FibroScan

What it measures: fibrosis, steatosis
Who should take it: undiagnosed and diagnosed NAFLD/NASH patients
Where to get it: specialty care centers, hospitals, some primary care providers

FibroScan is an imaging-based diagnostic test developed by Echosens that looks at liver fibrosis (stiffness, scarring) and steatosis (fat) using transient-elastography technology. FibroScan can be used on patients in need of staging of their NAFLD/NASH, whether their condition is suspected or biopsy-confirmed. FibroScan works similarly to an ultrasound, emitting a small pulse of energy, called a shear wave. The speed of the shear wave is measured as it travels through your liver, generating two scores to determine overall liver health. The first score measures liver stiffness and the second score measures liver fat. In combination, these scores can help you understand your overall liver health and how it may change over time with lifestyle or medical interventions.[1] The only thing you will feel while taking the test is a light vibration on your skin and the entire procedure takes less than 10 minutes.

Depending on where you get a FibroScan may determine the scoring system used in your diagnosis. Typically, a 5-pointscoring system is used to grade the degree of liver fibrosis, from F0-F4. Scores from the FibroScan will be in kilopascals (kPa), ranging from 2 to 75 kPa. Normal livers fall between 2 and 6 kPa, with anything outside this range indicating some degree of liver disease.[2] The table below, adopted from MSK, considers different scores in the context of different liver diseases and can be used to help determine fibrosis score. It is important to remember that the ranges in the table are estimates, and your actual fibrosis score may not match what the table says. When determining your actual fibrosis score, in addition to your fibrosis measurement, your provider will take into consideration your health history and the grade of steatosis.

To use the table, find the liver disease that you have on the left side of the table. Read across the row from left to right until you find the range that includes your fibrosis result. Then, look at the top of that column to see the fibrosis score.[3]

FibroScan has been in available in the European market since 2003 and was expanded to China, Canada, Brazil, Japan, and many other countries before being approved by the FDA in 2013.[4] It is reimbursable by insurance. To find a location near you with a FibroScan machine, use Echosens’ locator, which can be found here.

[1] Echosens, For Patients, https://echosens.us/for-patients/

[2] Memorial Sloan Kettering Cancer Center, Understanding Your FibroScan Results, February 2018, https://www.mskcc.org/cancer-care/patient-education/understanding-your-fibroscan-results

[3] Memorial Sloan Kettering Cancer Center

[4] Echosens, FDA Approves FibroScan® for Non-invasive Liver Diagnosis, April 2013, https://www.prnewswire.com/news-releases/fda-approves-fibroscan-for-non-invasive-liver-diagnosis-203186961.html#:~:text=%2D%20Echosens%E2%84%A2%20is%20pleased%20to,technology%20in%20the%20United%20States.