FibroScan, also known as transient elastography, is a non-invasive diagnostic procedure used to assess the condition of the liver. It measures both liver stiffness (which correlates with fibrosis or scarring) and the amount of fat in the liver (steatosis) using ultrasound-based technology.
Unlike a traditional liver biopsy, FibroScan does not require needles, incisions, or sedation. It offers a safe, quick, and painless alternative to estimate the degree of liver damage.
A Gastroenterologist or Hepatologist may recommend a FibroScan when there is suspicion or risk of chronic liver disease. Common indications include:
Nonalcoholic fatty liver disease (NAFLD) / Nonalcoholic steatohepatitis (NASH)
Chronic viral hepatitis (e.g. hepatitis B, hepatitis C)
Alcohol-related liver disease
Monitoring disease progression or response to therapy in patients with known liver disease
Evaluating whether liver fibrosis has progressed, or detecting early cirrhosis
Because it is non-invasive and relatively easy to repeat, FibroScan can serve as a monitoring tool over time.
Preparation
Typically, you will be asked to avoid eating or drinking (fast) for a few hours before the scan (commonly 2–3 hours) to reduce interference.
Wear loose, comfortable clothing to allow access to the right upper abdomen.
Continue any regular medications unless specifically instructed otherwise.
During the Test
You lie flat on your back, usually with your right arm raised above your head to expose the liver region.
A gel is applied to the skin over the liver area (under the right ribs).
A small probe is placed against your skin. It emits a gentle vibration (a “flick” or pulse) that transmits low-frequency shear waves into the liver tissue.
The device measures how fast the waves travel through the liver. Because stiffer (fibrotic) tissue transmits waves more rapidly, the results allow estimation of liver stiffness (fibrosis) and fat content (steatosis).
The scan typically takes less than 10–15 minutes.
No pain, needles, sedation, or hospital stay are required. Many patients describe only a slight sensation of vibration.
After the Test
You can resume normal activities immediately.
Results are processed and interpreted by your physician, usually the same day or shortly thereafter.
A follow-up appointment is scheduled to review the findings and plan any further care.
Liver Stiffness Measurement (LSM)
Expressed in kilopascals (kPa)
Normal ranges are often from about 2 to 7 kPa (depending on the lab and device)
Higher values suggest increasing fibrosis.
Based on LSM, patients are often staged (e.g. F0–F1 = no or mild fibrosis, up to F4 = cirrhosis)
CAP (Controlled Attenuation Parameter)
Expressed in dB/m, this measures the degree of liver fat (steatosis)
There are standard ranges correlating to steatosis grades (S0, S1, S2, S3) depending on how much of the liver is fatty.
Considerations & Limitations
Results may be less reliable in certain conditions:
- Obesity (especially with a high body mass index)
- Presence of ascites (fluid in the abdomen)
- Inflammation or congestion of the liver (which can temporarily increase stiffness)
- Mass lesions or hepatic tumors
Because FibroScan samples a larger volume of liver than biopsy, it reduces sampling error.
However, FibroScan is a surrogate measurement, not a direct biopsy, so correlation with clinical, laboratory, and imaging data is important.
No risk of bleeding or complications associated with invasive biopsy.
Quick, outpatient procedure (minutes vs several hours for biopsy)
Repeatable over time, facilitating disease monitoring.
Less costly and less burdensome for patients.
Once your FibroScan results are available, your physician will use them along with blood tests, imaging, and your clinical history to:
Determine the stage of fibrosis and degree of steatosis
Decide whether further interventions or treatments (antivirals, lifestyle modifications, pharmacotherapy) are needed
Monitor disease progression or regression over time (by repeating FibroScan periodically)
Adjust management strategies to slow or reverse liver damage
