Fibroscan

A non-invasive liver elastography examination.

Liver stiffness and, when CAP is available, liver fat.

It helps assess the likelihood and severity of liver fibrosis or scarring.

No. FibroScan is generally painless.

Fully Automated Elisa Plate Reader with Washer

No.

No.

Usually only a few minutes, although appointment time can vary.

No. FibroScan is non-invasive, while liver biopsy involves removing a small tissue sample.

FibroScan is a specialised form of liver elastography that measures the stiffness of liver tissue.

The examination uses a probe placed against the skin over the liver. The device sends controlled vibrations through the liver and measures how quickly the resulting waves travel through the tissue.

Stiffer liver tissue generally allows the waves to travel differently from softer, healthier tissue. The measurement is then used to estimate the degree of liver fibrosis.

FibroScan can also measure liver fat when the device provides a Controlled Attenuation Parameter (CAP) measurement.

This makes the examination useful for assessing two important aspects of liver health:

Liver stiffness → fibrosis/scarring

CAP → liver fat/steatosis

B.P. Poddar Hospital similarly describes FibroScan as using transient elastography for liver stiffness measurement and CAP for assessment of steatosis.

Liver fibrosis means that scar tissue has developed in the liver as a result of ongoing injury or inflammation.

Persistent liver injury can occur because of conditions such as:

• Fatty liver disease
• Chronic hepatitis B
• Chronic hepatitis C
• Alcohol-related liver disease
• Certain autoimmune liver diseases
• Some metabolic or inherited conditions
• Other chronic liver disorders

Fibrosis can develop gradually.

In its early stages, a person may have few or no symptoms. As liver disease progresses, fibrosis can become more extensive and eventually contribute to cirrhosis.

This is one reason doctors may recommend non-invasive liver fibrosis assessment even when a patient feels relatively well.

Liver stiffness refers to how firm the liver tissue is when assessed by elastography.

Fibrosis can increase liver stiffness, which is why FibroScan can provide useful information about the likelihood and extent of liver scarring.

However, liver stiffness is not determined by fibrosis alone.

Inflammation, congestion and other factors can sometimes influence the measurement.

This means a FibroScan result should not be interpreted in isolation. Your doctor may consider the result alongside your symptoms, medical history, liver function tests, ultrasound findings and other investigations.

CAP stands for Controlled Attenuation Parameter.

CAP is a measurement used to assess the amount of fat in the liver.

Fat accumulation in the liver is calledhepatic steatosis, commonly known as fatty liver.

A FibroScan examination that includes CAP can therefore provide information about both:

• Liver stiffness
• Liver fat

This is particularly useful in patients being evaluated for metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), as well as other causes of fatty liver.

It is important to remember that CAP and liver stiffness answer different questions.

CAP asks: How much fat may be present?

Liver stiffness asks: How stiff is the liver, which may reflect fibrosis or other influences?

Your doctor may recommend FibroScan when they want more information about the condition of your liver without immediately proceeding to an invasive procedure.

Common reasons include:

• Fatty liver
• Persistently abnormal liver enzymes
• Chronic hepatitis B
• Chronic hepatitis C
• Alcohol-related liver disease
• Suspected liver fibrosis
• Known liver fibrosis
• Cirrhosis monitoring
• Assessment of liver disease progression
• Monitoring response to treatment or lifestyle changes

A FibroScan may also be recommended when other tests suggest that the liver could have sustained chronic damage.

FibroScan may be useful for people who have been diagnosed with or are at increased risk of chronic liver disease.

Your doctor may consider the examination if you have:

Fatty liver

Patients with fatty liver may undergo FibroScan to assess whether there is evidence suggesting significant liver stiffness or fibrosis in addition to fat accumulation.

Hepatitis B or C

Chronic viral hepatitis can cause progressive liver damage. FibroScan can provide non-invasive information about liver stiffness.

Alcohol-related liver disease

Long-term excessive alcohol consumption can cause inflammation, fibrosis and cirrhosis. FibroScan may form part of the overall liver assessment.

Abnormal liver function tests

Persistently abnormal ALT, AST or other liver-related blood tests may lead your doctor to investigate further.

FibroScan is not a replacement for blood tests, however. It provides different information.

Suspected liver fibrosis

When there is concern about liver scarring, elastography can provide useful non-invasive information.

Known cirrhosis or advanced liver disease

Your treating doctor may use repeated liver stiffness measurements as part of ongoing monitoring, although FibroScan should always be interpreted alongside the rest of the clinical picture.

FibroScan with CAP can provide a non-invasive assessment of liver steatosis, or fat accumulation.

However, having a high CAP measurement does not by itself establish the exact cause of fatty liver.

Your doctor may consider factors such as:

• Body weight
• Diabetes
• Cholesterol and triglycerides
• Alcohol intake
• Medications
• Other medical conditions
• Liver enzyme results
• Ultrasound findings

A complete liver assessment may therefore involve several different tests.

FibroScan can provide useful information about liver stiffness and may support the assessment of advanced fibrosis or cirrhosis.

However, FibroScan does not diagnose cirrhosis by itself.

A doctor may combine the FibroScan result with:

• Clinical examination
• Liver function tests
• Complete blood count
• Viral hepatitis testing
• Abdominal ultrasound
• Other imaging
• Medical history
• Other fibrosis scores

If the findings are unclear or there is concern about advanced liver disease, additional investigations may be necessary.

FibroScan vs Liver Biopsy

Patients are often relieved to learn that FibroScan does not require a needle.

