Why did my doctor refer me for Fibroscan instead of a Liver Biopsy?

If you have been referred for FibroScan to assess your liver health, you may be wondering why your doctor chose this over a traditional liver biopsy. While both tests provide valuable insights, FibroScan offers several advantages that make it a preferred choice by both doctors and patients. 

Unlike the invasive and uncomfortable liver biopsy, FibroScan is a non-invasive, quick, and painless alternative that provides reliable results. In this article, we’ll go over what FibroScan is, the conditions it can detect, and why your doctor has referred you for this type of liver imaging. 

What is FibroScan?

FibroScan, also known as liver elastography, is a specialized ultrasound test that measures liver stiffness and fat content. This non-invasive, quick, and painless procedure assesses liver scarring (fibrosis) and fat accumulation(steatosis), which can indicate liver disease. FibroScan is increasingly used as a safe and comfortable alternative to a traditional liver biopsy.

What does FibroScan Measure?

FibroScan provides two critical measurements that assess liver health:

• Liver Stiffness Measurement (LSM): This measures liver stiffness, which is directly related to the amount of liver scarring (fibrosis). A high stiffness score may suggest advanced liver disease or cirrhosis.
  
  
• Controlled Attenuation Parameter (CAP): This measures the amount of fat in the liver. High fat levels could indicate fatty liver disease, which can lead to liver damage over time if left untreated.
  
  

By measuring both liver stiffness and fat content, FibroScan provides a comprehensive picture of your liver health and can help detect early signs of liver disease before more serious damage occurs.

What Conditions Can FibroScan Detect?

 FibroScan is a powerful tool for assessing liver health, and it can help diagnose or monitor a variety of liver conditions. By measuring liver stiffness and fat content, FibroScan provides valuable information about the liver’s structure and function. Here are some of the conditions that FibroScan can help your doctor identify and treat:

1. Liver Fibrosis and Cirrhosis

Fibrosis is the buildup of scar tissue in the liver, often caused by chronic liver diseases such as hepatitis, fatty liver disease, or excessive alcohol consumption. As fibrosis progresses, it can lead to cirrhosis, a severe form of liver damage where normal liver tissue is replaced by scar tissue, impairing liver function.

• FibroScan measures liver stiffness, which correlates directly with the level of fibrosis. A higher stiffness score can indicate the presence of liver fibrosis or cirrhosis, helping your doctor assess the severity of the liver damage.

2. Fatty Liver Disease (MAFLD/MASH)

Metabolic dysfunction-associated fatty liver disease (MAFLD) and Metabolic dysfunction-associated steatohepatitis (MASH), are both types of chronic liver disease. This condition occurs when fat builds up in liver cells. In its early stages, fatty liver is often asymptomatic, but over time, it can cause inflammation and lead to more serious liver damage.

• FibroScan uses the Controlled Attenuation Parameter (CAP) score to measure the amount of fat in the liver. A higher CAP score indicates a higher degree of fat accumulation, which could be a sign of MAFLD. In more severe cases, it can progress to MASH, which can cause inflammation and fibrosis in the liver.

3. Liver Inflammation

Liver inflammation, or hepatitis, occurs when the liver becomes swollen due to infection, alcohol use, or other liver injuries. Although FibroScan does not directly measure inflammation, it can detect liver stiffness caused by inflammation, which could indicate an active or past liver injury.

• FibroScan results showing increased stiffness could suggest that liver inflammation is present, prompting further testing to identify the underlying cause (such as viral hepatitis or alcohol-related liver disease).

4. Chronic Hepatitis B or C

Chronic hepatitis B and C are viral infections that can lead to liver damage, including fibrosis and cirrhosis, if left untreated. These conditions can progress slowly, so early detection is critical to prevent severe liver complications.

• FibroScan helps monitor liver stiffness in patients with chronic hepatitis, allowing doctors to track the progression of fibrosis and evaluate the effectiveness of treatment over time.

5. Alcoholic Liver Disease

Excessive alcohol consumption over time can damage the liver, leading to alcohol-related liver disease (ALD).  This can result in liver inflammation, and eventually fibrosis and cirrhosis.

• FibroScan is a useful tool to assess the extent of liver damage in patients with a history of heavy alcohol use. It can identify early signs of liver scarring and help doctors intervene before cirrhosis develops.

Can Liver Damage be Reversed?

In cases of mild-to-moderate liver damage, lifestyle changes (such as healthier eating, exercise, and controlling alcohol consumption) can prevent further damage and may even allow some recovery of liver function. 

Why is early-detection of liver damage so important?

Liver disease is often asymptomatic, meaning you might not notice symptoms until significant damage has occurred. As liver damage progresses and scar tissue accumulates, the liver’s blood supply can become impaired, leading to further liver dysfunction. If the damage continues unchecked, it can result in irreversible cell death and liver failure.

FibroScan provides valuable insights into liver health, enabling earlier intervention and more effective treatment. If your doctor suspects liver disease, FibroScan can offer a safer, quicker, and more comfortable alternative to invasive tests like liver biopsies.