Your liver. Your future.
A comprehensive UK guide to Liver FibroScan®, liver fat, fibrosis, cirrhosis risk, clinical indications, result interpretation and the role of early non-invasive assessment.
In this guide
Liver disease can progress silently
The liver can continue functioning despite significant injury. Fat accumulation, inflammation and fibrosis may therefore develop without obvious symptoms, making targeted risk assessment especially important in people with metabolic, alcohol-related, viral or other recognised liver risks.
This is a simplified educational pathway. Not everyone with steatosis progresses, and progression varies between individuals.
Why UKSONO focuses on early assessment
UKSONO Healthcare combines advanced ultrasound technology, experienced specialist practitioners and evidence-based pathways to help identify clinically important liver risk before complications develop.
Depending on the selected package, assessment may combine FibroScan with diagnostic liver ultrasound, relevant blood testing and clear recommendations for onward care.
What is a Liver FibroScan®?
FibroScan is a proprietary form of vibration-controlled transient elastography. A probe placed over the right upper abdomen produces a gentle mechanical pulse while ultrasound tracks the resulting wave through the liver.
The speed of the wave is used to estimate liver stiffness. The system can also calculate Controlled Attenuation Parameter (CAP), which estimates ultrasound attenuation associated with liver fat.
What patients usually experience
- Probe placed between the ribs over the liver
- Brief tapping sensations
- No needles or sedation
- No ionising radiation
- No routine recovery period
What does FibroScan measure?
1. Liver stiffness measurement
Reported in kilopascals (kPa). Higher stiffness may be associated with increasing fibrosis, but inflammation, cholestasis, congestion, recent food intake and technical factors may also raise the result.
There is no single universal kPa cut-off for every liver condition.
2. Controlled Attenuation Parameter
Reported in dB/m. CAP estimates hepatic steatosis and may be described as absent/minimal, mild, moderate or severe.
CAP thresholds vary between populations, probes, liver conditions and protocols.
Who may benefit from a Liver FibroScan?
Metabolic risk
- Fatty liver on imaging
- Type 2 diabetes or prediabetes
- Overweight, obesity or increased waist circumference
- High triglycerides or dyslipidaemia
- Hypertension or metabolic syndrome
Abnormal tests
- Raised ALT, AST or GGT
- Persistently abnormal liver blood tests
- Low platelets or other concern for advanced disease
- Incidental imaging findings requiring fibrosis assessment
Known liver risk
- Alcohol-related liver disease or sustained high alcohol exposure
- Chronic hepatitis B or C
- Selected autoimmune, cholestatic, genetic or medication-related conditions
- Monitoring established liver disease where appropriate
What happens before, during and after the examination?
Before the test
- Follow the clinic’s fasting instructions because food can affect liver stiffness.
- Continue prescribed medicines unless advised otherwise.
- Bring relevant blood tests, imaging and a medication list where available.
- Tell the practitioner about pregnancy, implanted devices or conditions affecting positioning.
During and after
- You usually lie on your back with your right arm raised.
- The practitioner identifies a suitable intercostal window.
- Multiple valid readings are taken to meet quality criteria.
- The procedure commonly takes around 10–15 minutes.
- You can normally return to usual activities immediately.
Understanding the result: more than one number
A clinically useful result should consider measurement quality, the probe used, the reason for testing and conditions that can falsely elevate or reduce the reading.
Quality indicators
- Number of valid measurements
- Reliability and variability criteria
- Interquartile range relative to the median where relevant
- Probe selection and technical limitations
- Whether preparation requirements were met
Clinical correlation
- FIB-4 or other validated fibrosis scores
- Liver blood tests and platelet count
- Conventional liver ultrasound
- Alcohol and medication history
- Metabolic risk factors
- Hepatology review or further testing when indicated
FibroScan vs conventional ultrasound vs liver biopsy
| Feature | FibroScan® | Conventional ultrasound | Liver biopsy |
|---|---|---|---|
| Main role | Estimates stiffness and liver fat | Assesses liver structure, focal lesions, gallbladder, bile ducts and portal features | Provides microscopic tissue diagnosis |
| Invasive? | No | No | Yes — needle tissue sampling |
| Ionising radiation? | No | No | No, although image guidance may be used |
| Fibrosis assessment | Indirect through stiffness | Can show advanced disease features but is less sensitive for early fibrosis | Direct histological staging |
| Focal masses | Not designed to characterise them | Can detect and assess many focal lesions | Characterises sampled tissue only |
| Repeat monitoring | Well suited where clinically appropriate | Well suited where clinically appropriate | Limited by invasiveness and sampling risk |
Limitations and factors affecting accuracy
Biological factors
Acute inflammation, biliary obstruction, hepatic congestion and recent meals can increase stiffness independently of long-term fibrosis.
Technical factors
Body habitus, narrow rib spaces, ascites, poor positioning or unsuitable probe selection can make readings unreliable or unobtainable.
Clinical limitations
FibroScan does not detect every liver condition and does not replace blood tests, diagnostic ultrasound, MRI, specialist assessment or biopsy when indicated.
Frequently asked questions
Does a normal liver blood test rule out fibrosis?
No. Liver enzymes can be normal in some people with clinically important liver disease. Assessment should be based on overall risk and other tests where appropriate.
Is FibroScan the same as ultrasound?
No. FibroScan estimates stiffness and fat, while conventional ultrasound assesses anatomy and surrounding structures.
Can fatty liver improve?
In many people, sustained weight management, physical activity, diabetes control and reduced alcohol exposure can improve liver fat and reduce progression risk.
Can FibroScan diagnose cirrhosis?
A technically valid high stiffness result can support assessment for advanced fibrosis or cirrhosis, but no single measurement should be interpreted alone.
How often should FibroScan be repeated?
There is no universal interval. Repeat testing depends on the underlying condition, baseline result, treatment and clinical recommendation.
Book your Liver FibroScan®
Private liver assessment at Canary Wharf, Orpington or Tunbridge Wells.
Website: www.uksono.com
Telephone: 01892 251532
Email: info@uksono.com
References and clinical sources
- NICE. FibroScan for assessing liver fibrosis and cirrhosis outside secondary and specialist care.
- NICE NG50. Cirrhosis in over 16s: assessment and management.
- NICE NG49. Non-alcoholic fatty liver disease: assessment and management.
- Newsome PN et al. Guidelines on the management of abnormal liver blood tests. Gut. 2018.
- EASL Clinical Practice Guidelines on non-invasive tests for liver disease severity and prognosis.
- British Liver Trust. Liver disease in numbers.
Medical disclaimer: This article is educational and does not replace personalised medical advice, diagnosis or emergency assessment. FibroScan® is a registered trademark of Echosens.
Clinical content reviewed and updated: 2 August 2026.