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Fibrosan

Category: Blood Pressure

Description

Vasotec is used for treating high blood pressure, heart failure, and other heart problems.

Active Ingredient: Enalapril

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What is FibroScan®?

What is FibroScan® ?

Examination with FibroScan®, also called transient elastography, is a technique used to assess liver stiffness (measured in kPa correlated to fibrosis) without invasive investigation. The result is immediate, it shows the conditionof the liver and allows physicians to diagnoseand monitor disease evolution in conjunction with treatment and collateral factors. Exam results help to anticipate various complications, as well as to monitor and assess the damage caused by conditions such as cirrhosis. The FibroScan® examination is painless, quick and easy. During measurement, you feel a slight vibration on the skin at the tip of the probe.

What does the FibroScan® examination consist of?


  • You lie on your back, with your right arm raised behind your head. Physician applies a water-based gel to the skin and places the probe with a slight pressure
  • The examination includes 10 consecutive measurements made at the same location
  • The result is delivered at the end of the examination, it’s a number which can vary from 1.5 to 75 kPa. Your doctor will interpret the result

What does the result mean?

Your physician interprets the result according to your history and underlying disease.

Who can prescribe the FibroScan® examination?

Your physician or hepatologist will indicate the most appropriate time for you to have the examination.

What difference does FibroScan® make to me?


  • Fibroscan® provides immediate results, it’s easy and fast (5-10 minutes)
  • The exam is painless and non-invasive
  • In case of close follow-up, the examination can be safely repeated

Other articles

FibroScan Results: The Scoring Card - Hepatitis C New Drug Research And Liver Health


FibroScan® Scoring Card - Understanding The Results

FibroScan®
FibroScan®, sometimes called transient elastometry (TE) is a FDA approved non-invasive test to measure liver inflammation and fibrosis, (arguably) comparable to a liver biopsy, particularly in the higher end of the Metavir scale (Stages 3 and 4).

What is Metavir Grading System?
Several grading systems are used to determine "liver biopsy " results. Th e Metavir grading system uses two standardized numbers: one called "grade" to indicate degree of inflammation (tissue swelling and irritation) and the other called "stage" which indicates the degree of fibrosis (tissue scarring due to prolonged inflammation).

A 4-point scale is used in grading the degree of liver inflammation or histological activity:

  • A0= no inflammation
  • A1= mild inflammation
  • A2= moderate inflammation
  • A3= severe inflammation

Stage

A 5-point scale is used in grading the degree of liver fibrosis:

  • F0= no fibrosis
  • F1= minimal fibrosis
  • F2= fibrosis has occurred and spread inside the areas of the liver including blood vessels
  • F3= fibrosis is spreading and connecting to other liver areas that contain fibrosis
  • F4= cirrhosis or advance liver fibrosis

Fibroscan scoring card

Keeping this in mind, we can use the Fibroscan scoring card to convert Fibroscan results measured in ( kPa ) into the Metavir scale F1-F4.

Located on the bottom of the Fibroscan scoring card is Fibroscan results in (kPa ) measurements 0-75, more accurately Fibroscan results range from 2.5 kPa to 75 kPa. B etween 90–95% of healthy people without liver disease will have a liver scarring measurement less then 7.0 kPa (median is 5.3 kPa ).

A person with chronic hepatitis C and a liver stiffness more then 14 kPa has approximately a 90% probability of having cirrhosis, while patients with liver stiffness more then 7 kPa have around an 85% probability of at least significant fibrosis.

However, r esearch has shown Fibroscan accuracy in assessing lower degrees of liver fibrosis (F1-F2) is not as reliable compared to diagnosing advanced fibrosis and cirrhosis (F3/F4)

Fibroscan Scoring Card

Fibroscan® - Chong Lap

Chong Lap Echosens – Fibroscan®

Chong Lap is proud to have become the exclusive distributor of Echosens in Hong Kong, Taiwan, and Macau.

