What is FibroScan? Liver Fibrosis Measurement and its Advantages
One of the most frequently heard concepts when it comes to liver health is liver fibrosis (scar tissue formation) and the risk of progression to cirrhosis over time. In this process, which can progress without symptoms for a long time, early diagnosis and regular follow-up are very valuable. At this point, a modern method frequently used by physicians in recent years stands out: FibroScan.
So what is FibroScan and why has it become so popular? FibroScan is a non-invasive (needle-free) test that evaluates the level of fibrosis by measuring the “stiffness” of the liver, which is an alternative to biopsy or reduces the need for biopsy in most patients. It can also provide information about fatty liver by measuring CAP (Controlled Attenuation Parameter) in many centers. In short, it can be considered as a practical “liver screening” tool in terms of both measurement of liver stiffness and assessment of adiposity.
In this article, we will discuss what FibroScan measures, how it is performed, how the results are interpreted, its advantages/limitations and the curious FibroScan prices in a user-oriented manner. (Note: This content is for informational purposes; gastroenterology/hepatology specialist evaluation is required for diagnosis and treatment)
What does FibroScan measure? Liver stiffness (kPa) and CAP value
FibroScan, technically known as transient elastography, provides insight into the level of fibrosis by measuring the stiffness of liver tissue. The measurement result is usually expressed in units of kPa (kilopascal). To put it simply:
- As liver stiffness increases, the likelihood and degree of fibrosis (scar tissue) may increase.
- Lower kPa values generally suggest less fibrosis; higher values may raise suspicion of more advanced fibrosis/cirrhosis.
In many centers, the FibroScan device also provides a CAP value. The CAP helps to assess the level of fatty deposits in the liver. For this reason, FibroScan stands out especially in people with suspected fatty liver (NAFLD/NASH) as it can evaluate both fibrosis and fat in the same session.
What do fibrosis stages (F0-F4) mean?
In clinical practice, fibrosis is often expressed in stages:
- F0: No fibrosis
- F1-F2: Mild to moderate fibrosis
- F3: Advanced fibrosis
- F4: Advanced fibrosis consistent with cirrhosis
An important point: a single threshold such as “this kPa is definitely F3” is not valid for every patient. Thresholds may vary depending on the type of disease (hepatitis B/C, fatty liver, etc.), device/probe, body structure of the person and accompanying conditions. Therefore, the FibroScan result must be interpreted in conjunction with clinical evaluation and, if necessary, findings such as blood tests/ultrasound.
How is FibroScan done? Is it painful, how long does it last?
“How to do a FibroScan?” is one of the most common questions for those who hear about the test for the first time and are worried. The good news: FibroScan is usually painless, quick and does not interfere with daily life.
Process steps (general process)
- The patient usually lies on his/her back with the right arm extended over the head.
- The physician/technician applies gel to the right upper abdomen where the liver is located.
- The probe (similar to an ultrasound probe) is brought into contact with the skin and short measurements are taken.
- The device measures stiffness by analyzing the speed of the mechanical wave passing through the liver tissue.
How long does it take?
For most people, the procedure is completed within 5-10 minutes. With preparation, recording and reporting, the total duration is usually short, although it varies from center to center.
Is FibroScan painful?
It is usually not painful. Some people may feel a slight pressure in the area where the probe is applied. It is considered more comfortable than a liver biopsy because there is no need for needles, anesthesia or incisions.
Will I get the result on the same day?
In many centers FibroScan results can be given the same day. However, a physician consultation may be required to interpret the report and explain “what it means”. If you have a condition such as hepatitis, fatty liver or elevated enzymes, your physician will evaluate the result together with blood tests (ALT/AST, platelets, etc.) and imaging.
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Preparation before FibroScan: How to go hungry or full, what to look out for?
the question “FibroScan is performed fasting or fed?” is a critical detail in terms of both result accuracy and prevention of unnecessary repeat measurements. In general practice, a short fast before FibroScan may be recommended because postprandial liver blood flow and some physiological changes may affect the measurement.
General preparation recommendations (may vary by center)
- Fasting: Fasting for at least 2-3 hours is usually required, some centers may require fasting for 3-4 hours. Be sure to ask about the center’s protocol when making an appointment.
- Alcohol: Alcohol consumption in the days preceding the measurement may affect liver enzymes and inflammation and should be avoided on the advice of a physician.
