From the Guidelines
FibroScan is indicated for non-invasive assessment of liver fibrosis and steatosis in patients with chronic liver disease, particularly for evaluating patients with viral hepatitis (B and C), alcoholic liver disease, non-alcoholic fatty liver disease (NAFLD), and non-alcoholic steatohepatitis (NASH) 1.
Key Points
- FibroScan uses transient elastography to measure liver stiffness, which correlates with the degree of fibrosis, and controlled attenuation parameter (CAP) to quantify steatosis.
- The test is recommended for initial evaluation of suspected liver disease, periodic monitoring of known liver conditions, and assessment before and after antiviral therapy for hepatitis.
- A FibroScan value of ≥15 kPa is highly suggestive of compensated advanced chronic liver disease (cACLD), whereas a value between 10 and 15 belongs to the gray zone where platelets can help 1.
- The procedure is painless, quick (typically 5-10 minutes), and has minimal risks compared to liver biopsy.
- However, results may be less reliable in obese patients, those with ascites, or individuals with acute inflammation of the liver, and interpretation should consider clinical context and other laboratory findings.
Indications
- Evaluation of liver fibrosis in patients with chronic liver disease
- Monitoring of disease progression and treatment response
- Assessment of liver fibrosis before and after antiviral therapy for hepatitis
- Initial evaluation of suspected liver disease
- Periodic monitoring of known liver conditions
Limitations
- Less reliable in obese patients, those with ascites, or individuals with acute inflammation of the liver
- Cannot accurately assess inflammation or rule out other causes of chronic liver disease
- May overestimate the amount of fibrosis due to histologic inflammation or recent food intake 1.
From the Research
Indication of Fibroscan
The indication of Fibroscan, also known as transient elastography, is for the non-invasive assessment of liver fibrosis in patients with chronic liver diseases, including:
- Chronic hepatitis C (HCV) 2, 3, 4
- Chronic hepatitis B (HBV) 2, 3, 5
- Non-alcoholic fatty liver disease (NAFLD) 2, 6, 4
- Alcoholic liver disease (ALD) 2, 6
Key Features of Fibroscan
Some key features of Fibroscan include:
- Accurate detection of advanced fibrosis and cirrhosis 2, 3
- Non-invasive and painless procedure 2, 3
- Can be used to monitor treatment response and disease progression 4
- Correlates with survival and major clinical end-points, such as liver decompensation and development of hepatocellular carcinoma 5
Comparison with Other Methods
Fibroscan has been compared to other non-invasive methods, including:
- Biomarker panels, such as API, FIB-4, and FibroTest 2, 3
- Imaging methods, such as acoustic radiation force impulse and magnetic resonance elastography 3, 4
- Liver biopsy, which is considered the gold standard for assessing liver fibrosis, but has limitations and risks 2, 3
Clinical Applications
Fibroscan has several clinical applications, including: