Diagnosing liver disease

Liver scarring (‘fibrosis’) is the most important outcome of all liver diseases including hepatitis B and C, fatty liver, and alcoholic liver disease. Until recently, physicians have relied on blood tests, imaging, and biopsy to determine the severity of liver damage. Unfortunately, blood tests (e.g. ALT, GGT) and imaging (e.g. ultrasound, CT, MRI) are too inaccurate, and liver biopsy is an invasive procedure that may cause serious complications including pain (1 in 5 patients), bleeding (1 in 1,000), and even death (1 in 10,000). As a result, patients and physicians have long sought accurate, non-invasive methods for assessing liver disease severity. The FibroScan® - approved for clinical use in Canada in 2009— is one such tool.

New technology

The FibroScan® is a non-invasive device that measures liver stiffness using a technique called Vibration-Controlled Transient Elastography (VCTE™). With VCTE™, a mechanical impulse is transmitted through the skin to the liver and its speed of passage is measured using an ultrasound-based method. As scarred livers become stiff, the wave travels faster in patients with liver fibrosis/cirrhosis. The examination lasts only minutes, provides immediate results, and has no side effects. Most importantly, hundreds of clinical studies have confirmed the accuracy of the FibroScan® compared with biopsy for most liver diseases.

Stats on your liver:

  • An estimated 600,000 Canadians are living with hepatitis B or C.
  • Liver cancer is one of the fastest rising forms of cancer in Canada.
  • Liver failure due to hepatitis C is the leading cause of liver transplants.
  • Fatty liver disease linked to obesity is the most common form of liver disease in Canada.

As such, the FibroScan has become the standard means of assessing liver scarring by specialists in Canada and globally. Liver stiffness measured by the FibroScan® also predicts the risk of developing liver-related complications. In particular, patients with low liver stiffness have a very low risk of developing liver failure, requiring a transplant, or developing liver cancer.  In fact, monitoring for changes in liver stiffness over time is a useful method of tracking liver disease progression.

Risk factors

Another advantage of the FibroScan® is its ability to determine the severity of fatty liver (‘steatosis’) using a technique called the Controlled Attenuation Parameter (CAP®). Fatty liver affects 20-30 percent of Canadians and is increasing in frequency due to rising rates of overweight/obesity, diabetes, elevated cholesterol, and excess alcohol intake. As some patients with fatty liver may develop cirrhosis, accurate identification of affected patients and determining the quantity of liver fat is vital to initiate appropriate therapy and prevent liver complications.