Painless test can predict severity of chronic liver disease

Doctors have completed a study that looks at the efficacy of a non-invasive device called the FibroScan to determine the prognosis of patients with liver disease.

Chronic liver disease, which includes illness due to fatty liver and viral hepatitis, affects at least one in 10 Canadians. University of Calgary research shows that the device is an effective method to predict the severity of liver fibrosis and health outcomes such as liver failure, liver cancer, and death.

The device, which uses a technique called transient elastography to determine the stiffness of the liver, is being increasingly used by liver specialists (hepatologists) instead of performing a liver biopsy. The stiffness of the liver correlates with the severity of liver scarring (fibrosis), which may end in cirrhosis and complications such as the need for transplantation.

The most important advantage of the device over liver biopsy — the traditional method of gathering this information — is that it is non-invasive. A biopsy, however, may lead to pain, bleeding, and even death. In addition, the device provides a rapid and immediate assessment of liver disease severity at a substantially reduced cost compared with biopsy.

“Many patients are very anxious about undergoing a liver biopsy, as it’s quite invasive and can be painful. Our study shows that we can get equally informative results using the FibroScan®, which is accurate yet has no known complications” says Dr. Robert Myers the lead author of the study and a University of Calgary researcher in the Snyder Institute for Chronic Diseases. 

Liver disease is often caused by hepatitis B or C, or more commonly, non-alcoholic fatty liver disease. Some estimates suggest that 20 to 30 per cent of the population may have fatty liver — typically due to overweight, diabetes, and/or elevated cholesterol — yet be unaware of their condition. 

Simple blood work or a liver ultrasound ordered by a family doctor could determine if you have liver disease and then a biopsy, or a FibroScan, would determine its severity. “Using this easy and affordable technology, we can now screen a large proportion of the population to determine who is at serious risk of complications, and in many cases, reassure our patients about their prognosis,” says Myers.

Dr. Myers uses the machine on a regular basis in his clinic and is also taking the machine to the Calgary Urban Project Society (CUPS) this week for a liver disease screening event. He hopes the device will be able to give affected patients at the centre a quick diagnosis on the severity of their liver condition so he can offer appropriate treatment.

Dr. Myers has been using the machine for research at the University of Calgary Liver Unit since 2008. Calgary patients were some of the first in North America to have access to this new technology. The machine was approved for clinical use by Health Canada in 2009 and there are about 20 machines in use across Canada.

The findings of this research study were published in the April 2014 edition of PLOS One.

The study was funded in part by grants from CIHR, AIHS, and the Canadian Liver Foundation, and is based on data provided by Alberta Health.