Alternatives to biopsy: measuring liver stiffness (FibroScan) and biomarkers
Fibroscan
The FibroScan is a non-invasive approach that is already showing promising results.
It is a scan that measures the ‘stiffness’ or ‘elasticity’ of the liver, using an ultrasound scan to create waves and measure their speed.
Wave speed is used to determine liver stiffness; the harder the liver tissue, the more rapidly the waves will pass though it.
Although this scan is much less sensitive in detecting mild or moderate liver damage, it is very sensitive at picking up severe damage. It can therefore identify people who need HCV treatment more urgently.
Results are presented as a figure in kilopascals (kPa). The higher the figure, the stiffer and more damaged the liver.
Results from Fbroscan do not equal fibrosis measured on other scores for all patients.
However, a score of over 7.2kPa indicates higher likelihood of significant fibrosis (F2 or greater on Metavir and needing HCV treatment) and over 13kPa indicates cirrhosis (F4 on the Metavir scale).
These results need to be interpreted in the clinical context and should be repeated before labelling significant fibrosis/cirrhosis.
FibroScan is not painful. In the UK, both the Royal Free Hospital and the Chelsea and Westminster Hospital are using Fibroscan to monitor people with HCV/HIV coinfection.
I refused to have a biopsy and for years argued with the specialists, but last month I had a FibroScan. This tests how stiff the liver is and can give an indication of the extent of liver damage. It was easy and painless
Non-invasive biomarkers of liver disease
New research is looking at whether results from laboratory tests can be used in place of a biopsy.This could easily change the way that HCV is managed in the future.
Studies using combinations of these lab results suggest they are useful for identifying serious liver damage, but it remains controversial whether they are a reliable substitute for a liver biopsy.
Youtube – FibroScan