What is liver fibrosis?
Liver fibrosis is the formation of scars in liver resulted by repeatedly or continuously damage of liver. Fibrosis itself causes no symptoms, but severe scarring can result in cirrhosis, liver failure, and even liver cancer, which can cause symptoms. Early detection can provide early treatment for preventing disease progression of liver cirrhosis and its complications.

What is FibroScan®?
FibroScan® is non-invasive medical device specialised for instant quantification of liver fibrosis and fatty liver. With a patented technology known as Vibration-Controlled Transient Elastography (VCTE), the ultrasound emitted by the FibroScan® probe is capable of providing reliable, accurate and reproducible assessment of liver tissue stiffness and liver steatosis. With the Controlled Attenuation Parameter (CAP), FibroScan® is also capable for the detection of fatty liver.

Difference between FibroScan® and Liver Biopsy?

Although liver biopsy remains the gold standard for evaluating liver fibrosis, liver biopsy is an invasive procedure that
has the potential to cause bleeding and other undesirable complications. Also due to the limited sample size, errors
may occur. In contrast, FibroScan® is non-invasive and can be used for repeated monitoring in those patients with chronic liver disease.

For healthy individuals with no known liver disease in general, FibroScan® can provide a safer and more accurate liver examination alternative to liver biopsy.

Who needs a FibroScan®?
A large local study for diabetic patients in Hong Kong reported that 47% of fatty liver and 33% of severe liver fibrosis showed normal result in liver function test. This reflects the limited use of routine blood testing in accessing health status of liver. FibroScan® offers a non-invasive mean for the measurement of liver tissue stiffness and liver steatosis. The following groups of patient with higher chance of having liver related disorder such as liver cirrhosis or liver cancer are suggested to have liver check-up regularly:

• Chronic Hepatitis B carrier
• Hepatitis C carrier
• Persons with fatty liver disease
• Diabetes patients
• Persons with high alcohol intake
• Patients with alcoholic liver disease
• Patients on certain medications (e.g. Corticosteroids)

How is a FibroScan® done?

1. You will need to fast for 3 hours before the assessment.
2. During the scan, you will need to lay down on the bed and put your right hand under your head.
3. Water-soluble lubricant will be applied on your right abdomen.
4. Several measurements will be obtained by the probe placed on your right abdomen.
5. The whole process will only take 5 to 10 minutes.

References

1. https://www.med.cuhk.edu.hk/ tc/press-releases/cuhk-discovers-fatty-liver-causing-severe-liver-fibrosis-or-cirrhosis-in-1-out-of-5-diabetic-patients
2. Wong VWS, Vergniol J, Wong GLH, Foucher J, Chan HLY, Bail BL, Choi PCL, Kowo M, Chan AWH, Merrouche W, Sung JJY, & de Ledinghen V. (2010). Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology, 51(2), pp. 454-462
3. Chan HLY, Wong GLH, Choi PCL, Chan AWH, Chim AML, Yiu KKL, Chan FKL, Sung JJY, & Wong VWS. (2009). Alanineaminotransferase-based algorithms of liver stiffness measurement by transient elastography (FibroScan®) for liver fibrosis in chronic hepatitis B. Journal of Viral Hepatitis, 16, pp. 36-44
4. Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, Darriet M, Couzigou P, & de Ledinghen V. (2005).Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology, 128 (2), pp. 343-350.
5. Nguyen-Khac E, Chatelain D, Tramier B, Decrombecque C, Robert B, Joly J, Brevet M, Grignon P, Lion S, le Page L, & Dupas J. (2008). Assessment of asymptomatic liver fibrosis in alcoholic patients using FibroScan®: prospective comparison with seven noninvasive laboratory tests. Alimentary Pharmacology & Therapeutics, 28(10), 1188-1198. oi:10.1111/j.1365-2036.2008.03831.x
6. Fung J, Lee C, Chan M, Seto W, Wong DK, Lai C, & Yuen M. (2013). Defining normal liver stiffness range in a normal healthy Chinese population without liver disease. Plos ONE, 8(12), doi:10.1371/journal.pone.0085067
7. Karlas T, Petroff D, Sasso M, Fan JG, Mi YQ, de Ledinghen V, Kumar M, Lupsor-Platon M, Han KH, Cardoso AC, Ferraioli G, Chan WK, Wong VWS, Myers RP, Chayama K, Friedrich-Rust M, Beaugrand M, Shen F, Hiriart JB, Sarin SK, Badea R, Jung KS, Marcellin P, Filice C, Mahadeva S, Wong GLH, Crotty P, Masaki K, Bojunga J, Bedossa P, Keim V, Wiegand J. (2017). Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis. Journal of Hepatology, 66 (5), pp. 1022-1030