1. For what liver diseases is the FibroScan® useful?
The FibroScan® was originally studied in patients with hepatitis C. However, the accuracy of the FibroScan® for staging liver fibrosis (scarring) has now been demonstrated in nearly all liver disorders, including fatty liver, hepatitis B, alcoholic liver disease, hemochromatosis, cystic fibrosis, autoimmune liver diseases, and others.
2. What can I expect during my FibroScan® procedure? Is it painful?
The FibroScan® examination is an entirely non-invasive, painless procedure, with no known complications. You will only feel a gentle tapping over your liver in the right upper abdomen. The entire appointment will last less than 15 minutes.
3. Is there any preparation necessary (e.g. fasting) prior to my FibroScan®? Are there any restrictions after the procedure?
We recommend that you fast for at least 3 hours prior to your FibroScan® examination as a large meal as may cause an overestimation of liver stiffness. There are no restrictions after the procedure.
4. What is the difference between a FibroScan® and liver imaging (radiology) procedures like ultrasound, CT, or MRI?
A liver ultrasound uses sound waves to produce a visual image of the liver, like a blurry photograph. Similarly, CT and MRI produce images of the liver, albeit based on different technologies. None of these imaging (radiology) procedures provide information about the severity of liver scarring except in very extreme circumstances (i.e. advanced cirrhosis). Unlike the radiology procedures described above, the FibroScan® does not take an image of the liver, and therefore, can not identify findings such as liver cancer, gallstones, or bile duct problems. However, unlike these procedures, FibroScan® measures liver stiffness and is much more sensitive for identifying scarring (i.e., fibrosis). In other words, the greater sensitivity of the FibroScan® allows one to identify liver scarring at an earlier stage than these imaging procedures, and therefore, start appropriate treatment before the disease is too advanced. With respect to fatty liver, the FibroScan® is also more sensitive than the abdominal imaging procedures described above and has the advantage of being able to quantify or grade the severity of fatty infiltration.
5. Are there alternatives to the FibroScan®?
The FibroScan® is typically performed as an alternative to liver biopsy. Liver biopsy is an invasive procedure that involves passing a needle through the skin into the liver to take a small piece for examination under the microscope. Due to its invasiveness, biopsy may cause complications including pain (seen in 1 in 5 patients), bleeding (1 in 1,000 patients), and/or death (1 in 10,000 patients). On the contrary, the FibroScan® is entirely non-invasive, and therefore, has no complications. Liver biopsy also requires a patient to miss a day of work whereas a FibroScan® appointment takes only 15 minutes. Lastly, biopsies sample only 1/50,000th of the liver, whereas the FibroScan® samples 1/500th of the liver (a 100-fold difference). Therefore, the FibroScan® may give more accurately assess liver health. The other major alternatives to the FibroScan® are blood tests such as the FibroTest/FibroSure®. Although the costs of these tests are similar, the FibroTest® is not widely available in Canada and has a significant delay (4 to 6 weeks) before results are obtained. On the contrary, FibroScan® results are available immediately. As mentioned above, liver imaging (radiology) tests such as ultrasound, CT, and MRI provide images of the liver (which FibroScan® does not), but these tests do not give an accurate assessment of the stage of liver damage except in very severe cases when it's generally too late to intervene.
6. Are there any patients who can not have a FibroScan®?
In patients with ascites (fluid in the abdomen), the exam may fail. In other patients, liver stiffness may be elevated due to liver problems other than scarring (e.g. severe inflammation, congestion due to heart failure, or bile duct obstruction).
7. Can children have a FibroScan®?
The FibroScan® is useful in children, however, a specially designed probe (the S2 probe) may be needed. This probe has a narrower tip than the standard adult (M) probe which fits more easily between the ribs of children. We do not currently own one of these probes; however, many children can be scanned using an adult (M) probe. If you would like your child to have a FibroScan®, please contact us at email@example.com or by calling 416-268-0150 to confirm. If we cannot scan your child, Liver Scan Direct will not charge you for your FibroScan®.
8. Is a referral from a physician needed for a FibroScan®?
A physician referral is not needed to schedule an appointment at Liver Scan Direct because the procedure is not covered by provincial health care plans (e.g., OHIP). However, interested physicians may complete a FibroScan® referral form and fax it to us at 647-494-3243 or email it to firstname.lastname@example.org.
9. How can I book an appointment myself?
You can book an appointment by pushing the red button at the top of this page that reads "BOOK YOUR APPOINTMENT ONLINE NOW". This will take you to our secure scheduling website which provides all available appointment times. You will be able to select a clinic that is most convenient for you and will be asked to provide a few basic contact details that will remain confidential. It takes less than one minute to complete the entire process. If you would prefer to book an appointment over the phone, please call 416-268-0150, or email email@example.com.
10. How much does the procedure cost? How can I pay?
The FibroScan® is not currently covered by provincial health care plans (e.g., OHIP). Therefore, we charge $140 for the procedure (additional charges may apply at satellite clinics). Liver Scan Direct accepts payments by cash, VISA, MasterCard, and Amex. We accept debit payments at certain locations. You will receive a receipt after your appointment. Private insurers and employee flexible spending accounts may reimburse this fee and it may be claimed on your income tax return.
11. What happens if a FibroScan® measurement cannot be obtained?
In some patients, we cannot obtain a FibroScan® measurement. Most of these 'FibroScan® failures' occur due to obesity. However, with a specially designed probe (the XL probe), failures occur in only 1-2% of obese patients. Nevertheless, if we cannot obtain a measurement, Liver Scan Direct will not charge you for your FibroScan®.
12. What is your cancellation policy?
Liver Scan Direct requires at least 24 hours notice prior to a cancellation or rescheduling of your booking. If you do not provide at least 24 hours notice, Liver Scan Direct may invoice you the full cost of the procedure.
13. How long will it take to receive my results?
Please provide your physician's name and fax number at your appointment and your report will be faxed to them within 10 business days. Your physician will review your results with you.
14. How often can the FibroScan® be repeated?
There are no limits on the frequency of FibroScan® examinations. In many patients, repeat FibroScans® are performed every 1 to 2 years to monitor for disease progression or improvement. For example, in patients with fatty liver, intermittent monitoring of liver stiffness and CAP can determine if the severity of fatty liver is improving with treatment (e.g., with weight loss or control of diabetes and/or high cholesterol).
15. Will Liver Scan Direct travel to scan patients outside of the Etobicoke head office?
Liver Scan Direct offers satellite clinics in the offices of partner physicians throughout Toronto, Scarborough, Mississauga, Brampton, Richmond Hill, Woodbridge, Newmarket, Burlington, Waterloo, Kitchener, Cambridge, and Guelph. Please inquire about scheduling at one of these locations if more convenient for you. Due to additional expenses, the fee for a FibroScan® is up to $150 at these satellite clinics. If you are a physician interested in scheduling group bookings at your office, please contact us at 416-268-0150 or email firstname.lastname@example.org. In some circumstances, financial support from third parties may be available to support FibroScan® clinic days.
If you have additional questions that are not answered above, feel free to email us at email@example.com.