volume of liver measured through a typical liver biopsy. This in turn minimizes the sampling error. However, there can be a slight inter-observer variation (one doctor to another).

What Happens During The Test?

Your doctor will ask you to lie down in a supine position (lie on your back), pull your shirt up to expose your ribcage, and raise your right arm behind your head. The probe is placed and pressed against your skin in the right upper quadrant of your abdomen (where the liver lies).

This test is painless but you might feel a slight flick on the skin as the probe produces a shear/vibration wave that will travel through your liver tissue. The speed of the shear wave is measured and used to calculate the stiffness of the liver. This test can also measure the extent of fat deposition in your liver.

The results of this test will be interpreted by your physician according to your personal medical history as a part of a comprehensive assessment of your liver health.

What Are The Benefits of This Test?

  • Fast and pain-free assessment of overall health of your liver: It takes about 5 to 10 minutes to carry out this test. It requires no hospitalization or sedation and is practically painless and risk-free. 

    It is a quick test with instant results aiding your physician in early diagnosis and prevention of various conditions affecting the liver such as metabolic syndrome, non-alcoholic fatty liver disease, chronic viral hepatitis, and excess alcohol intake. 
  • Accurate Assessment: It is a valuable tool in the early diagnosis of liver conditions. The test can be done multiple times to track the illness progression, cessation, or regression. 

    This quantitative and real-time measurement of the liver disease can help the physician to tailor the treatment plan as per individual/patient needs. 
  • Safer than liver biopsy: Liver biopsy often comes with risks and complications such as bleeding, infection, and accidental injury to a major artery or any of the nearby structures.

    FibroScan is considered safer than a liver biopsy. 

Are There Any Contraindications For This Test?

There are no absolute contraindications. However, this test requires an adequate visualisation of the liver to obtain accurate readings. Any factor that obscures this visualisation may give unreliable or inaccurate findings such as in patients with BMI >30 kg/m2, old age, features of the metabolic syndrome (type 2 diabetes, hypertension, increasing waist circumference), presence of ascites from among others. 

Its usage is not recommended in pregnancy and in patients with a pacemaker.

FibroScan, in addition to standard laboratory tests and diagnostics (such as ultrasound scans of the abdomen), continues to reduce the necessity for liver biopsies. In the end, it improves, prolongs, and simplifies the care for patients suffering from liver disease. 

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.