FibroScan® is a new medical device in the United States – approved by the FDA – that provides a painless and reliable alternative to liver biopsy. Gastrocure is pleased to offer this examination to patients with the FibroScan® 502 device.
Why you should have a FibroScan examination:
• FibroScan may help you get approval for the new Hepatitis C treatments: if the FibroScan score shows that your liver is becoming scarred – for example that you have severe fibrosis (F3) or cirrhosis (F4) – your doctor and your pharmacist have a better chance of persuading your insurance company to cover the new drugs now for your treatment (e.g. Harvoni, Sovaldi/Sofosbuvir, Olysio/Simeprevir) without having to get a biopsy.
• On the other hand, a very low FibroScan score can provide you and your loved ones reassurance that your liver can afford to wait for better/less expensive treatment options in the future.
• In many cases FibroScan can help you and your doctor avoid the added risk and possible complications of a liver biopsy
• After a successful treatment (e.g. Hepatitis C) annual FibroScan can monitor your liver’s recovery.
• Recovery from liver fibrosis may lower your long term risk of cancer. FibroScan can show you how your recovery is advancing.
A FibroScan examination might be needed if you have any of the following conditions:
• Virus infections, such as Hepatitis B or Hepatitis C
• Alcohol related liver disease
• Obesity related liver disease (Non-alcoholic fatty liver disease)
• Other types of chronic liver disease
How FibroScan® works
Fibroscan uses “shear waves” to measure the elasticity of the liver using an improved technique called Vibration-Controlled Transient Elastography (VCTE™). As the shear wave passes through the liver, it is affected by the amount of scarring (fibrosis), and this is interpreted to give an accurate global assessment of the stage of fibrosis (fibrosis staging). The proper use of shear wave velocity analysis requires control of various physical parameters to ensure an accurate, reliable, and reproducible assessment of tissue stiffness, all novel features incorporated into the Fibroscan 502 Touch device. The stiffer the liver the more severe fibrosis.
What is liver fibrosis and why detect it early?
Liver fibrosis is a condition of scarring and stiffness of the liver and is caused by a variety of medical conditions. The most advanced and feared form of scarring is called Liver Cirrhosis. Cirrhosis (end stage liver disease) can result from long term liver infections or long term liver toxins (including excessive alcohol, some medications) in which the healthy liver tissues are slowly replaced by scar tissues. Initially the scar tissue is fine and delicate and hard to detect but over time it becomes thicker and can start to strangle the liver. This can prevent the liver doing what its job: nutrient metabolism and elimination and can lead to an advanced (often irreversible) condition termed “liver failure”.
Patient with liver failure usually need a transplant. Avoidance of cirrhosis by early detection of fibrosis has been a challenge for both patients and doctors, in part because clinical examination and blood tests can easily miss it. In addition, doctors and patients alike prefer to avoid liver biopsies because they are both expensive and can have complications (e.g. pain and/or bleeding).
However some patients surprise us and their disease can progress faster than we expected or don’t return to clinic for fear of biopsy. In this way, valuable time can be lost.
The Fibroscan test of the liver is now routinely used in Europe and elsewhere and has offered a great opportunity to both replace biopsy but also to track responses to treatment in a way that biopsy could not be used.
Using the FibroScan® 502 device, our office can now routinely provide this test to all patients who have or had chronic conditions of the liver including those patients who previously underwent treatment.
FibroScan® for Hepatitis B and Hepatitis C patients
Patients who live with viral hepatitis might not have any noticeable health problems for years. However, as the years progress, scarring in the liver can build up and slowly lead to liver failure. Once that stage is reached, the patient will need a liver transplant.
With the new FibroScan technology it is now easy to measure the health of the liver and see how much scarring the hepatitis virus has caused. Knowing the stage of fibrosis can help a patient decide if they need to start a treatment plan immediately.
Monitoring the progress of the liver disease
FibroScan® tests can be repeated regularly (e.g. every 6-12 months) without any health risks, which can help us monitor the progression of a liver disease. In case you start a treatment (e.g. for Hepatitis C), or making lifestyle changes to mitigate the damage to your liver, we can tell you with a follow-up examination how successful the treatment/lifestyle change was.
You will lie down on your back and with your right arm raised behind your head.
Your physician or liver nurse will apply a small amount of water based gel to your right side and place the probe with a slight pressure
Ten consecutive measurements will be made at the same location. The device will measure the state of the liver globally, as opposed to a biopsy where only a very small sample is measured.
The test takes about 10 minutes, and the result is delivered immediately at the end. It will be a number between 1.5 and 75 kPa.
Your doctor will evaluate and interpret the results.
The technical details
FibroScan® uses a button shaped probe placed at the skin surface that gives out a series of mechanical pulses (gentle shock waves) that travel through the liver. The FibroScan® measures how quickly these waves travel through the liver and how quickly they bounce back. In other words, it is measuring the velocity of the shock wave. Velocity of the wave correlates with the stiffness of the liver which reflects the degree of fibrosis. The quicker the wave travels, the stiffer your liver is and the more scar tissue you have in your liver. The unit of resistance is measured in Kpa. In general, cirrhosis is a concern at a resistance of 12 kPa and higher.
The bottom line
The sooner you know the state of your liver, the sooner you can act to prevent irreversible liver damage. The FibroScan® test gives you a quick and easy way to get an accurate assessment of the state of your liver.