In Office Testing
Vibration Controlled Transient Elastography (Fibroscan) is a non-invasive method for the assessment of hepatic (Liver) Fibrosis in patients with chronic liver disease measuring stiffness. It can easily be performed in an outpatient setting and is painless.
During measurement, a slight vibration on the skin can be felt. There is minimal preparation for this test and it is covered by most insurance plans.
Understanding your FibroScan® Results
This information will help you understand your FibroScan® results.
FibroScan is a specialized ultrasound machine for your liver. It measures fibrosis (scarring) and steatosis (fatty change) in your liver. Fatty change is when fat builds up in your liver cells.
FibroScan will help your healthcare provider learn more about your liver disease. It can be used alone or with other tests (such as blood tests, imaging scans, or biopsies) that also measure scarring or fatty change in your liver.
Your FibroScan Results
FibroScan steatosis result (CAP score): __________ decibels per meter (dB/m) – Steatosis grade: _________
FibroScan fibrosis result: __________ kilopascals (kPa) – Fibrosis score: _______________
Your healthcare provider will talk with you about your results during your appointment. If you have questions, call your doctor’s office. You can reach them Monday through Friday from 9:00 am to 5:00 pm at 212-639-7336.
The rest of this resource explains your FibroScan results in more detail, including how your healthcare provider uses your results to determine your steatosis grade and fibrosis score. You can read the sections below if you’d like to learn more.
About Your CAP Score
Your CAP score is a measurement of fatty change in your liver. Your healthcare provider will use your CAP score to find out your steatosis grade.
The CAP score is measured in decibels per meter (dB/m). It ranges from 100 to 400 dB/m. The table below shows ranges of CAP scores and the matching steatosis grade and amount of fatty change.
|CAP Score||Steatosis Grade||Amount of Liver with Fatty Change|
|238 to 260 dB/m||S1||11 to 33%|
|260 to 290 dB/m||S2||34 to 66%|
|Higher than 290 dB/m||S3||67% or more|
About Your Fibrosis Result
Your fibrosis result is a measurement of the amount of scarring in your liver. FibroScan measures scarring by measuring the stiffness of your liver.
The fibrosis result is measured in kilopascals (kPa) It’s normally between 2 and 6 kPa. The highest possible result is 75 kPa. Many people with liver disease(s) have a result that’s higher than the normal range.
Your healthcare provider will use your FibroScan fibrosis result and your medical history to determine your fibrosis score.
- Fibrosis score F0 to F1: No liver scarring or mild liver scarring
- Fibrosis score F2: Moderate liver scarring
- Fibrosis score F3: Severe liver scarring
- Fibrosis score F4: Advanced liver scarring (cirrhosis)
Using your FibroScan fibrosis result to estimate your fibrosis score
The table below shows liver diseases, ranges of fibrosis results, and the matching fibrosis score. The ranges of fibrosis results in the table are estimates. This means that your actual fibrosis score (the score that your healthcare provider tells you) may not match the fibrosis score in the table. If you have more than one liver disease, you may not be able to use the table.
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.
|F0 to F1||F2||F3||F4|
|Hepatitis B||2 to 7 kPa||8 to 9 kPa||8 to 11kPa||18 kPa or higher|
|Hepatitis C||2 to 7 kPa||8 to 9 kPa||9 to 14 kPa||14 kPa or higher|
|HIV/HCV Coinfection||2 to 7 kPa||7 to 11 kPa||11 to 14 kPa||14 kPa or higher|
|Cholestatic Disease||2 to 7 kPa||7 to 9 kPa||9 to 17 kPa||17 kPa or higher|
|Non-alcoholic Fatty Liver Disease (NAFLD or NASH)||2 to 7 kPa||7.5 to 10 kPa||10 to 14 kPa||14 kPa or higher|
|Alcohol Related Disease||2 to 7 kPa||7 to 11 kPa||11 to 19 kPa||19 kPa or higher|
Your fibrosis result may be over-estimated (your liver may have less scarring than what your fibrosis result says) if you have:
- Liver inflammation. This can be caused by a recent liver illness or drinking alcohol.
- Benign (not cancerous) or cancerous tumors in your liver.
- Liver congestion (when your liver is too full of blood or other fluids). This is usually caused by heart failure.
Your FibroScan results may also be less accurate if you have:
- A body mass index (BMI) higher than 30 (obesity)
- A build-up of fluid in your abdomen (ascites)
- Too little bile flowing out of your liver (biliary obstruction)
Hydrogen Breath Test
A hydrogen breath test is used as a diagnostic tool for small intestine bacterial overgrowth (SIBO) and carbohydrate malabsorption, such as lactose and fructose. The test is a simple non-invasive test and it is performed after a short period of fasting with dietary restrictions prior to the test. The test may last up to three hours with samples taken every 30 to 6o minutes in our office setting.
The breath samples that are taken are analyzed in a machine which are then placed on a graft and interpreted by your medical provider. The provider will give direction based on the results of your breath test.
Wireless Capsule Endoscopy
Wireless Capsule Endoscopy is a procedure designed to help our physician see what is happening inside your gastrointestinal (G.I.) tract. The G.I. tract is the tube which extends from the mouth to the anus in which the movement of muscles digests food.
Wireless capsule endoscopy helps your doctor determine the cause for recurrent or persistent symptoms such as abdominal pain, diarrhea, bleeding or anemia in most cases where other diagnosis procedures failed to determine the reason for your symptoms. The capsule is a bit larger than a pharmaceutical capsule and it contains a tiny camera and an array of LED’s powered by a battery.
After a patient swallows the capsule, it passes along the G.I. tract taking a number of images per second which are transmitted wirelessly to receivers connected to a portable recording device carried by the patient. At the end of the procedure (about 8 hours in total), patients return and the recorder is downloaded for the provider to review the images on the computer screen.
If this test is ordered for you, you will be provided the following information:
• How to prepare for the test
• Contraindications for the test
• Possible complications for the test
• What to expect during the test
• Indications and reasons for ordering and performing the test