Liver stiffness (FibroScan)

Measuring liver damage

Liver damage used to be defined in two ways, based on liver biopsy results.

  1. The “stage” measured the amount of fibrosis (scarring).
  2. The “grade” measured the amount of inflammation, which is related to the rate of future liver scarring.

In 2017, non-invasive scans like FibroScan just report liver damage as mild, moderate or severe.

Liver stiffness (FibroScan)

In the UK, scans such as FibroScan are recommended for monitoring liver health in people with coinfection.

This scan is painless: zero pain and zero risk. It takes less than ten minutes and produces immediate results. FibroScan has dramatically reduced the need for having a liver biopsy.

FibroScan asseses liver stiffness by measuring how quickly vibration waves pass through the liver. The more damaged or stiff the liver, the more rapidly the waves will pass through it. Results are presented as a number in kilopascals (kPa). A higher number indicates more liver damage.

Results from FibroScan need to be interpreted based on other factors.

A score of over 7.2 kPa indicates higher likelihood of significant fibrosis. A score over 14.5 kPa in someone with HCV/HIV coinfection indicates cirrhosis.

However, FibroScan is not a perfect test and does not work for everyone.

  • It can be too difficult to perform and results may be unreliable in people who are obese.
  • It can overestimate damage in acute HCV.
  • It is less sensitive at detecting small differences between mild or moderate liver damage.

However, FibroScan is very sensitive at picking up severe damage. It can therefore identify people who need HCV treatment more urgently.

If FibroScan results indicate serious liver damage, the test should be repeated to confirm the results.

YouTube video

Dr Sanjay Baghani from the Royal Free Hospital in London shows how a Fibroscan works.

Last updated: 17 August 2017.