FibroScan and liver biopsy are not interchangeable tests.

A biopsy provides microscopic information about liver tissue and can sometimes be necessary when the diagnosis remains uncertain or when specific histological information is required.

FibroScan, on the other hand, provides a non-invasive way of assessing liver stiffness and, when CAP is available, liver fat.

The decision about which test is appropriate belongs to your treating doctor.

No.

FibroScan is generally painless and does not involve needles or incisions.

During the examination, a probe is placed against the skin over the liver. You may feel mild pressure or vibration, but the procedure is generally well tolerated.

No sedation or anaesthesia is normally required.

B.P. Poddar describes the examination as non-invasive and painless and notes that it can generally be performed without sedation or anaesthesia.

FibroScan is a non-invasive examination and does not use ionising radiation.

There is no surgical incision and no tissue is removed.

However, whether FibroScan is appropriate for a particular person depends on their clinical circumstances. If you have a medical condition, are pregnant, have a medical device or have been advised against a particular examination, discuss this with your doctor before the test.

Do not assume that every patient or every liver condition can be assessed adequately with FibroScan alone.

FibroScanis usually performed with you lying on your back, with the right side of your abdomen exposed.

A trained operator places the probe against the skin over the liver.

The device sends controlled vibrations into the liver and measures the resulting wave response.

Multiple measurements are usually obtained rather than relying on a single reading.

The device then provides measurements that can be used by the healthcare professional to assess liver stiffness and, where available, CAP.

The examination is external and does not require a needle.

The actual examination is usually quick.

Many centres can complete the measurement within 5–10 minutes, although the overall appointment may take longer depending on preparation, positioning, the number of measurements required and the quality of the readings.

B.P. Poddar Hospital states that its FibroScan procedure typically takes about 5–10 minutes.

Preparation instructions can vary according to the equipment, protocol and diagnostic centre.

Many FibroScan protocols recommend fasting for several hours before the examination, because food intake can affect liver stiffness measurements.

For this reason, do not rely on generic instructions found online.

When booking your FibroScan at Sparsh Diagnostic Centre, confirm:

• Whether fasting is required
• How many hours you should fast
• Whether you may drink water
• Whether you should take your regular medicines
• Whether any other preparation is necessary

If your doctor has given you specific instructions, follow those instructions.

Do not stop prescription medication simply because you are having a FibroScan unless your doctor has specifically instructed you to do so.

Tell the diagnostic centre and your doctor about the medicines and supplements you take.

If the FibroScan is being performed alongside blood tests or other investigations, preparation requirements may be different.

If you have been advised to undergo a FibroScan, it is useful to bring:

• Your doctor’s prescription or referral
• Previous FibroScan reports
• Liver function test reports
• Previous abdominal ultrasound reports
• Hepatitis B or C reports, if relevant
• Other liver-related medical records

Previous measurements are particularly useful when FibroScan is being repeated to monitor liver disease over time.

A FibroScan report commonly contains measurements relating to:

Liver stiffness measurement

This is generally expressed in kilopascals (kPa).

Higher liver stiffness measurements can be associated with more advanced fibrosis, but the result must be interpreted according to the underlying liver disease and clinical circumstances.

CAP score

When CAP is measured, it provides information about liver fat.

CAP values are generally expressed in dB/m.

The higher the CAP value, the greater the likelihood of hepatic steatosis, although interpretation should follow the appropriate clinical reference ranges and device-specific guidance.

Measurement quality

A report may also provide information about the number and reliability of measurements obtained.

This is important because a single number should not be interpreted without considering the quality of the examination.

There is no single FibroScan number that can be called “normal” for every patient.

Liver stiffness thresholds vary according to:

• The underlying liver disease
• The specific cause of liver injury
• The patient’s clinical condition
• The probe used
• The quality of the examination
• Other factors that can temporarily affect liver stiffness

For example, a kPa value should not be interpreted in exactly the same way in a person with chronic hepatitis C as in someone with fatty liver disease.

Therefore, avoid interpreting your report using a generic internet chart without discussing it with your doctor.

Not necessarily.

A higher liver stiffness measurement can indicate a greater likelihood of significant fibrosis, but liver stiffness can also be influenced by factors such as active inflammation and other liver conditions.

A high value therefore needs clinical interpretation.

Your doctor may combine the result with blood tests, ultrasound, medical history and other investigations before deciding whether advanced fibrosis or cirrhosis is likely.

Several factors can influence liver stiffness measurements.

These may include:

• Recent food intake
• Active liver inflammation
• Cholestasis
• Liver congestion
• Ascites
• Technical factors
• Probe selection
• Difficulty obtaining reliable measurements

This is another reason why preparation and proper technique matter.

If the result is unexpectedly high or technically unreliable, your doctor may recommend repeating the examination or using another diagnostic method.

No.

FibroScan and conventional abdominal ultrasound provide different information.

Abdominal ultrasound

An ultrasound can evaluate structures such as:

• Liver size and appearance
• Gallbladder
• Bile ducts
• Pancreas, where visualisation is possible
• Spleen
• Kidneys
• Ascites
• Certain focal liver lesions

FibroScan

FibroScan primarily provides:

• Liver stiffness measurement
• CAP measurement when available

Therefore, your doctor may recommend both ultrasound and FibroScan because they answer different clinical questions.

All tests are carried out after running quality controls on each machine Quality controls are checked by senior staff Tests are carried out only after the controls are proper