What is Fibroscan?

The liver is the body’s largest organ and is considered the body’s metabolic factory. The liver is located in the upper right side of the abdominal cavity. It is located below the diaphragm and is responsible for synthesizing many substances. Chronic liver diseases are one of today’s important health problems. In the later stages of chronic liver diseases, liver cells become damaged and swollen (ballooned). As the disease progresses, scar tissue forms in the liver and this tissue is defined as fibrosis.

As fibrosis tissue increases, the liver cannot function properly and its function deteriorates over time. If fibrosis becomes severe, cirrhosis, portal hypertension and liver failure occur. For this reason, correct diagnosis of the fibrosis stage in chronic liver diseases is important in follow-up and treatment decisions. Liver biopsy is an effective method to evaluate fibrosis. However, according to recent study results, reasons such as biopsy-related complications, differences in interpretation between evaluators, and situations where biopsy needs to be repeated with insufficient samples create the restrictive effects of biopsy. In order to minimize the problems arising from these reasons, FibroScan, which is a reliable, repeatable and non-invasive method for evaluating fibrosis, is one of the most frequently preferred methods recently.

What is FibroScan?

In chronic liver diseases, liver tissue hardens. FibroScan is a technological device that numerically measures the elasticity of soft tissues. With FibroScan, data is measured in kilopascals (kPa) and indicates the amount/stages of fibrosis in the liver. FibroScan examines an area of ​​the liver that is at least 100 times larger than the tissue that can be removed with a liver biopsy. Therefore, this method provides better visualization of the liver parenchyma. The FibroScan study protocol is as follows:

• FibroScan consists of a probe, electronic system and control unit.
• The ultrasonic transducer in the probe sends vibrations of low frequency and wavelength (amplitude) such as 50 MHz to the liver.
• The created elastic wave travels through the tissue.
• The transmission speed of the wave is directly proportional to the elasticity of the tissue it passes through.
• As the stiffness increases, the propagation speed of the wave increases, and this speed is determined by the detector on the probe.
• FibroScan application is painless, does not cause any discomfort, and the procedure takes 1-2 minutes.
• The person to be measured is asked to lie on his back and place his right arm behind his head. This makes imaging the liver easier.

In Which Situations Is Fibroscan Test Recommended?

The FibroScan test (Transient Elastography) has two important areas of use. Determination of the degree of fibrosis and diagnosis of liver disease in liver patients. In the presence of some chronic liver diseases, FibroScan test is recommended by the physician. Some of these diseases can be listed as follows:

• Metabolic and Autoimmune Hepatitis Disease
• Genetic Diseases (such as Hemochromatosis and Wilson’s Disease)
• Cirrhosis
• hepatitis B
• Hepatitis C
• Alcoholic Liver Disease
• Nonalcoholic Steatohepatitis (NASH)
• Hepatocellular carcinoma

What are the Benefits of FibroScan (Liver Damage Measurement)?

The FibroScan method, which is used to determine the stages of fibrosis, is more useful than other methods. The benefits of the FibroScan method can be listed as follows:

• FibroScan applications are fast, cheap and painless.
• It is an easy to apply and repeatable method.
• It is a non-invasive procedure.
• The procedure time is short (1-5 minutes).
• Results are achieved immediately. Result reliability is evaluated by the physician and the device.
• FibroScan enables selection of patients suitable for biopsy. This helps prevent unnecessary biopsy.

Things to Consider When Going for the Test

The preparations that the patient should pay attention to before the test are as follows:

• The patient must fast for at least 4-6 hours. (He should not eat or drink anything)
• Coffee and cigarette use should be stopped one day before.
• Excessive exertion should be avoided before the procedure to prevent tachycardia (palpitations). For example, the elevator should be used instead of stairs when going to the procedure.
• If possible, you should rest for approximately 10-20 minutes before the procedure.
• Appropriate clothing should be worn for comfortable viewing.

Frequently Asked Questions About FibroScan

Frequently asked questions about FibroScan are as follows:

What is FibroScan? What is Liver FibroScan?

FibroScan is the name of the medical device that measures liver functions using advanced technology. It provides a quick, easy examination without any intervention into the body. FibroScan uses advanced ultrasound technology called transient elastography to measure liver stiffness (elasticity).

In Which Situations Does a Physician Request a FibroScan Test?

FibroScan is requested by the physician in the presence or suspicion of the following diseases. These diseases are:

• chronic liver disease,
• Metabolic and Autoimmune Hepatitis Disease,
• Genetic Diseases (such as Hemochromatosis and Wilson Disease),
• Hepatitis B,
• hepatitis C,
• Cirrhosis,
• Alcoholic Liver Disease,
• Nonalcoholic Steatohepatitis (NASH),
• Presence and/or suspicion of hepatocellular carcinoma.

What Does the FibroScan Test Look for in the Body?

In liver diseases, tissue elasticity decreases and becomes stiff. FibroScan is used to measure liver health and determine the stage of liver disease. It helps determine whether fibrosis is present and the degree of fibrosis.

Does FibroScan Measure Fatty Liver?

Not all FibroScan devices have the CAP feature. Devices with CAP feature measure the amount of fat in the liver more precisely than ultrasound. A CAP result above 300 db/m is considered a sign of serious fatty liver.

What is a Normal FibroScan Result?

Fibrosis Score is in the range of 2.5-75 kPa as a result, reflecting normal liver elasticity. A low score in the test result indicates a healthy liver. Cap Score is measured in decibels per meter (dB/m) and corresponds to the degree of steatosis (S1, S2 and S3). The lower the FibroScan CAP score and the degree of steatosis, the healthier the liver. A grade of S1 steatosis with a CAP score of 5% or less indicates a healthy liver.

Is FibroScan the Same as Ultrasound?

Using the FibroScan test method, it is actually a kind of liver ultrasound. However, the FibroScan method uses advanced technology to measure tissues at a much larger size. There are similarities between FibroScan and ultrasound, but they are not exactly the same procedure.

How Should I Prepare for the FibroScan Test?

Fasting for at least 3-4 hours is required for FibroScan preparation. Comfortable clothing should be preferred to ensure viewing in a supine position with the right arm behind the neck. It is important to be rested before the procedure. To ensure adequate rest, the area to be treated should be arrived 15-20 minutes in advance.

Is FibroScan Painful?

No, FibroScan is not a painful procedure; Anesthesia is not required. The probe is applied with water-based gel and electronic waves are sent under the skin to the right side of the abdominal cavity, thus providing imaging. The patient feels these waves as slight vibrations.

How Long Does the FibroScan Procedure Take?

The FibroScan test measurement process takes approximately 1-5 minutes. The total examination time is approximately 25-30 minutes, with 15-20 minutes of rest before the procedure. After the procedure, the patient can quickly return to his daily life.

What are the Limitations of FibroScan?

Although Fibroscan is a fast, cheap, repeatable and painless method, it has some limitations. It is not recommended for use in patients with ascites, as the presence of fluid in the abdomen (ascites) will change the propagation of elastic waves. It is not recommended for use in pregnant women and in the presence of implanted medical devices (such as pacemakers). The patient’s physical characteristics may be another limiting factor for FibroScan. For example, S size probe is used for those with close intercostal space (distance between ribs), XL size probe is used for people with body mass index greater than 28 kg/m2. Although probe sizes are preferred according to the person’s weight, the presence of obesity may be a limiting factor.