Echosens SA is a young and dynamic medical imaging equipment company based in Paris, France. Their primary product, Fibroscan®, resulted from five years of development and research in an innovative technology called transient elastography. Fibroscan® is the world’s first non-invasive device for assessing hepatic fibrosis. The device measures liver stiffness by generating a shear wave from the probe to the tissues. This wave is then tracked by ultrasound flashes and its velocity is measured. Since stiffness is proportional to the speed of the shear wave in soft tissues, Fibroscan® allows practitioners evaluate liver stiffness in patients.

Fibroscan®

Fibroscan® is the world’s first non-invasive device for assessing hepatic fibrosis. The device measures liver stiffness by generating a shear wave from the probe to the tissues. This wave is then tracked by ultrasound flashes and its velocity is measured. Since stiffness is proportional to the speed of the shear wave in soft tissues, Fibroscan® allows practitioners to evaluate liver stiffness in patients with chronic liver diseases.

Why Fibroscan®?

Hepatitis B & C, diabetes, alcoholism, obesity, and certain drugs can cause liver fibrosis, cirrhosis, and even hepatcellular carcinoma (HCC). In Hong Kong, around 9% of the population are chronic hepatitis B (CHB) carriers, many of whom are at high risk of developing cirrhosis and HCC. Although not all CHB carriers develop cirrhosis, once a cirrhotic patient, it is 20 times more likely for HCC to develop within 10 years.

The most direct examination of the liver is done through a biopsy. However, its invasiveness and side-effects mean that it has been:

  • Regulated to a later stage in the investigation of liver disease assessment
  • Reduced in frequency since biopsy cannot ethically be used to monitor all but the most aggressive approaches

Experience supported by research has shown that liver biopsy has drawbacks such as:

  • Considerable pain in 30% of cases
  • 0.3% morbidity (haemorrage) and one death in 3,000 cases
  • Difficult to reproduce and dependent on operators
  • High error rate (25% false negatives for cirrhosis diagnosis)
  • Expensive

Fibroscan® offers a different way of managing liver disease. By providing a non-invasive measurement of liver stiffness, the Fibroscan® gives the practitioner an easily-accessible insight into the patient’s liver condition without incurring risks for the patient. The measurement result is instantaneous, which allows the doctor to have immediate information for deciding the next course of action.

Fibroscan® is an excellent diagnostic device with advantages such as:

  • Totally non-invasive and painless
  • Quick and easy to use
  • Rreproducible
  • Quantitative
  • Liver volume measured 100-200 times larger than liver biopsy
  • Immediate results
  • Operator independent
  • Usable on almost all patients with compensated liver disease

In addition, unlike ultrasound imaging devices, only dexterity training is required for the operation of Fibroscan®. so it is accessible to any trained healthcare technician. The simplicity of Fibroscan® opens the possibility of:

  • Incorporating Fibroscan® into diagnostic routines of specialized centers as an additional input to determine treatment choice and monitor treatment progress
  • Using Fibroscan® routinely to assess the state of cirrhosis, determine the frequency of liver disease, and help decide on the type of monitoring used
  • Devolving the screening of patients to peripheral centers; providing information about which patients need to be referred to a central specialized facility for more precise diagnosis
  • Communicating the appropriate sense of urgency (or lack thereof) in treatment courses where compliance is a major factor

In summary, Fibroscan® allows faster and more informed decisions to be made based on a better understanding of the severity of fibrosis and cirrhosis, which can help doctors determine the prognosis for the patient.

Fibroscan® Screening

During the screening, the patient should lie down on the examination bed with his/her right hand behind his/her head. The practitioner will place the probe between the right ribs of the patient.

The screening is quick and easy, usually taking less than 15 minutes. Fibroscan® should only be administered by trained practitioners. Patients should consult their attending doctors before conducting the test.

Please contact us for additional information about Fibroscan®.

Warning

Clinical Studies

Clinical Studies

Liver fibrosis is the main predictor of the progression of chronic hepatitis C, and its assessment by liver biopsy (LB) can help determine therapy. However, biopsy is an invasive procedure with several limitations.

