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Fibroscan (liver fibrosis assessment)

What is a Fibroscan (liver fibrosis assessment)?

Fibroscan is designed to perform non-invasive measurements of liver vibration shear wave speed and estimate liver tissue stiffness. It is based on Vibration Controlled Transient Elastography (VCTE) technology.

Fibroscan provides distinct information than an ultrasound scan, and together the two are a complementary combination. Ultrasound is typically utilised to diagnose cancer or gallstones, whereas fibroscan evaluates whether liver fibrosis or scarring is present.

Healthy livers typically have a low median Liver Stiffness Measurement (LSM).

If your LSM is above the average range, it may indicate severe liver fibrosis or cirrhosis. Consequently, if this occurs, you should consult with your doctor to discuss treatment options and consider regular monitoring for signs of liver cancer.

When a Fibroscan becomes necessary

Fibroscan is particularly invaluable when examining individuals facing chronic liver conditions. For example, hepatitis B and C, alcohol or non-alcoholic fatty liver disease (NAFLD), autoimmune liver diseases, or inherited hepatic issues. As fibrosis and scarring accumulate, liver stiffness readings steadily increase.

Fibroscan helps in assessing the need for:

How does a Fibroscan work?

During the procedure, you will be positioned to lie on the examination couch with your right arm above the head. This is so that the staff is capable of examining your abdomen to find the ideal place to perform the scan.

A probe will be laid on your abdomen. The probe features a low-amplitude vibrator which sends an elastic wave through the skin and space between ribs into the liver. Ultrasound is used to follow this shear (elastic) wave, identify its speed, and calculate an estimated stiffness of the organ. Afterwards, these results will be displayed on our system unit for you to observe.

Although it may feel uneasy, Fibroscan should not cause any discomfort. 10 readings will be carried out to guarantee a precise outcome. The entire procedure is estimated to take between 10 and 20 minutes.

Quick Easy Way to Assess / Diagnose Your Liver Health

Your CAP Score, and What It Means

What is CAP Score: The Controlled Attenuation Parameter (CAP) score, measured during a Fibroscan, evaluates the quantity of fat present in the liver, providing a percentage of fatty changes within the organ.

  • Significance of CAP score: A high CAP score may suggest the presence of non-alcoholic fatty liver disease (NAFLD), an increasingly common condition that can lead to cirrhosis if left untreated.
  • Changing CAP score: If your CAP score has changed significantly from a previous Fibroscan, it may indicate a change in the amount of fat in your liver.
  • Health Implications: A high CAP score combined with other factors such as high blood sugar or obesity can increase your risk for developing more severe liver diseases.

 

The table indicates CAP scores and steatosis grades, revealing the level of fat in your liver.

A healthy liver can have up to 5% fat. If your score is below 238 dB/m, your liver fat is within the normal range.

Interpretating Your Liver Stiffness Result

Your liver stiffness is quantified in kilopascals (kPa), with normal values typically ranging from 2 to 7 kPa. A result exceeding this range may indicate liver disease. The maximum measurable value is 75 kPa.

Connecting the Dots: How Your Liver Stiffness Reflects Your Fibrosis Score

Factors That Can Impact Your Fibrosis Results

FibroScan May Give Less Accurate Results, If You Have:

  • Obesity: This indicates that your body mass index (BMI) exceeds 30, denoting a significantly high and unhealthy level of body fat.
  • Ascites: Accumulation of fluid in your abdomen.
  • Biliary obstruction: A blockage that prevents sufficient bile from flowing out of your liver.
  • Scar tissue: Scar tissue has formed near your liver as a result of surgery or radiation treatment.


Your healthcare provider might employ imaging techniques like ultrasound, CT scans, or MRIs to examine your liver. They could also conduct blood tests or utilize a specific MRI type to assess the extent of scarring and fat accumulation in your liver.

If you have any concerns or questions, don’t hesitate to contact your healthcare provider.

Preparing for a Fibroscan

There is not much to prepare before a fibroscan. Prior to your fibroscan appointment, please make sure to check in at the clinic and be ready to get escorted to the consulting room by the medical staff for the procedure.

Before undergoing the scan, it is highly recommended that you consult with your doctor to ensure any questions are answered. If everything checks out, then proceed with the procedure, knowing you are making an informed decision on the day of your scan.

After a Fibroscan

After the fibroscan procedure is complete, you are free to head home or return to your job. It may take some time for your physician to assess the results, hence the subsequent discussion will take place during a follow-up visit.

gastroenterology specialist singapore

FELLOWSHIP TRAINED SPECIALIST

Dr. John Hsiang

MBChB (NZ), FRACP (Australasia), MD (Doctorate), FRCP (Edinburgh), FAMS (Gastro)

Dr. John Hsiang is a Gastroenterologist and Hepatologist with more than 20 years of clinical experience across public and private practice.

Dr. John Hsiang’s special clinical interests are in gastroesophageal reflux disease, stomach conditions, fatty liver, and gastrointestinal cancer screening

Dr. John Hsiang has spent more than five years in the Singhealth cluster serving in the Gastroenterology Department at Changi General Hospital and Sengkang General Hospital.

Clinical interests:

Gastrointestinal Diseases, Endoscopy, Helicobacter Pylori infection, Viral Hepatitis, Fatty Liver Disease, Management of Abnormal Liver tests.

Dedicated Insurance Support

We understand that navigating the financial aspect of healthcare can be overwhelming. We welcome all patients with or without insurance and can assist with claims regardless of your personal or corporate insurance plan. Here at Richmond Gastroenterology Centre, we strive to ensure the most efficient claims process for our patients. To that end, our team works diligently with their insurers to obtain Letters of Guarantee and pre-authorization certificates prior to any procedures.

Make an appointment to consult our Doctor.

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Dr. John Hsiang is an Accredited Specialist Across All Private Hospitals in Singapore.