Information
Liver fibrosis is the end result of the majority of liver diseases which includes but is not limited to fatty liver disease (NAFLD/NASH), Hepatitis B, Hepatitis C, alcoholic liver disease, haemachromatosis and autoimmune hepatitis. Liver fibrosis does not produce signs or symptoms, nor are there specific blood markers to determine the degree of fibrosis.
Over time, the accumulation of liver fibrosis can result in cirrhosis (severe or irreversible fibrosis). The presence of cirrhosis and its sequelae has a substantial impact on a person’s morbidity and mortality. It is beneficial to identify the presence of liver fibrosis before it becomes severe and complications arise.
Until recently, liver biopsy has been the sole method to quantify fibrosis. This procedure is invasive, painful and carries the risk of bleeding and infection. These complications make liver biopsy an undesirable procedure to have performed repeatedly to monitor liver fibrosis.
The use of non-invasive measurement of liver fibrosis is now well established and Fibroscan® can provide a reliable method of detecting fibrosis. Fibroscan® uses transient elastography (TE) to assess liver fibrosis or ‘stiffness’. Shear waves are propagated from the probe and ultrasound follows the shear waves, measuring the speed at which the waves travel to a particular depth in the liver and back again.
The greater the degree of fibrosis the ‘stiffer’ the liver – the faster the wave response the greater the fibrosis. A Fibroscan® takes approximately 15 minutes and causes no discomfort to the patient. Patients are required to fast for at least three hours prior to the scan, but drinking water is fine.
Quantifying Steatosis – we now include a CAP™ score with the Fibroscan®. CAP™, the Controlled Attenuation Parameter, is a non-invasive measurement of steatosis or the amount of fat in the liver. It is based on the attenuation of ultrasound signals from the Fibroscan®, expressed in dB/m and combines with the fibrosis measurement to track the progression of liver disease. Risk factors for Hepatic Steatosis include but are not limited to obesity, diabetes and excessive alcohol consumption.
Referrals
There are many ways to make a referral. Please review the referral requirements below before choosing a preferred method.
- Patients full name
- DOB
Height
Weight
Indication for Fibroscan® and/or synopsis of patients medical history
FBC (preferably within 4 months)
Liver Function tests (preferably within 4 months)
Your contact details for the report
We accept referrals via Medical Objects. When making a referral using their system, please supply the following information :
Our Medical Objects ID : Liverscan Brisbane
Patient’s Name
DOB
Reason for referral
Your contact details
To open/download a referral form, please click the link below.
Alternatively, if you would prefer to have a Referral Pad posted, please complete your details below.
Once referral is completed fax to (07) 3319 6917 or email to: info@liverscanbrisbane.com.au
Useful links
Indications for Fibroscan®
Patients with abnormal LFT’s
Hepatitis C – assessment pre anti-viral treatment
Hepatitis B
Autoimmune Hepatitis
Alcoholic Liver Disease (ALD)
Fatty Liver (NAFLD)
Haemochromatosis
Assessment of liver fibrosis for drug / therapeutic indications e.g. Methotrexate use
Diabetes
Heart Disease
The result can be used to measure the current scarring, monitor its progression (eg. serial scans over time) and facilitate management of the patient’s treatment and prognosis. An ultrasound is often used in conjunction with Fibroscan®, to assess diseases such as hepatocellular carcinoma, lesions such as tumors or cysts, or portal hypertension and abdominal varices.
Contraindications
The manufacturers (Echosens, Paris) do not recommend the use of Fibroscan® on patients who are pregnant, or those fitted with a pacemaker or a cardiac defribrillator.
The presence of ascites may prevent the propagation of a shear wave.
In patients with a BMI > 35kg/m2 a specially developed probe (the XL probe) is used to allow for adequate visualisation of the liver.
Interpretation of the results is best performed in conjunction with other markers. At Liver Scan Brisbane we include an APRI score, NAFLD score (where appropriate) and FIB-4 Score.
If a consult for the patient with Dr Tony Rahman is also required, please state this on the form.