- Intense exercise: Very intense exercise may affect some blood values and transient inflammatory states; avoiding excessive exertion before measurement may be recommended.
- Medicines: Do not stop your regular medicines, but consult your doctor about which medicines to take and when to take them.
Situations that can lead to misleading results
Although FibroScan is a practical method of measuring liver stiffness, in some cases the results may be over/underestimated:
- Acute inflammation (e.g., active hepatitis attack, elevated ALT)
- Cholestasis (conditions in which bile flow is impaired)
- Heart failure and hepatic congestion
- Obesity (measurement quality may decrease, especially if the appropriate probe is not selected)
- Fasting (measured after a meal)
Hence the answer to the question “Will the FibroScan be wrong?”: misleading results can occur if the right conditions are not met or if accompanying clinical conditions are not taken into account. This shows the importance of interpretation and preparation, not the test.
At this stage, the other question is: FibroScan’s relationship with ultrasound. Ultrasound can roughly show the structure of the liver and fatty deposits, but may be limited in reliably quantifying the degree of fibrosis. FibroScan, on the other hand, provides more targeted information, especially for fibrosis monitoring. For detailed comparison: Differences Between Ultrasound and Elastography
The advantages and limitations of FibroScan and what you should know about FibroScan prices
The main reason for the widespread use of FibroScan is that it both increases patient comfort and facilitates follow-up processes in clinical practice. Nevertheless, like any test, it has its limitations.
Advantages
- Needle-free and fast: More comfortable than liver biopsy.
- Suitable for follow-up: Can be repeated at regular intervals in chronic diseases (hepatitis B/C, fatty liver, etc.).
- The liver screening approach: can help catch fibrosis early in people at risk.
- Lubrication assessment with CAP: Provides additional data on lubrication in some devices.
Limitations: Is it a substitute for biopsy?
the answer to the question “**Does it replace a liver biopsy?” depends on the patient. FibroScan can reduce the need for a biopsy in many cases; however:
- If the results are contradictory,
- If clinical suspicion is high,
- If other concomitant liver diseases are considered, the physician may recommend additional tests (such as blood tests, MR elastography) or a biopsy. So FibroScan is often a powerful tool, but it should not be considered as the ultimate decision test.
Who should have FibroScan?
Evaluation of liver fibrosis with FibroScan is frequently considered in the following groups
- Fatty liver and metabolic syndrome (insulin resistance, obesity)
- Chronic hepatitis B/C follow-up
- History of long-term alcohol use
- People with unexplained elevated liver enzymes (ALT/AST)
- Patients at risk of cirrhosis and requiring regular follow-up
FibroScan prices: What does it depend on?
“FibroScan prices” is one of the most searched topics. Since net fees vary from institution to institution, it may not be correct to give an exact figure here; however, the main factors affecting the price are as follows
- city and type of institution where the procedure was performed (private hospital, medical center, university hospital)
- Whether or not a physician examination/interview is included in addition to the measurement
- CAP measurement, report format and additional testing requirements
- SGK/private insurance coverage (may vary according to policy and institution agreement)
For current fee information and appointment scheduling, please visit the following page:
Frequently Asked Questions (with Short Answers)
**How often is FibroScan performed? The frequency of follow-up depends on the disease and risk level. In fatty liver or chronic hepatitis, physicians may usually recommend intervals of 6-12 months or longer depending on the clinical situation.
**Is FibroScan a substitute for ultrasound? No, it is not. Ultrasound is more targeted for anatomical assessment and FibroScan is more targeted for measurement of liver stiffness (fibrosis). Often they complement each other.
**Is FibroScan performed during pregnancy? The decision on this issue is made by the physician. As with any test during pregnancy, a risk-benefit calculation should be made.
**Is FibroScan performed in children? It can be performed in some centers with pediatric probe and experience. The evaluation of liver diseases in children should be planned by a pediatric gastroenterologist/hepatologist.
Summary: FibroScan, with the clearest answer to the question what is fibroscan; is a modern method that evaluates fibrosis and often fatty deposits in the liver without a needle. With the right preparation, correct patient selection and expert interpretation; it offers significant advantages both in the diagnostic process and in long-term follow-up. If you are planning a liver scan due to fatty liver, hepatitis follow-up or enzyme elevation, you can evaluate whether FibroScan is suitable for you by consulting a gastroenterology/hepatology specialist.
