Liver diseases are very common in India. As per the Indian Council of Medical Research, more than 30% of the Indian population has liver problems. Prolonged live diseases and problems can cause critical health conditions such as fibrosis and cirrhosis. Both of these account for more than 2 lakh deaths in the country every year. Most of the deaths are a result of late diagnosis; hence, it is very critical to identify the symptoms and get an effective diagnosis for liver problems.
And until recently, the best method used to diagnose liver problems and diseases was a liver biopsy. A liver biopsy is an invasive method by which the doctor collected a part of the liver tissue to examine for the presence of infection or disease. It is also used to detect the progression of problems such as cirrhosis. But the technique apart from being invasive is also expensive and associated with a lot of medical complications such as damage to the nearby tissues, bleeding, etc. Thus, with recent medical advancements, a non-invasive method of diagnosis – of critical liver problems such as fibrosis and cirrhosis – was introduced. This novel method is referred to as fibroscan.
A fibroscan helps to provide an overall evaluation of the health of the liver. It assesses the stiffness of the liver, helps to quantify liver fibrosis, as well as quantifies the fat in the liver. A fibroscan is not only non-invasive but is also cheaper, less painful, quicker and a lot safer as compared to a liver biopsy; though it is as accurate as a biopsy. Like a biopsy, it can also help to know the progression of the disease, thus allowing tailored treatments.
The technique uses ultrasound technology to know the degree of fibrosis or scarring which has affected the liver. That said, the results from a fibroscan can help only when used in conjunction with other health information, lab test results, as well as liver imaging results.
Risks of Fibroscan
Unlike a liver biopsy, a fibroscan is a non-invasive, simple and painless method. The procedure is only 10 minutes long and often tends to cause no after-effects or complications. Though the test can be used to assess a variety of liver diseases, it cannot be used in patients that have the following conditions:
- Fluid accumulation in the abdomen
- Acute hepatitis or other liver infection
- Right heart failure
- Small rib cages
- Inability to lie completely flat
Applicability of Fibroscan
The physician might recommend a fibroscan test, provided the patient has the following conditions:
- Hepatitis B
- Hepatitis C
- Alcoholic liver disease
- Non-alcoholic steatohepatitis
- Auto-immune hepatitis
- Genetic diseases
Procedure of Fibroscan
To prepare the patient for a fibroscan, the doctor will advise no food or liquid at least for 3 hours before the procedure. The patient must arrive at least 15 minutes before the test. A fibroscan is non-invasive hence, the patient does not need to be sedated; the entire length of the process will not be more than 10 minutes.
The patient will be asked to wear loose clothing and lie flat on the exam table for 10 minutes, while the physician performs the test.
Once the patient is placed, the technician will place the fibroscan probe, similar to an ultrasound probe, between the ribs on the right lower chest wall. The technician then presses a button to send a shear wave (painless pulse) into the liver and assess the stiffness. The results are recorded in the device and an overall score of the liver stiffness is ascertained. Ten such readings are taken and the overall score is assessed by a qualified physician to know the presence and advancement of critical liver issues such as cirrhosis, fibrosis, non-alcoholic fatty liver, chronic hepatitis, hepatitis C and Hepatitis B, etc.
Once the recordings are made, the patient is immediately allowed to go home. There is no need for the patient to be accompanied by another person since the procedure does not involve any pain, injection, anaesthesia or incision to be made. The results of the test will be available in about one to two weeks; these results are then assessed by the doctor and adequate medical treatment is initiated.
Overall, a fibroscan is a new and simple method, as well as relatively less risky method when compared to a liver biopsy. Though in some cases and conditions, fibroscan might not be able to furnish the best results and a liver biopsy may be required. Currently, fibroscan cannot completely replace a liver biopsy but given the medical advancements, the procedure is expected to become more comprehensive and include diagnosis of all kinds of chronic liver disease. That said, with the increasing awareness, today a fibroscan is increasingly being preferred over liver biopsy.