Liver Elastography — Helping Patients Avoid an Invasive Liver Biopsy

April 30, 2017 Doctors continually strive to get the best possible information available while striking a balance between good, reliable data which is essential for accurate diagnoses, and patient comfort and safety.

Enter liver elastography.

For years, a liver biopsy was the most reliable way to assess the status of patients with chronic liver disease.

Dr. Scott King, a radiologist at Inland Imaging, explains the background, “When someone has chronic liver disease, most commonly Hepatitis C, Hepatitis B, and alcohol abuse, the chronic inflammation eventually results in liver scarring. When this scarring, or fibrosis, becomes severe, the risk of complications of chronic liver disease, including liver cancer, increases dramatically.”

Liver biopsy can determine the degree of liver fibrosis. There are potential medical complications with biopsy, however, not to mention other inconveniences. Patients may experience pain, must undergo sedation, require up to a day of recovery time, and need to arrange for transportation to and from their appointment.

In contrast, liver elastography can provide the information a doctor needs without the biopsy in most patients. The patient only undergoes a non-invasive ultrasound.

“The exam itself is simple and painless,” says Dr. King.

To prepare, patients should not eat or drink for 4 hours prior to their appointment. During the exam, the patient lies comfortably on their back while an ultrasound technologist will take images of the liver, gallbladder, spleen and sometimes more, depending on the ordering provider's request. Then there is about 5-10 minutes of additional imaging of the liver to obtain the elastography measurements. After the exam, the patient will leave with no lingering side effects.

“For most patients, it’s a ticket to avoid a liver biopsy,” says Dr. King.

A radiologist will review the images and assess an “F-score,” or fibrosis score. This tells the doctors the level of liver scarring present. Dr. King explains the results, “The F-score scale is from F0-F4, with scores of F3 and F4 corresponding to severe fibrosis and cirrhosis, respectively. Scores of F0-F1 correspond to No or Minimal Fibrosis, respectively. F2 is in-between. Your provider will use this information to help determine the most appropriate care plan.”