Fibroscan - A new and simple method for early diagnosis of liver disease

By Dr. Shanti Swaroop Dhar in Gastroenterology, Hepatology & Endoscopy

Jul 15 , 2015 | 4 min read


Till recently the best method for diagnosis of cirrhosis was liver biopsy which is not only invasive but costly and associated with complications. We now have a novel technique, the fibroscan, which allows noninvasive assessment of liver stiffness (fibrosis and cirrhosis), thus, obviating the need for liver biopsy.

In addition to the quantification of liver fibrosis, the fibroscan also quantitates the amount of fat in the liver. The method is not only cheaper and non-invasive but quicker and equally accurate as liver biopsy in diagnosis. It also helps in monitoring the progression or regression of liver disease, thus allowing treatment to be tailored to individual needs.

Liver disease is common in India. According to the Indian Council of Medical Research, almost 32% of the Indian population has liver problems. The continuing liver problem leads to liver fibrosis and Cirrhosis (the liver does not function properly due to long-term damage) which accounts for almost 200,000 deaths in India every year. Liver cirrhosis causes is one of the top 10 causes of death worldwide and 1/5th of the global deaths due to cirrhosis occurs in India.

The commonest cause of chronic liver disease is NAFLD (Non-Alcoholic Fatty Liver Disease), which is a lifestyle disease occurring in individuals with improper diet, lack of exercise, tendency to fat around the stomach, and lipid and sugar-related problems in the blood, occurring in about 1/3rd of the Indian population.

The other causes are alcohol and Hepatitis B & C infections. Such patients can progress to chronic liver disease with fibrosis and cirrhosis without having any symptoms and with essentially normal liver function tests. Hence, an early diagnosis is difficult and often missed.

By the time patients develop symptoms such as jaundice, ascites, encephalopathy, and gastrointestinal bleeding, the liver disease is advanced and the lifespan of the patient is significantly reduced. About 50% of patients presenting with the above symptoms die within 1-1 ½ years of diagnosis. It is therefore of utmost importance that an early diagnosis is made so that early treatment may prevent disease progression and save a life.

What is Fibroscan (Liver Elastrography)?

Fibroscan is a non-invasive imaging technique that uses ultrasound to examine the liver. This scanning technology is used to assess the health of the liver and check for fibrosis.

Fibrosis is the accumulation of excess tissue that occurs with the scarring of collagen tissue. Doctors recommend the fibroscan test as a screening test for various diseases but not limited to cirrhosis and hepatic tumours. In these instances, a Fibroscan can help detect signs of deteriorating liver function and acute liver failure. Fibroscan also helps you assess abnormal fat buildup in your liver or fatty liver.

Why Do I Need Fibroscan?

Fibroscan is used by doctors to visualise the liver and check for fibrosis. This imaging test allows you to evaluate the health of your liver. Fibroscan can give you valuable information about your liver, so it's a good idea to get a Fibroscan liver test if you have signs of any progressive liver disease. In fact, a Fibroscan is more specific and sensitive than an ultrasound scan in detecting fibrosis.

About Your CAP Score

The CAP score helps you assess the amount of damage in your liver, which may include cirrhosis and possible liver failure. The higher your CAP score, the more severe your cirrhosis might be.

CAP Score Steatosis grade Amount of liver with fatty change
238 to 260 dB/m S1 Less than ⅓ (11% to 33%)
260 to 290 dB/m S2 Between ⅓ and ⅔ (34% to 66%)
290 to 400 dB/m S3 More than ⅔ (67%)

About Your Fibrosis Result

Your fibrosis score is an assessment of your liver's scarring, which may be caused by a disease or a condition, such as cirrhosis. This scoring system helps you measure whether the scarring in your liver is mild, moderate, or severe. In most cases, the more scarring in your liver, the more likely you are to develop liver failure.

Conditions F0 to F1 F2 F3 F4
Hepatitis B 2 to 7 kPa 8 to 9 kPa 8 to 11 kPa 18 kPa or higher
Hepatitis C 2 to 7 kPa 8 to 9 kPa 9 to 14 kPa 14 kPa or higher
HIV/HCV Coinfection 2 to 7 kPa 7 to 11 kPa 11 to 14 kPa 14 kPa or higher
Cholestatic Disease 2 to 7 kPa 7 to 9 kPa 9 to 17 kPa 17 kPa or higher
Non-Alcoholic Fatty Liver Disease (NAFLD) 2 to 7 kPa 7.5 to 10 kPa 10 to 14 kPa 14 kPa or higher
Alcohol-Related Disease 2 to 7 kPa 7 to 11 kPa 11 to 19 kPa 19 kPa or higher

  • Fibrosis Score - F0 to F1 - No or mild liver scarring
  • Fibrosis Score - F2 - Moderate liver scarring
  • Fibrosis Score - F3 - Severe liver scarring
  • Fibrosis Score - F4 - Advanced liver scarring

Risks or Complications of Fibroscan

The Fibroscan liver test is easy, painless, and quick. Unlike invasive biopsy, Fibroscan is a noninvasive procedure. Patients can undergo the test without anaesthesia or sedation. It is also a safe procedure for patients, most of whom do not report any side effects from the procedure.

Preparation for Fibroscan

You should avoid alcohol for at least 24 hours before the scan. In addition, you should not eat anything or drink large quantities of fluids prior to 3 hours before the scan.

How Much Time will Fibroscan Test Take?

The Fibroscan test only takes about 15 minutes to complete. The procedure is very easy, and there are minimal risks or side effects.

What to Expect After Fibroscan?

The test is painless and takes only a few minutes. You can return to your normal activities immediately following the test.


A Fibroscan liver test is a non-invasive imaging technique that uses ultrasound to examine the liver. This scanning technology is used to assess the health of the liver and check for fibrosis. The Fibroscan test takes only 15 minutes, and you can go home after the test on the same day.

This state-of-the-art, Fibroscan technology, for the diagnosis of liver disease is now available at Max Super Speciality Hospital and provides an immediate, non-invasive, and painless measurement of liver health. It is useful in patients with fatty liver in order to identify those with fibrosis who have progressive disease. It is also useful for the assessment of fibrosis and cirrhosis of the liver due to any cause.