Fibroscan®: Indications and Results in Ambulatory Patients

Abstract

Fibroscan®, or impulsion elastometry, has become essential in the management of chronic liver diseases. It is primarily used to diagnose and monitor liver fibrosis, as well as hepatic steatosis through CAP. The aim of this study is to examine the indications and clinical applications of Fibroscan® and compare the results with current clinical practices. Methods: This is a cross-sectional, retrospective study conducted from May 2019 to December 2023, which included all patients referred for evaluation of fibrosis and/or steatosis using FibroScan®. Results: A total of 750 patients were included: 440 women (58.6%) and 310 men (41.4%). The mean age was 50.2 years. Clinically, 8.2% had signs of chronic liver disease and 4% had signs of portal hypertension. Abdominal ultrasound showed abnormalities in 44.5% of the patients. The indications for Fibroscan® were distributed as follows: 34% referred for HBV, 21% for HCV, 15.7% for MASLD, 5.1% for MASH, 1.2% for AIH, 7.1% for cholestatic diseases, 2.1% for drug-induced chronic hepatitis, 0.9% for alcoholic liver disease, 1.2% for chronic liver disease of undetermined etiology, and 10.1% for portal hypertension. The average liver elasticity value was 8.7 kPa. It was classified as F0-F1 in 70.1% of cases and F4 in 16.1%. The average values were 12.9 kPa for HCV, 7.18 kPa for HBV, 5.2 kPa for MASLD, and 13.5 kPa for MASH. The average CAP value was 231.5 dB/m. 56.1% of cases showed no steatosis, and 20.5% had steatosis classified as S3. The average CAP values were 208.7 dB/m for HCV, 227.7 dB/m for HBV, 286.3 dB/m for MASLD, and 274.6 dB/m for MASH. Conclusion: Fibroscan® is a valuable and accessible tool that is effectively used to assess the severity of liver fibrosis and/or steatosis across a wide range of populations with commendable sensitivity and specificity. FibroScan® is then a reliable tool for significantly improving early diagnosis, guiding treatment decisions, and enhancing patient outcomes in the management of chronic liver diseases.