FibroScan: The painless way to assess your liver

Written by: Professor Aftab Ala
Published: | Updated: 09/08/2023
Edited by: Nick Howley

Your liver cleans your blood, assists your digestive system by producing bile and it helps your body store carbohydrates. Therefore, it's vital to make sure it's healthy and functioning as it should and one very safe and easy way to do this is with a FibroScan. Leading consultant gastroenterologist and hepatologist Professor Aftab Ala, an expert in liver problems, explains all about this liver test.

A doctor is having a consultation with an elderly patient and his partner. He is reading the results of an examination, perhaps a FibroScan.

 

What is a FibroScan?

FibroScan (or hepatic elastography) is a device that uses sound waves (ultrasound) to measure the hardness and elasticity of the liver and, depending on its state (the hardness and elasticity), enables the diagnosis of diseases such as scarring (fibrosis), fatty liver (steatosis) and liver cirrhosis. This technique is painless, avoids the need to perform a guided and invasive liver biopsy, which may be associated with side effects (such as pain and bleeding).

 

 

Who needs a FibroScan examination?

FibroScan may be suitable for you if you have:

  • risk factors for fatty liver, such as type 2 diabetes or a raised body mass index (BMI)
  • a family history of liver disease
  • relatively high consumption of alcohol
  • hepatitis, e.g. hepatitis B, C, autoimmune liver disease
  • a history of medications (such as methotrexate, some chemotherapy agents) with the potential of liver injury

It can also form part of a general health check-up, to assess your risk of long-term illnesses such as diabetes and cardiovascular disease.

The test is not suitable if

  • you are or might be pregnant
  • you have implanted medical devices.

FibroScan can detect disease, but it can also be a useful preventative tool. If the doctor detects a risk of developing liver disease in the future, they can advise you on what lifestyle changes or medical treatments to make to reduce your risk.

 

 

What can I expect from the procedure?

Make sure you don’t eat or drink anything at least three hours before the procedure. On the day, you should only drink clear fluids.

 

FibroScan is not painful and is free of complications. The test does not require admission nor does it have any abrasive or invasive side effects. You will lie on your back, with your right arm raised above your head. The doctor will apply a water-based gel to the skin and place the probe gently. The test should take around five to 10 minutes.

 

 

How the procedure works and what results mean

The FibroScan technique consists of sending a mechanical pulse, which initiates an ultrasound wave that is transmitted by the liver. The heavier the liver tissue, the faster the wave diffuses and, therefore, tissue damage is greater. The result is expressed in kilopascals (kPa) and you'll be able to get your results immediately.

There are four possible phases of patient status:

  • If the value is less than 6-7 kPa, there is a low risk of progression of fibrosis and it is advised not to start treatment.
  • Between the values of 7 and 9.4 kPa, moderate fibrosis is indicated. It is advisable to test with FibroScan periodically, in order to evaluate the progression and the need for treatment.
  • If the margin is between 9.5 and 12 kPa, fibrosis is in an advanced state and medical treatment is necessary or advisable.
  • If the result exceeds 12-14 kPa, it means that fibrosis is severe and there is a high risk of cirrhosis, and future risk of liver cancer, so treatment is of an urgent nature.

 

 

 

Don't hesitate to check the health of your liver, particularly if you have any reason to be concerned. Book a consultation with Professor Ala via his Top Doctors profile

By Professor Aftab Ala
Gastroenterology

Professor Aftab Ala is an internationally recognised consultant gastroenterologist and hepatologist who specialises in liver disease, liver function tests, FibroScan, colonoscopy, gastroscopy and SIBO. His private practice is based at Mount Alvernia Hospital, Nuffield Health Guildford Hospital, Prime Health Surrey and Spire Clare Park Hospital, with NHS base at the Royal Surrey NHS Foundation Trust, Guildford and Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London. 

FibroScan, one of Professor Ala's areas of expertise, is a non-invasive technique that allows the assessment of hepatic fibrosis, as well as quantification of liver fat. It's fast, reliable and is alternative to a biopsy, which takes longer than a FibroScan test and has potential complications.   

Professor Ala is highly qualified, with an MB BS from Charing Cross and Westminster Medical School (Imperial College, London) an MD (United States Medical Licensing Examination) and a PhD in hepatology from University College London, where he won a National Wellcome Trust Research Training fellowship in immune and inflammatory medicine mechanisms linking liver and gut disease. Following specialist training in global centres of excellence at King's and Royal Free Hospitals, he was awarded a Certificate of Completion of Specialist Training (CSST) in gastroenterology and internal medicine.

He undertook further focused training as advanced hepatology fellowship to Mount Sinai Hospital in New York from 2003 to 2004, building international expertise on rare liver diseases, chronic liver disease and liver/bowel transplantation. Professor Ala is a fellow of the Royal College of Physicians, London the Chair of the Gastroenterology and Hepatology, Clinical and Experimental Medicine Department at the University of Surrey and a consultant hepatologist at Royal Surrey and Kings London.

He has written and contributed to over 200 peer-reviewed original medical articles and oral presentations. He has supervised PhD students at the University of Surrey and King's College London leading research programmes supported by National (NIHR and UKRI-MRC) and International funding in genetic metabolic liver disease and inequalities of health in which he has an active track record of scientific achievement and running international and national clinical trials, including first in human studies.

He is a member of numerous scientific committees in his field, and is the lead for hepatology at the National Institute of Health and Research (NIHR) for Kent, Surrey and Sussex (South East England). Professor Ala is also a previous group member for hepato-pancreatic biliary (HPB) NHS England's South East coast Clinical Reference Group, NICE Guidelines on Hepatitis B, Clinical Advisor to the NHS England and currently British Liver Trust-

Professor Ala is a member of various professional organisations including the Royal College of Physicians London, the British Society of Gastroenterology (BSG) British Association for the Study of the Liver (BASL). He is the lead of the Wilson's Disease and Rare Liver Disease Special Interest Group for BASL, member of the American Association for the Study of the Liver (AASLD) and the European Association for the Study of the Liver (EASL).

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