FibroScan (Transient Elastography): Purpose & Results

FibroScan is the brand name for transient elastography, an abdominal ultrasound that measures the stiffness of liver tissues. The scan can help screen for scarring or fibrosis (tough connective tissue buildup).

A radiologist (a doctor specializing in imaging tests) or radiology technician performs this test, which helps healthcare providers diagnose liver disease, determine any damage, and monitor liver health.

Healthcare providers use FibroScan to measure your liver’s elasticity (flexibility or stiffness) to help detect or monitor liver disease. Stiffness or toughness is a sign of fibrosis, tough, connective tissue buildup.

Your healthcare provider may order transient elastography if you have symptoms of liver damage, have a diagnosed liver disease, or have a condition that puts you at higher risk of cirrhosis, like diabetes or alcohol use disorder.

Detect Liver Diseases

Fibrosis may occur with several liver diseases. These include:

• Hepatitis B
• Hepatitis C
• Alcoholic liver disease
• Metabolic-associated steatotic liver disease (MASLD)
• Metabolic-associated steatohepatitis (MASH)
• Cirrhosis, or severe scarring of your liver that can impact your liver’s ability to filter blood and perform other vital functions

Manage Liver Diseases

Transient elastography also helps healthcare providers:

• Understand how severe a disease is
• Monitor how the disease is improving or getting worse
• Assess your risk of complications
• Choose the best treatment options

Transient elastography usually takes place in the imaging department of a hospital or radiology clinic. You may need to prepare for the test before you arrive. Your healthcare provider may tell you to fast (avoid food or drink) for two hours before the test. Small sips of water to take medication are usually allowed.

It’s also important to wear a loose, comfortable shirt to make it easy to expose the skin on your abdomen.

Talk to your healthcare provider beforehand if you’re feeling nervous or want company during the test. You may be able to bring someone with you.

Insurance and Costs

Before your test, you may want to figure out what it will cost and, if you have insurance, whether that insurance will cover some or all of it. Some plans require prior authorization (special approval from the insurance plan) before offering coverage. Talk to your healthcare provider’s staff or your insurance company to learn how much you can expect to pay.

When coming into the clinic, make sure you have your identification and payment for any co-pay or charge. If you’re using insurance, bring your insurance card as well.

FibroScan is a relatively quick, painless, and noninvasive procedure.

The radiologist or radiology technician uses a specialized wand, called a transducer, which they move over the skin of your belly. The transducer directs the ultrasound waves to your liver and reads how quickly they bounce back. The rate at which the waves bounce back can help detect fibrosis or scar tissue. Faster waves indicate more liver stiffness.

During the Test

You’ll be awake and won’t need any anesthesia or medications for the test. The healthcare provider will ask you to lift your shirt to expose your upper right abdomen near your liver. You’ll then lie on a table facing up or on your left side, with your right arm raised above your head.

The healthcare provider will apply a gel to the region above your liver. They will move the transducer over your skin and ask you to hold your breath for 10-15 seconds. During this time, the device sends sound waves through your skin. You’ll feel painless, pulse-like vibrations.

Once picked up by the transducer, the waves are sent to a computer screen, producing detailed, close-up images of fibrous or scarred liver tissue.

Your healthcare provider may repeat these steps several times. The entire process typically takes about 10 minutes overall.

After the Test

You can leave right after the imaging test is over. You’ll be able to resume your normal activities without restrictions, including driving yourself home if you drove.

Transient elastography causes few to no side effects for most people, but it may not be safe if you’re pregnant. Let your healthcare provider know if you are or may be pregnant.

This test sometimes isn’t effective or accurate. Certain health conditions and factors—such as obesity, being overweight, or fluid buildup called ascites—can interfere with the results. Your healthcare provider may recommend other testing in those cases.

A radiologist will analyze the images and send them to your healthcare provider. Your provider will likely schedule an appointment or talk to you over the phone to help you understand your results and what they mean for your health and care.

Interpreting Your Results

Healthcare providers grade the results and determine the severity and extent of damage. This helps them decide the best approach to treatment. For fibrosis level, healthcare providers break results into categories ranging from no fibrosis to severe fibrosis:

• F0: No evidence of fibrosis in the liver; a healthy result)
• F1: Very little fibrosis in the liver; this result is within the normal, healthy range
• F2: Moderate fibrosis and scarring in the liver
• F3: Severe fibrosis, stiffness, and scarring
• F4: Very severe scarring, or cirrhosis

FibroScan also tells healthcare providers the percentage of fat in the liver, known as a controlled attenuation parameter (CAP) score. In a healthy liver, the fat content is 5% or less.

Your healthcare provider will review your results with you. They’ll discuss the extent of any liver damage, treatment options, and next steps.

Your healthcare provider may recommend additional tests if your results are inconclusive (don’t confirm a diagnosis). To diagnose a liver disease, you may sometimes also need a liver biopsy (a test that involves taking a sample of your liver tissue).

FibroScan is a quick, noninvasive test that causes no side effects for most people. This ultrasound test measures the stiffness of your liver.

Increased stiffness is a sign of fibrosis (tough connective tissue buildup) and scarring in the liver, which can indicate several liver diseases.