Until relatively recently, it has been difficult to assess liver damage accurately without performing a liver biopsy – an invasive procedure with potential complications. FibroScan now represents a simple non-invasive strategy to assess liver damage, rendering liver biopsies virtually redundant which, of course, is good news for patients.
Professor Patrick Kennedy is an internationally-renowned liver specialist who has practised at St John and St Elizabeth Hospital for almost 10 years, shortly after which FibroScan was introduced into our range of cutting-edge clinical diagnostic tools.
Here, Professor Kennedy explains when a FibroScan might be necessary, how it works and why it represents a significant technological step forward compared to other methods of assessing liver damage.
What is a FibroScan and why would you need it?
A FibroScan is a simple, non-invasive test to assess liver damage, which we refer to as fibrosis – or liver damage in its most severe form, cirrhosis. We’re also able to assess the amount of liver fat, using the CAP modality, which is associated with a condition called fatty liver disease, and another more worrying condition called non-alcoholic steatohepatitis or NASH.
In a nutshell, the FibroScan gives two really important pieces of information. The most important being the degree of fibrosis, information we cannot ascertain from simple blood tests. The second piece of information is the degree of liver fat. This is an important measurement as fatty liver disease is now so prevalent, and assessing liver fat is an important indicator of not just liver health, but also general health.
Commonly people come to see me because of concerns about their level of alcohol consumption and its potential impact on their liver health. Alternatively, patients may be referred by their GP if they have abnormal liver tests or similarly if there are concerns about risk factors for liver disease in the presence of normal liver enzymes.
How does a FibroScan work?
FibroScan is an easy test which takes approximately 10 minutes to perform and immediately providing important information about the liver. Patients should fast for a minimum of three hours before undertaking the test but there is no requirement to stop any medications or take any precautions prior to having a FibroScan.
The FibroScan works by generating a shear wave which is transmitted into the liver. We then measure the return of that shear wave and the higher the reading, the more fibrotic the liver is.
What are the benefits of a FibroScan over an alternative test?
Historically, in order to get this level of information, a patient would have to undergo a liver biopsy, with all the inherent complications associated with an invasive procedure. A FibroScan provides a similar level of information with a simple non-invasive machine, the results of which are available immediately.
There are some alternatives, including specific laboratory tests or other ‘newer’ imaging modalities, but none of these offer the immediate results or the simplicity of a Fibroscan.
A unique selling point of FibroScan is the patient leaves the consultation knowing the degree of their liver damage.
Immediate results mean immediate action.
When a patient has a FibroScan with me at the St John’s and St Elizabeth’s, we discuss the results and formulate a management plan straight away. Every patient leaves the consultation room knowing exactly what the next steps are.
For example, if the FibroScan shows significant liver damage, the focus is the investigation and management of a patient with chronic liver disease, and this will require specific additional tests to formulate an appropriate management plan. Conversely, if the FibroScan shows significant liver fat only (without fibrosis), the management plan is around lifestyle intervention, be that reducing alcohol intake, increasing physical exercise and losing weight in order to reverse fat deposition and improve liver health. Moreover, as a non-invasive examination, the FibroScan offers the advantage of being able to reassess the liver following a period of lifestyle intervention, therefore providing a tool for longitudinal assessment.
If you would like to book an appointment with Professor Patrick Kennedy please call 020 7078 3802