What Is a FibroScan?
A FibroScan is a type of ultrasound that measures scarring called fibrosis in your liver. An ultrasound uses high-frequency sound waves that painlessly bounce off your liver to estimate liver stiffness. This noninvasive imaging test helps your doctor keep tabs on your health.
Liver elastography is another name for this test.
FibroScan vs. MRE
Magnetic resonance elastography (MRE) is another test doctors use to detect liver fibrosis. Like a FibroScan, it creates a map of the scarring in your liver. But an MRE uses magnetic resonance imaging (MRI) to create images of sound waves passing through your liver.
How Does a FibroScan Work?
A technician or radiologist puts a probe on the skin over your liver. The probe releases waves of energy that pass through your liver. By measuring how quickly the energy waves move through your liver, the ultrasound calculates its stiffness. The stiffer your liver is from scarring, the faster the energy waves will pass through it. The scan also measures how much fat has built up in your liver cells.
Reasons You Might Get a FibroScan
A FibroScan is a way to test for liver damage and find out the stage of your liver disease. Your doctor can order a FibroScan to diagnose, treat, and monitor progression of conditions like:
- Alcoholic liver disease
- Nonalcoholic fatty liver disease (NAFLD), also called nonalcoholic steatohepatitis (NASH)
- Chronic hepatitis B and C
- Cirrhosis of the liver
- Genetic diseases like hemochromatosis and Wilson’s disease
This test can:
- Diagnose liver conditions and show how severe they are
- Predict your risk of complications
- Help your doctor plan your treatment
- Monitor how well treatment is working
What to Expect With a FibroScan
A FibroScan is a quick procedure that you have at a doctor’s office, imaging center, or hospital.
Before the procedure
Arrive about 15 minutes before your scheduled test time. You may be asked to bring your insurance card and photo ID. Also bring a list of all the medicines you take, including over-the-counter drugs and supplements. Let the staff know whether you have any allergies.
You may be asked not to eat or drink anything for three hours before the scan. While you can have small sips of water, if necessary, don't drink large amounts. You might want to wear a loose shirt because you'll have to expose your belly during the test. Remove any piercings on your abdomen, such as belly button rings.
Tell your doctor if you are pregnant or if you have an implanted device like a pacemaker or defibrillator. If so, you may not be able to have this test.
A FibroScan test may not be as accurate if you have fluid buildup called ascites in your belly or if you have obesity.
During the procedure
You will lie on your back on a table with your right arm raised above your head or tucked behind your head. The right side of your belly will be exposed. A staff member will apply a water-based gel to the skin over your liver. Then they'll place a wand-like probe over that area.
The probe releases sound waves that travel through the skin, muscles, and other tissues of your belly to reach your liver and then bounce to a computer. The computer creates an image of your liver on a screen. You may need to hold your breath for 10 to 15 seconds while the test is done.
You might feel a small vibration as the sound waves pass through your skin into your liver, but you shouldn't feel any pain. The test should take about 10 to 15 minutes.
After the procedure
After the test, the FibroScan computer will analyze the results. You'll get the results before you leave, or the results will be sent to the doctor who ordered the test. The entire visit should last less than an hour You can go back to work or your usual activities afterward, and you can eat and drink normally.
What are the risks of a FibroScan?
This test is generally safe. It is noninvasive, meaning that it won't go through your skin or into your body. It is not likely to cause any side effects, risks, or complications. The alternative to a FibroScan is a liver biopsy, which is an invasive test that can cause risks such as bleeding.
How to Interpret FibroScan Results
The FibroScan test produces two kinds of scores: the controlled attenuation parameter (CAP) score and the fibrosis score. Together, these scores tell your doctor how much fat buildup and scarring are in your liver.
CAP score
This score measures how much fat has built up in your liver cells. It's measured in decibels per meter (dB/m). Your doctor will use this score to find your steatosis (fatty liver) grade:
- Grade S0: Healthy liver
- Grade S1: Mild steatosis
- Grade S2: Moderate steatosis
- Grade S3: Severe steatosis
The lower your CAP score, the less of your liver contains fatty changes and the healthier it is.
Fibrosis score
Your doctor uses your fibrosis score to figure out how scarred and stiff your liver is. The lower the score, the less scarring you have in your liver and the healthier your liver is. The fibrosis score is measured in kilopascals (kPa):
- 2 to 7 kPa is normal. This means your liver has no scarring or only mild scarring.
- 7 kPa to 14 kPa is moderate to severe scarring. It's reversible with treatment, and you may not have symptoms.
- 14 kPa or higher means that you have severe scarring, or cirrhosis.
Based on your liver stiffness result, your doctor will assign a fibrosis score of F0 to F4:
- F0 or F1: Normal – no scarring or mild scarring
- F2: Moderate scarring
- F3: Severe scarring
- F4: Advanced scarring called cirrhosis of the liver
FibroScan Results Chart
Understanding your CAP score
| CAP Score | Steatosis Grade | Percentage of Your Liver With Fatty Changes |
| 238 to 260 dB/m | S1 | 11% to 33% |
| 260 to 290 dB/m | S2 | 34% to 66% |
| Higher than 290 dB/m | S3 | 67% or higher |
Understanding your liver stiffness results
Liver Stiffness Result | Fibrosis Score | Your Liver |
2 to 7 kPa | F0 or F1 | Normal |
7 to 11 kPa (The range can vary, depending on the condition that caused the scarring.) | F2 | Moderate scarring |
8 to 14 kPa (The range can vary, depending on the condition that caused the scarring.) | F3 | Severe scarring |
14 kPa or higher | F4 | Cirrhosis |
Conditions That Can Affect FibroScan Results
Some medical conditions can make the FibroScan result less accurate. These conditions may show more scarring than you have:
- Liver swelling from an illness or from long-term heavy alcohol use
- Tumors in your liver that are either cancerous or noncancerous (benign)
- Liver congestion, which is when blood backs up in your liver, often from heart failure
These conditions could interfere with the ultrasound waves and give you a less accurate FibroScan result:
- Obesity: A body mass index (BMI) higher than 30, especially when you have extra fat around your belly
- Ascites: Fluid buildup in your belly
- Biliary obstruction: A blockage in the ducts that carry the digestive fluid bile from your liver to your small intestine
- Scar tissue around your liver from a past surgery or radiation therapy
Takeaways
A FibroScan is a noninvasive test that uses ultrasound to measure scarring called fibrosis in your liver. Your doctor might order this test to assess liver damage from a condition like alcoholic liver disease, NAFLD or NASH, chronic hepatitis B and C, or cirrhosis of the liver. The higher your CAP and fibrosis scores, the more fat buildup and scarring there is in your liver. Your doctor can use the results of the FibroScan to plan your treatment.
FibroScan FAQs
What does a FibroScan test for?
A FibroScan measures fat buildup and scarring in the liver. It's a way to assess liver damage and find out your stage of liver disease.
Why would a FibroScan be ordered?
Your doctor might order a FibroScan to diagnose or treat a liver condition like alcoholic liver disease, NAFLD/NASH, chronic hepatitis B and C, or cirrhosis.
What is the difference between a FibroScan and an ultrasound?
A FibroScan is a type of ultrasound. An ultrasound uses sound waves to show different organs in your body. A FibroScan measures how quickly sound waves pass through your liver to measure fat buildup and stiffness.
How much does a FibroScan cost?
The cost depends on what type of health insurance you have, whether it covers this test, and how much of the test cost it covers. Medicare and Medicaid may not pay for a FibroScan.
How long does a FibroScan take?
The test itself should take less than 15 minutes. With the preparation and waiting time, you may need to stay at the imaging center for up to an hour.
