Diagnosis of Fatty Liver Disease with Fibro Scan CAP

Fatty Liver Disease refers to the accumulation of fat within the cells of the liver mostly in the form of triglycerides, and may include liver infection. In some individuals it may be a chronic infection leading to liver fibrosis. The
cause of this condition is unclear at the moment, however there may be a number of factors which may include insulin resistance, and other mechanism that cause storage of fat, infection, and eventual cell death.

Most patients will not display clear symptoms, however some may experience a feeling of tightness on the right side of the abdomen lasting for a prolonged periods. Symptoms of liver fibrosis include weariness and an enlarged
abdomen. This condition may be diagnosed with a blood test or an annual health check-up; detection and prompt treatment can help to reduce risks of further complications.

Today an effective diagnostic tool is the Fibroscan with CAP (Controlled Attenuation Parameter). Bangkok Hospital is the first in Thailand to introduce this technology which is capable of diagnosing liver fibrosis in its earliest stages, as well as evaluating severity; it is effective in providing a quick insight into the amount of fat stored within the liver. This allows doctors to develop an appropriate treatment plan to prevent complications

Functions

1. Fibroscan utilizes sound waves and ultrasound and measures the wave velocity that is reflected back to determine the presence of severity of liver fibrosis. The principle states that the faster the sound travels back (measured in kPa) the more likely that the liver has hardened.

2. Controlled Attenuation Parameter: CAP Utilizes ultrasound waves into the liver and measures resistance. A higher concentration of fat will result in higher resistance (measured in decibels/meter).

Advantages of Fibroscan with CAP

Preparation for this test is quite simple; there is no need for the patient to abstain from consuming food or liquids. It can be conducted immediately, and can provide insight into the status of the liver within just one session.

The Fibroscan lasts approximately 8-10 minutes and is highly accurate as it can penetrate as deep as 6.5 cm x 3 cm. Results can be obtained immediately after the scan and there are no complications. These tests can be done as
many times as required without risk of negative side effects, patients are not required to spend the night at the hospital and may return home right after. Furthermore, this is not considered to be a high-cost procedure.

Limitations of Fibroscan with CAP

It is unable to diagnose tumor or cancer in the liver and may not be used on patients with a BMI of more than 28 kg/m2. It is unsuitable for pregnant women and patients with ascites (fluid in the abdominal cavity). It is also
unsuitable for patients with a pacemaker, implants, heart patients, cancer in its latter stages, and certain other medical limitations.

Who is eligible for Fibroscan with CAP

• Patients with hepatitis B or C

• Patients who have liver fibrosis that is not caused by a virus

• Patients with a fatty liver

Procedure

• The patient lies still with both arms raised above their head
• A gel will be applied to the patient's right side before the ultrasound procedure can begin. This may be done 10 times and a session will last approximately 8-10 minutes. There are no other specific instructions for this test.