Transient elastography (FibroScan; Echosens, Paris, France) is a novel, noninvasive, and rapid bedside method to assess liver fibrosis by measuring liver stiffness. We prospectively assessed the performance of FibroScan in patients with chronic hepatitis C, in comparison with and combined with currently available biochemical markers…

The current study aimed to establish the liver stiffness (LS) cut-off values and their performance in the prediction of the fibrosis stage in chronic hepatitis C (CHC) patients, to find the anthropometric and biochemical factors leading to overestimation of the fibrosis stage…

The accurate diagnosis of hepatitis C virus (HCV)-related fibrosis is crucial for prognostication and treatment decisions. Due to the limitations of biopsy, noninvasive alternatives including FibroTest and FibroScan have been developed. Our objective was to systematically review studies describing the accuracy of these tests for predicting HCV-related fibrosis.

Ultrasound-based transient elastography is a promising noninvasive alternative to liver biopsy for detecting hepatic fibrosis. However, its overall test performance in various settings remains unknown.

Chronic hepatitis B

The need for new non-invasive tools to assess liver fibrosis in chronic liver diseases has been largely advocated. Liver stiffness measurement (LSM) using transient elastography (FibroScan), Echosens) has been shown to be correlated to liver fibrosis in various chronic liver diseases.

The aim of this study is to know the liver stiffness measurement (LSM) cutoffs for different stages of liver fibrosis in chronic hepatitis B (CHB) and to investigate the effect of alanine aminotransferase (ALT) on LSM.

Transient elastography (TE), a non-invasive tool that measures liver stiffness, has been evaluated in meta-analyses for effectiveness in assessing liver fibrosis in European populations with chronic hepatitis C (CHC). However, these data cannot be extrapolated to populations in Asian countries, where chronic hepatitis B (CHB) is more prevalent.

Non invasive methods for fibrosis evaluation remain to be validated longitudinally in hepatitis B

Antiviral treatment follow up

Transient elastography measures liver stiffness, which correlates with the hepatic fibrosis stage and has excellent accuracy for the diagnosis of cirrhosis in patients with chronic hepatitis C.

Liver stiffness (LS) measurement by means of transient elastography (TE) is accurate to predict fibrosis stage. The effect of antiviral treatment and virologic response on LS was assessed and compared with untreated patients with chronic hepatitis C (CHC).

To evaluate the association between liver stiffness measured by transient elastography (FibroScan) and the efficacy of long-term nucleoside analog (NA) treatment for patients with chronic hepatitis B.

Coinfection

Chronic hepatitis C in HIV-infected patients is an increasing cause of death dependent on the development of liver fibrosis, which is currently assessed by liver biopsy despite its limitations. Liver stiffness measurement, a new noninvasive method, allows the evaluation of liver fibrosis.

To evaluate the course of liver fibrosis, 328 HIV-hepatitis C virus (HCV)-coinfected patients (210 HCV treated and 118 HCV untreated) were followed-up for 38-42 months. Liver fibrosis was assessed by biopsy or elastometry at baseline and by elastometry afterward, in addition to other noninvasive indexes.

Transient elastography (TE) is a noninvasive technique to evaluate liver fibrosis. We compared the performance of TE with liver biopsy (LB) in patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection.

Fibrosan diseases

Do you suffer from liver cirrhosis, chronic viral hepatitis (hepatitis B, C, D) or other chronic liver diseases? Then FibroScan is exactly what you need for proper and effective diagnosis. Designed specifically to find out the degree the liver tissue is affected, FibroScan is noninvasive, painless and has no side effects and operates on ultrasound.

In medical terms, this method is called “hepatic elastography” and FibroScan is the device used to carry out the investigation. Recently implemented to assess liver function, elastography can successfully replace “well-known” puncture. Until nowadays, people from the Republic of Moldova, suffering from liver cirrhosis, chronic hepatitis or other liver diseases, were forced to apply puncture to find out the degree the liver has been damaged by the disease. Besides numerous risks they faced due to the intervention, there was another problem. Not always the doctor managed to collect conclusive tissue samples, which resulted in wrong diagnosis, while the inappropriate treatment shortened patients’ lives. Now, due to the German Diagnostic Centre and advanced FibroScan device, the patients can quickly find out the state of their liver, easily and risk-free, whenever they need it. It should be noted that this investigation is not recommended for pregnant women in the first and the third trimester of pregnancy; however, in order to assess the risk for the mother and the child’s health, FibroScan investigation will be carried out at the hepatologist’s recommendation.

