A FibroScan uses ultrasound waves and vibrations to measure the degree of liver fibrosis (‘hardening’). A healthy liver is soft, whereas a liver with fibrosis is hard. The presence of liver fibrosis indicates significant damage. If liver fibrosis is not treated, one may develop liver cirrhosis and liver cancer.
In the past, the assessment of liver fibrosis was done with a liver biopsy by a hepatologist. This requires the insertion of a large bore needle directly into the liver to extract liver tissue. It may cause pain and has a risk of bleeding. The FibroScan is a modern device, which obviates the need for a biopsy. It is painless and safe.
FibroScans are performed in individuals with liver problems, such as chronic viral hepatitis (e.g. Hepatitis B or C) and fatty liver which are common in Singapore.
Our FibroScan machine at Nobel Gastroenterology Centre is equipped with additional technology called Controlled Attenuation Parameter (CAP) which quantifies the amount of liver fat. This information enables us to track the progress of a patient with fatty liver disease.
A CT scan examines solid organs (e.g. liver, pancreas, kidney, spleen) in detail. However, it cannot accurately examine hollow organs like the stomach and colon. Endoscopy (gastroscopy and colonoscopy) are more accurate in evaluating hollow organs, so they are complementary for the evaluation of digestive problems, because the abnormality may lie either in solid organs like the liver and pancreas, or hollow organs like the stomach and intestine.
The MRI scan is a painless diagnostic test, which utilises a magnetic field to generate images of the human body. Unlike a CT scan, the MRI scan is free of radiation. To perform this test, a patient is asked to lie on a special bed, which enters the MRI machine. This scan takes forty-five minutes to an hour to complete. During the procedure, contrast may be given via an injection.
The MRI scan is suitable for pregnant women and children. However, individuals who have non-MRI compatible metal implants in their body (e.g. pacemaker, artificial heart valves) cannot undergo this scan.
MRI scan is used to examine the liver and pancreas for abnormalities. It can also examine soft tissue, nerves and joints with a high degree of accuracy. The MRI scan can image the small intestine via a special protocol called an MRI Enterography.
A limitation of this scan is that ultrasound waves cannot penetrate an organ with air. Hence, it is unable to examine the stomach, small intestine or colon. Organs that are deep in the body, like the pancreas may not be visualised as well.
Dr Wang Yu Tien joins us with nearly 20 years of experience from Singapore General Hospital where he was senior consultant, director of research and a faculty of senior resident training at the department of Gastroenterology and Hepatology. He is experienced in managing the full spectrum of gastrointestinal and liver diseases as well as endoscopy. His subspecialty interest is digestive function disorders (e.g. Gastroesophageal Reflux and Irritable Bowel Syndrome). He was also the former director of the Gastrointestinal Function Laboratory at Singapore General Hospital and past Scientific Chairperson of the Gastroenterology Society of Singapore. He has published in top gastroenterology journals and is the current Gastroenterology specialty editor of Singapore Medical Journal.
Dr Eric Wee is a Gastroenterologist who manages all aspects of digestive, bowel and liver conditions. His subspecialty is in advanced endoscopy. Dr Wee is a member of the Royal College of Physician (UK), member of the American Gastroenterology Association (USA), member of the Faculty of Medical Experts (Academy of Medicine) and a fellow of the Academy of Medicine (Singapore). He has held senior appointments such as the Head of the Division of Gastroenterology at Khoo Teck Puat Hospital, Chairman of the Nutrition workgroup and Associate Program Director of the NHG Gastroenterology Residency Program.