What is the meaning of a Fibroscan (Fibrosis Scan) score of 20.4, steatosis (fatty liver disease) of 366, and an Interquartile Range (IQR) score of 11%?

From the Guidelines

A Fibroscan score of 20.4 kPa indicates significant liver fibrosis, likely in the range of advanced fibrosis or cirrhosis (stage F3-F4), and requires prompt medical attention from a hepatologist or gastroenterologist. The steatosis reading of 366 dB/m suggests severe fatty liver disease (grade S3 steatosis), while the IQR score of 11% indicates the test results are reliable (generally, an IQR below 30% is considered valid) 1. These combined findings point to advanced liver disease with both significant scarring and fat accumulation.

Key Findings and Recommendations

• The high Fibroscan score and steatosis reading are concerning and indicate a need for immediate evaluation and management to prevent progression to liver failure, portal hypertension, and increased risk of liver cancer.
• Lifestyle modifications, including weight loss if appropriate, abstinence from alcohol, and management of underlying conditions like diabetes or high cholesterol, are crucial 1.
• The specialist may recommend medications depending on the underlying cause, and potentially consider treatments like resmetirom for non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with significant liver fibrosis, as suggested by recent guidelines 1.
• Bariatric surgery is also an option in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity, highlighting the importance of a multidisciplinary approach to management.

Next Steps

• Schedule an appointment with a liver specialist immediately for further evaluation.
• Be prepared for additional blood tests to assess liver function, viral hepatitis screening, and possibly other imaging studies.
• Discuss lifestyle modifications and potential treatment options with the specialist, including the role of medications and surgical interventions in managing advanced liver disease.

From the Research

Interpretation of Fibroscan Results

• A Fibroscan score of 20.4 kPa indicates significant liver fibrosis 2, 3.
• The steatosis score of 366, as measured by the controlled attenuation parameter (CAP), suggests a high level of hepatic steatosis 4, 5.
• The IQR score of 11% is not directly addressed in the provided studies, but it may be related to the variability of the liver stiffness measurements.

Liver Fibrosis and Steatosis

• Liver fibrosis is a major component of chronic liver disease, and its assessment is crucial for determining prognosis and treatment 2, 6.
• Hepatic steatosis is also an important feature of liver disease, and its detection and quantification can be achieved non-invasively using techniques such as the controlled attenuation parameter (CAP) 4, 5.
• The combination of liver fibrosis and steatosis can lead to more severe liver disease and increased risk of complications such as hepatocellular carcinoma and portal hypertension 2, 6.

Clinical Implications

• The results of the Fibroscan test, including the liver stiffness measurement and steatosis score, can be used to categorize patients into different fibrosis groups and guide treatment decisions 3.
• Regular monitoring of liver fibrosis and steatosis using non-invasive techniques such as Fibroscan can help track disease progression and response to treatment 2, 3.
• Patients with significant liver fibrosis and steatosis may require closer surveillance and management to prevent complications and improve outcomes 2, 6.