Why Is FibroScan Important?
Before FibroScan was available, the only way to accurately assess liver fibrosis was through a liver biopsy — an invasive procedure that requires inserting a needle into the liver under local anaesthesia, carries a small but real risk of complications, and can only sample a tiny portion of the liver.
FibroScan has transformed liver disease management by providing:
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Accurate fibrosis staging without needles, sedation, or hospital admission
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Immediate results — the test takes just 5–10 minutes and results are available instantly
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The ability to repeat the test regularly to track disease progression or response to treatment
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Simultaneous assessment of both liver scarring (LSM) and liver fat (CAP score)
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Excellent correlation with liver biopsy results in most clinical scenarios
Who Should Have a FibroScan?
FibroScan is recommended for any patient with known or suspected liver disease, or significant risk factors for liver disease. Specifically, consider FibroScan if you are:
- Patients diagnosed with fatty liver disease (NAFLD/MASLD) — to stage fibrosis and guide treatment urgency
- Patients with Hepatitis B or C — to assess fibrosis before and after antiviral treatment
- Patients with liver cirrhosis — for ongoing monitoring of disease progression or regression
- Patients with alcoholic liver disease — to assess the degree of damage
- Patients with autoimmune hepatitis — monitoring treatment response
- Patients with metabolic syndrome (diabetes, obesity, high cholesterol) — screening for silent liver disease
- Patients with persistently elevated liver enzymes on blood tests
- Patients being evaluated for liver transplantation — pre-operative assessment
- Patients post-liver transplant — monitoring graft health
Understanding Your FibroScan Results
FibroScan results are expressed using the METAVIR fibrosis scoring system, which classifies liver fibrosis from F0 (no fibrosis) to F4 (cirrhosis). Here is what the numbers mean:
| Stage |
LSM (kPa) |
Fibrosis Level |
Clinical Meaning |
| F0–F1 |
< 7.0 kPa |
None to mild |
No significant fibrosis — monitor and focus on lifestyle |
| F2 |
7.0–9.5 kPa |
Moderate |
Significant fibrosis — treatment and close monitoring needed |
| F3 |
9.5–12.5 kPa |
Severe |
Advanced fibrosis — specialist management essential |
| F4 |
> 12.5 kPa |
Cirrhosis |
Cirrhosis confirmed — comprehensive specialist care required |
CAP Score — Fatty Liver Assessment
- CAP < 238 dB/m — Minimal fat (S0): Normal
- CAP 238–259 dB/m — Mild fat (S1): Early fatty liver
- CAP 260–290 dB/m — Moderate fat (S2): Moderate fatty liver
- CAP > 290 dB/m — Severe fat (S3): Significant fatty liver
FibroScan vs Liver Biopsy — Which Is Right for You?
FibroScan
- Non-invasive — no needles
- Painless and comfortable
- Takes 5–10 minutes
- No sedation or recovery time
- Can be repeated as often as needed
- Assesses the whole liver
- No risk of complications
- Suitable for routine monitoring
Liver Biopsy
- Invasive — needle inserted into liver
- Mildly to moderately uncomfortable
- Requires local anaesthesia
- 30–60 minute procedure + recovery
- Samples only 1/50,000th of the liver
- Gold standard for diagnosis
- Small risk of bleeding (~0.5%)
- Required when FibroScan is inconclusive
In the majority of cases, FibroScan provides all the information needed to stage liver disease and guide treatment.
Liver biopsy is reserved for situations where the diagnosis is genuinely uncertain, or where knowing the exact degree of liver inflammation (not just fibrosis) will change your management plan.