The operating principle of the device is simple: the tougher the liver is, the higher the degree of fibrosis is. With the help of a transducer, the device emits ultrasonic waves to the liver’s parenchyma and the speed with which the wave beam is reflected to the emission probe is measured. The tougher the tissue is, the faster the wave propagates, and liver elasticity is assessed by calculating the average of several measurements performed in this area. The result of the investigation is available immediately and the procedure can be repeated as often as required.

Due to FibroScan, the doctor can accurately find if it is a mild or a severe fibrosis and according to these results can determine the appropriate treatment, which will extend the patient’s life.

Liver Elastography can be helpful if you suffer from:

- Chronic hepatitis (hepatitis B, C, D);

- Alcoholic liver disease;

- Cirrhosis of the liver;

- Diseases of the liver with prolonged jaundice (cholestasis);

- Chronic hepatitis or drug toxicity;

- Non-alcoholic liver steatosis;

- Evaluation of the liver after transplant;

- Dynamic evaluation of the state of the liver and effectiveness of the administered treatment;

- Need for a surgical biopsy.

Investigation has disadvantages for obese patients. Due to overweight, ultrasounds fail to cross the area required for the investigation. At the same time, people who have narrow spaces between the bones and those suffering from ascites (accumulation of fluid in the abdominal cavity) are prohibited to undergo hepatic elastography.

Fibroscan Technology: New Choice for Liver Diseases

Human liver is the major internal organ, charged with tasks to keep the body system continues to function at status quo.

The liver is the largest organ in your body and carries out many vital functions. Its responsibilities are, or example, digesting proteins and fats, removing toxins from your body, producing chemicals that stop the blood from clotting, and releasing bile in order to aid digestion. Any disruption or disorder on one of these functions could result in fatality.

Some of the diseases that might lead to liver damage or liver cancer are such as cirrhosis (a serious condition that destroys healthy tissue), hepatitis B and hepatitis C (both are blood-borne viral infection that can gradually cause damage to the liver), haemochromatosis (a rare genetic condition where the body absorbs an excess amount of iron from food, causing cirrhosis), and alcohol abuse (where the liver is unable to cope with the amount of alcohol and become damaged).

Somehow, there are standards for predicting the state of the liver and how much liver damage one may or may not have is done by the process of liver biopsy; which is executed by removing and examining a small piece of tissue from the patient's liver for signs of damage or disease.

Prior to the liver examination procedure, the patient must refrain from eating or drinking for at least 6 hours. The procedure is done by making a small incision, and then inserting a biopsy needle to retrieve a sample of the liver tissue. After the procedure, the patient also has to lie under observation for another 12-24 hours.

Now a new device in clinical trial is developed and known as the fibroscan. Fibroscan is a technique used to quantify hepatic fibrosis or damage to the liver in a totally non-invasive and painless manner, with no contraindication for the patient. With this technology, we are able to get an accurate assessment of the liver damage resulting from all pathologies that cause damage to the liver, namely, the metabolic syndrome and non-alcoholic fatty liver disease, chronic viral hepatitis and excess alcohol intake without having to use biopsy needles.

But no matter what, the best way to stay in good health is the best course. Some of the ways to do so are:
- To prevent hepatitis C - always have safe sex by using a barrier-form of contraception, do not share drug needles, and be careful if you need to come into close contact with blood products. As for hepatitis B you can take a vaccine to prevent it.
- To prevent cirrhosis of the liver which is the leading risk factor for liver cancer - limit the amount of alcohol you drink. The recommended daily amount of alcohol consumption is about 75-100 ml for men and 50-75 ml for women.

Gastro-Liver Health Technology

The 1st clinically validated device using Transient Elastography
The FibroScan® technique is used to quantify hepatic fibrosis in a totally non-invasive and painless manner. A painless, non-invasive alternative to liver biopsy for evaluating the stage of liver fibrosis.

