Frequently Asked Questions
General Questions
Is a referral required?
No. Referrals are not required to book a FibroScan appointment with Livera. You can book an appointment with us directly by clicking "Book Now", emailing us at liverahealth@gmail.com, or calling us at 647-221-8182 if you require assistance.
(For physicians/specialists) How can I refer my patient(s)?
If you want to refer your patient(s) to our current locations, you can fill out our Livera FibroScan® Referral Form and fax it to us at 1-855-262-3423. The form is also in Accuro under "Livera FibroScan Referral Form".
For OSCAR, we have an E-form, Livera FibroScan® E-Form.
If you have multiple patients or if our locations are not convenient, we are able to travel across Ontario for a full-day clinic to provide FibroScan® appointments. Visit our Doctors page to learn more. To request a full-day clinic, email us at liverahealth@gmail.com.
How much does it cost? How can I pay?
Due to the FibroScan® not being covered in the Ontario Health Insurance Plan (OHIP), the assessment costs $120-150. We accept cash or card (debit/credit) and you will get a receipt at your appointment. Many insurance companies will reimburse this and we offer direct billing with certain insurance companies.
What are your locations? What if I'm too far?
We have clinics in different cities and you can see an updated list of our current locations on our contact page. For these locations, you can book with us at any time through our "Book Now" page or by contacting us. We are always expanding our locations and will have more available in the future.
If you are unable to come to our location or would prefer we come to your place of residence, we can travel across Ontario for your convenience with an additional fee. Contact us for details.
Appointment Preparation
How do I prepare for the appointment?
You need to fast for at least 3 hours prior to the appointment. You can only have water during this time and you are permitted to take your usual medications. You should wear comfortable clothing that can be moved to access your upper right abdomen. You are also permitted to drive to and from your appointment.
What can I expect during the appointment?
You will be asked to lie down with your right arm raised above your head and your upper right abdomen exposed for the scan. A water-based gel is applied and you will feel some vibration and tapping on the FibroScan® probe's tip as the test is performed. The results are usually available within a few minutes.
The test will be followed by discussing the results and creating a care plan. The entire appointment will usually take 15 minutes.
FibroScan® Examination
How is the FibroScan® different from a liver biopsy?
Unlike FibroScan®, liver biopsy is an invasive procedure where a small amount of liver tissue is surgically removed for later examination. As a result, it has potential risks and side effects. A FibroScan® is completely non-invasive, meaning it does not break the skin or enter your body. There is no discomfort or complications with the FibroScan®, and the results are available immediately.
What do the results of the FibroScan® show?
The FibroScan® liver stiffness result is measured in kiloPascals (kPa) and it can range from 2 kPa to 75 kPa. This measurement indicates the amount of scar tissue on the liver (fibrosis), with the severity of the scarring ranging from F0 (minimal/none) to F4 (severe fibrosis/cirrhosis).
The FibroScan® CAP result is measured in decibels per meter (dB/m) and can range from 100 dB/m to 400 dB/m. This measurement determines the percentage of fatty buildup (steatosis) in your liver, with a healthy liver having a CAP score of 5% or lower. Above 11%, increasing fat percentages are graded from S1 to S3.
Can everyone have a FibroScan® examination?
Yes, FibroScan® can be performed on everyone. Echosens has certified that "[FibroScan®] examinations on pregnant women and patients with active implantable medical devices (pacemaker, defibrillator...) are not contraindicated."
How often can I have the FibroScan® assessment?
There is no limit to how many times you can have a FibroScan® assessment. With many patients, we recommend getting a FibroScan® assessment every 1-2 years (depending on the severity of the liver condition) to monitor the improvement/progression of their liver disease.
What if the FibroScan® measurements cannot be obtained?
We usually get a successful assessment for all patients. We also receive many patients that have been unsuccessful with other providers and we have been able to successfully complete their FibroScan® assessment. In the rare instance that the measurements are unclear or unattainable, the appointment will be free of charge and we may rebook you to try again another day.
Fatty Liver Information
What is fatty liver disease (hepatic steatosis)?
Fatty liver disease is the accumulation of fat cells in the liver, which can cause inflammation and lead to scarring (fibrosis). The amount of fibrosis in the liver is used to determine the severity of the fatty liver disease. The stiffness of the liver is caused by this fibrosis.
What are the major risk factors of developing fatty liver disease?
The major risk factors of fatty liver disease are being overweight/obese, having diabetes, having elevated cholesterol, and excess alcohol intake.
How is fatty liver disease treated?
Fatty liver disease is reversible at most stages of the disease following lifestyle changes including limiting/avoiding alcohol, losing weight if overweight, making changes to diet (avoiding excess calories and carbs), and exercising regularly.
If left untreated, the scarring in the liver can spread and impair the liver's function, known as cirrhosis. This potentially life-threatening condition is considered irreversible at its later stages and can cause liver failure. Therefore, early identification is vital for early intervention to prevent further complications.
If you have more questions, contact us and we will be happy to help.