Times of India
14 April 2010
By Pratibha Masand
Mumbai, India

Non–invasive check–up
During a trip to Mumbai, US–based Smita Thomas, who was undergoing treatment in America for fatty liver, consulted an endocrinologist in Mumbai. As suggested by the doctor, she went for a fibroscan that showed that Smita has been suffering from fourth–stage liver cirrhosis for a while.

“Most of the time, until a person’s liver has been 70% damaged, the person does not even come to know that there is something wrong. Earlier, the only option to diagnose a liver problem was through biopsy–done by extracting a tiny portion of the organ–which was a painful, complex and time–consuming method. The fibroscan of the liver, which we have recently started can scan the liver non–invasively within a span of 1.5 minutes,” said N H Banka, chief gastroenterologist at Bombay Hospital, adding that each scan cost around Rs 12,000.

The machine has a probe device, which when switched on near the belly of the patient, electrical propulsive waves touch the vibrations of the liver, reflecting the elasticity of the organ and other details on a connected screen. With the help of set parameters, the doctors can then diagnose if the person is suffering from cirrhosis and the stage of the ailment.

“There are several conditions, in which a person may be at higher risk of getting a liver disease. In any of the cases–if the person has Hepatitis B or C, has alcohol history or has a fatty liver. For each disorder, set parameters are there to test the safe elasticity of the liver,” said Banka.

However, Dr Aabha Nagral, consultant hepatologist at Jaslok and Fortis hospitals, said biopsies would always remain the golden standard. “Jaslok Hospital, too, has a similar but not quite the same machine with which we can scan the severity of the fibrosis of liver in a non–invasive way. Though this scan is good for patients where a biopsy is not possible, it cannot replace biopsy,” she said. But Nagral added that the scan helped when it came to checking on the improvements of a patient who was on antiviral drugs and those about to go for a kidney transplant who might be affected by Hepatitis B or C.

“Like a biopsy, these scans cannot find the root cause of the liver disease. However, any imaging is good as it does not need to go in the body. Earlier, the bones used to come in the way of ultrasound scans. But now, all scans have become quite advanced. However, how useful a fibroscan of the liver turns out to be, only time can tell,” said Dr Avinash Supe, professor of surgical gastroenterology at KEM Hospital.