Liver disease is increasing throughout the world. Early diagnosis and intervention can lead to a substantial reduction in morbidity and mortality from all conditions that lead to cirrhosis including hepatitis B and C and fatty liver disease.

FibroScan® technology has been validated for the accurate assessment of liver fibrosis in the setting of a variety of chronic liver diseases including non-alcoholic fatty liver disease, chronic viral hepatitis B and C and excess alcohol consumption.

FibroScan® allows your doctor to monitor the progression of your liver disease over time to facilitate the timely start of treatment.
In the early stages of liver disease, symptoms are virtually non-existent, liver function tests and conventional ultrasound cannot accurately detect the severity of liver fibrosis. The FibroScan® is the ideal diagnostic tool that allows your doctor to identify patients with significant liver fibrosis or cirrhosis. This allows treatment to be tailored to the individual's need.

Because FibroScan® can be repeated again at regular intervals, your doctor can monitor the progression, stability or regression of your liver disease and give an accurate quantitative measure of the success of treatments or lifestyle modification.

Greater patient comfort with no risk!
No inpatient stay is required to perform a FibroScan® examination. The FibroScan® examination is completely non-invasive, rapid and painless. 100% of patients accepted a FibroScan® examination.

FibroScan® examination process
A mechanical pulse is generated at the skin surface, which is propagated through the liver. The velocity of the wave is measured by ultrasound. The velocity is directly correlated to the stiffness of the liver, which in turn reflects the degree of fibrosis – the stiffer the liver, the greater the degree of fibrosis.

The examination is composed of 10 acquisitions. Easy to perform and rapid, the measurement is expressed with a clear figure in kPa. The patient lies on his / her back, with the right arm raised behind the head. The measurement is made on the right lobe of the liver, with the probe being placed in an intercostal space. The result is delivered at the end of the 10 acquisitions.

*Fibroscan® is not suitable for patients who are pregnant, have a cardiac pacemaker or ascites

FibroScan Measures Liver Disease

Reported December 9, 2015

FibroScan Measures Liver Disease

BALTIMORE. (Ivanhoe Newswire) – Thirty million Americans, or one in 10, have some form of liver disease. It could be scarring from a hepatitis C infection, cirrhosis or even liver cancer. Doctors are now using a new, non-invasive method to measure liver disease.

Rodney Reamer is a hairstylist, so every night Mikey and Lucy reap the benefits. Right now, he’s easing back into work. Thirty years of battling hepatitis C took its toll.

Reamer told Ivanhoe, “I knew something was eventually going to happen to my liver. It just depended on when. It wasn’t if, it was going to be when.”

Scarring or fibrosis can be progressive.

Paul Thuluvath, MD, FRCP, Director of the Institute of Digestive Health & Liver Disease at Mercy Medical Center in Baltimore, Maryland and Professor of Medicine & Surgery at the University Of Maryland School Of Medicine told Ivanhoe, “There is a risk of that person developing cancer.”

Four years ago, doctors diagnosed Rodney with liver cancer. Chemotherapy and transplant surgery wiped him out.

Reamer said, “When I went to the hospital I knew I had, at best, a 50/50 shot of coming out.”

Rodney beat the odds, but doctors will need to monitor his liver for the rest of his life.

Dr. Thuluvath explained, “The conventional test is a liver biopsy. It is safe. It can be done under local anesthesia, but it is an invasive test.”

Instead, Dr. Thuluvath is using a new non-invasive method to monitor scarring. The FibroScan works like an ultrasound. Doctors place the tip of a wand at a precise point on the patient’s side. Sound waves measure the stiffness of the liver; the harder the liver, the more serious the scarring.

After years of procedures for Rodney, a no-needle option keeps him moving toward recovery.

The FibroScan test takes about five to 10 minutes, and the results are immediate. Dr. Thuluvath says a liver biopsy is still the gold standard for assessing fibrosis; however, he says the FibroScan test in combination with blood work may help doctors determine which patients can be excluded from regular biopsies.

Contributors to this news report include: Cyndy McGrath, Supervising Producer & Field Producer; Cortni Spearman, Assistant Producer; Brent Sucher, Editor and Kirk Manson, Videographer.

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