From next-generation diagnostic technology like FibroScan® testing to the most groundbreaking treatments for serious conditions like Nonalcoholic Fatty Liver Disease and liver cancer, Hoag is committed to helping patients find accurate diagnosis and the treatment path that works best for them.
Facing fatty liver disease, cirrhosis, viral hepatitis or any chronic liver disease can be a scary proposition for any patient. Find the options you need to get back on the road to health. For liver treatment in Orange County, Hoag knows the way.
FibroScan is a non-invasive diagnostic test used to determine the health of the liver through transient elastography, a technique that utilizes sound waves to measure the degree of stiffness and fat buildup in liver tissue.
During FibroScan testing, a device delivers ultrasound waves through the liver from outside the body. The speed these waves travel through the liver can help measure liver stiffness, which can be important in determining the extent of liver fibrosis, and the patient’s level of steatosis (fatty liver), which is a buildup of excess fat in the liver. Both these issues can be symptoms of chronic liver disease.
A FibroScan result, along with other diagnostic procedures like blood tests, can help healthcare providers monitor overall liver health and determine the extent of a patient’s liver scarring (fibrosis).
Transient elastography can be important in diagnosing, monitoring and managing several chronic liver conditions that can result in liver inflammation and fibrosis, including:
Alcoholic Liver Disease
Nonalcoholic Steatohepatitis (NASH or nonalcoholic fatty liver disease)
Autoimmune or viral hepatitis, including chronic hepatitis c and hepatitis b
Cirrhosis
Certain types of genetic disease, including hemochromatosis and Wilson’s Disease
FibroScan is also crucial to determining a patient’s fibrosis score and CAP score, which indicate the degree of liver scarring and fat content. These scores can help healthcare providers recommend an appropriate treatment course for that patient.
Liver fibrosis is scarring of the liver. Usually, this scarring is caused by inflammation and damage due to issues like chronic hepatitis B or hepatitis C, nonalcoholic fatty liver disease, long-term alcoholism and other conditions.
Liver fibrosis begins when ongoing inflammation due to something harming the liver causes liver damage. The body attempts to repair this damage by forming scar tissue inside the liver. If left untreated, chronic liver inflammation can cause more and more scar tissue to form.
Over time, extensive scarring can begin to block the flow of blood through the liver, which can deprive the tissues of nutrients and oxygen. Over many years, this cycle can eventually lead to advanced liver scarring, with most of a person’s healthy liver tissue replaced by non-functioning scar tissue.
Advanced fibrosis can result in potentially life-threatening complications, including portal hypertension, in which scarring fully or partially blocks the portal vein that supplies blood to the liver.
Many of those who have fibrosis don’t know they have it, as mild to moderate scarring related to fibrosis often causes no noticeable symptoms. But if caught early and addressed, the progression of the disease can be halted and healthy liver tissue preserved.
If the underlying cause isn’t addressed, however, fibrosis can potentially progress to an advanced form of the disease called cirrhosis. Cirrhosis can eventually cause liver failure, in which the liver stops working altogether. Learn more about Liver Fibrosis.
Currently, liver transplantation is the only treatment for liver failure. Cirrhosis can also significantly increase a person’s risk of liver cancer.
Before the FibroScan test, your healthcare provider will likely talk to you about your medical history, any medications you may be taking, your allergies and what to expect during the procedure.
During the test, with the patient’s abdominal area exposed, an ultrasound source is placed on the skin of the abdomen over the general area of the liver. This source generates sound vibrations that painlessly penetrate the skin, tissues and muscles of the abdomen before traveling through through the liver.
Internal liver stiffness, which can be an important indicator of liver scarring and fibrosis due to liver disease, determines how fast these waves can pass through the liver. This speed is recorded and used to determine a liver stiffness measurement that can help physicians estimate the extent of the patient’s fibrosis (their fibrosis score) and the level of fatty change in their liver.
FibroScan results are used to determine what’s known as a fibrosis score. Ranging from F0 to F4, this score ranks the patient’s overall liver health by determining the amount of scar tissue in the liver. The score can be important in helping determine a treatment course.
Fibrosis scores are ranked in the following manner:
F0 to F1: No scarring or mild scarring (considered a normal result)
F2: Moderate scarring
F3: Severe scarring
F4: Advanced liver scarring (AKA cirrhosis)
Always follow your healthcare provider’s instructions, but in general, preparation for FibroScan testing includes:
Don’t eat or drink anything for at least three hours before your scheduled procedure time
Wear loose-fitting clothing to the appointment, as you’ll need to have your abdominal area exposed during the procedure so the ultrasound source can be placed on the skin near the liver
During the exam, you may be asked to lay on your back with your right arm placed behind your head so it’s out of the way. If you have any issues with lying on your back or raising your arms, be sure to tell your healthcare provider before the test
FibroScan is different from other procedures because it allows liver stiffness to be determined while still being completely non-invasive, meaning physicians don’t have to put anything inside the patient’s body during the test. Nevertheless, FibroScan can quickly and painlessly provide information on liver fibrosis and fatty change in the liver, allowing healthcare providers to monitor and assess liver health and chronic liver disease without the risks associated with more invasive procedures.
Traditional liver biopsy was previously the primary way to monitor and measure liver scarring and fibrosis. Liver biopsies are much more invasive in that they require a needle to be inserted through the skin and into the liver to collect tissue samples for examination.
The entire procedure, including preparation, will likely take under an hour, making transient elastography a very quick and convenient option for liver stiffness measurement. Once you’re in the examination room, the FibroScan itself usually takes less than 15 minutes. Because the test usually doesn’t involve any kind of sedation or anesthetic, having someone drive you to the test usually isn’t required.
There are several medical conditions that can potentially lead to a less-accurate assessment of liver stiffness when utilizing FibroScan. These issues may include:
Having ascites, which is fluid buildup in your abdomen.
Being obese: Having a thicker layer of fat on your abdomen can make it harder to get accurate FibroScan readings from your liver. A body mass index (BMI) higher than 30 is considered obese.
Having a biliary obstruction, which is a blockage that doesn’t allow the digestive fluid known as bile to flow freely through the liver.
Having cancerous or benign tumors in your liver.
Liver congestion, a condition in which your liver is overfilled with fluids or blood, often due to ongoing heart failure.
Having scar tissue inside the abdomen, as scarring from previous surgery near your liver can interfere with the ultrasound waves as they travel through the body.
Unlike traditional liver biopsy, FibroScan is completely non-invasive and painless. Patients may feel a slight “tickle” in the skin while the ultrasound-like probe generates vibration waves, but should not feel any discomfort during the procedure.
One of the major benefits of FibroScan is that the test utilizes ultrasound waves to measure scarring in the liver and does not involve radiation of any kind. Along with the totally non-invasive nature of the test, that makes FibroScan safe for most patients, including those who are pregnant, have implanted medical devices or who are immunocompromised.