Patient guide · Hepatology imaging
FibroScan, non-invasive transient elastography for liver fibrosis and steatosis (CAP).
FibroScan uses transient elastography to measure liver stiffness (fibrosis) and Controlled Attenuation Parameter (CAP) for steatosis. A 10-minute non-invasive alternative to liver biopsy — for NAFLD/MASLD, viral hepatitis, alcohol-related liver disease and post-transplant monitoring.
Why patients choose us
- 01
The right hands
We route you to a consultant hepatologist — with FibroScan expertise, who interprets the kPa and CAP numbers against your full clinical picture.
- 02
Often answers same-day
Findings can frequently be discussed immediately, with the written report to follow.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
FibroScan at a glance.
The essentials, in six lines — what it is, what it measures, and where it fits alongside biopsy and MRI.
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What it is
Transient elastography — a probe that measures liver stiffness and fat (CAP).
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Alternative to biopsy
Non-invasive, painless, and repeatable — no needle into the liver.
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Fast and light
10-minute test; no fasting required for stiffness alone.
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What it reports
Liver stiffness in kPa and Controlled Attenuation Parameter (CAP) in dB/m.
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Guideline-aligned
Interpreted against EASL and AASLD criteria for fibrosis and steatosis staging.
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Ideal for monitoring
Repeat scans track MASLD, hepatitis C, and alcohol-related liver disease over time.
The problem
A FibroScan is only as good as who reports it.
The kPa and CAP numbers are the answer — and the hepatologist interpreting them against your LFTs, imaging and risk factors decides what the numbers mean and the next step.
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Abnormal LFTs?
We arrange a FibroScan and route it into a hepatology work-up alongside imaging and bloods.
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MASLD or diabetes?
We stage fibrosis non-invasively and set the monitoring interval that matches your risk.
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Post-HCV or transplant?
Serial FibroScan tracks regression or graft fibrosis without repeated biopsy.
Preparation and journey
From consult to report — what happens, in order.
Hepatology-led, minimally invasive, and typically wrapped up in a single visit.
Phase 1 · Before your scan
Consultation and preparation
Phase 2 · On the day
~10 minutes at the clinic
Phase 3 · After
Report and next steps
- 01
Before
Hepatology or gastro consultation
A short, confidential form. We route you to a consultant hepatologist or gastroenterologist for the clinical context.
- 02
Before
Fasting 3 hours (for CAP accuracy)
For an accurate steatosis (CAP) reading, we ask you to fast for three hours before the scan.
- 03
On the day
Lie on your back with right arm raised
You lie flat on the examination couch with your right arm raised above your head to open the rib spaces.
- 04
On the day
Probe placed between the right ribs
The FibroScan probe sits over the right lobe of the liver, between the ribs. Painless — a small tap you can feel.
- 05
On the day
10 valid measurements captured
The operator collects at least ten valid stiffness measurements, typically in under 10 minutes.
- 06
After
IQR / median stiffness reported
The scan reports the median stiffness in kPa alongside the interquartile range (IQR) as a quality marker.
- 07
After
Written report with fibrosis stage
A consultant-authored report with your fibrosis stage (F0–F4), CAP steatosis grade, and the clinical next step.
Typical end-to-end: 3–7 days. Urgent cases: same day.
What it shows
When a FibroScan is the right test.
FibroScan answers two questions — how much fibrosis, and how much fat. These are the situations where the answer changes management.
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F0–F4 fibrosis stages (kPa)
Stages the degree of liver fibrosis from none (F0) through to cirrhosis (F4) using kPa thresholds.
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CAP steatosis grades (S0–S3)
Quantifies liver fat as a Controlled Attenuation Parameter grade from S0 (none) to S3 (severe).
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NAFLD / MASLD advanced fibrosis
Identifies patients with metabolic-associated steatotic liver disease who have moved into advanced fibrosis.
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Compensated cirrhosis
Detects compensated cirrhosis before it decompensates — a critical window for intervention.
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Post-viral clearance monitoring
Tracks liver stiffness after hepatitis C or B treatment to confirm regression of fibrosis.
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Post-transplant graft assessment
Serial FibroScan monitors graft fibrosis after liver transplantation without repeated biopsy.
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Response to weight loss / therapy
Repeat scans document the fibrosis response to lifestyle change or MASH-directed pharmacotherapy.
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Red flag: F4 cirrhosis + varices — urgent endoscopic surveillance pathway
F4 stiffness with signs suggestive of portal hypertension triggers an urgent variceal screening endoscopy.
Next steps
What a FibroScan result actually leads to.
The value of the scan is the pathway that follows — from lifestyle change to pharmacotherapy, endoscopy or surveillance.
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Lifestyle intervention
Structured weight loss and alcohol reduction — the first-line treatment for most MASLD and alcohol-related liver disease.
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Metabolic risk reduction
Diabetes, lipid and blood-pressure control alongside cardiovascular risk optimisation.
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Antiviral therapy for HCV / HBV
Direct-acting antivirals for hepatitis C, and nucleos(t)ide analogues for chronic hepatitis B.
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MASH-directed pharmacotherapy
Resmetirom and other emerging agents for biopsy- or FibroScan-confirmed MASH with fibrosis.
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Alcohol-cessation support
Structured pathway with hepatology, addiction medicine, and — where appropriate — pharmacological support.
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HCC surveillance for cirrhosis
6-monthly ultrasound (and AFP where indicated) for anyone with confirmed cirrhosis.
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Variceal screening endoscopy
Upper GI endoscopy when stiffness and platelets suggest clinically significant portal hypertension.
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Hepatology follow-up
Ongoing consultant-led follow-up with repeat FibroScan on the interval your stage requires.
Our vetted London network
A small panel of clinics, we picked them.
Hepatology partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant hepatologists and accredited FibroScan operators
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Guideline-aligned kPa and CAP thresholds (EASL / AASLD)
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Same-day report, with images available for onward review
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Onward endoscopy, HCC surveillance or transplant pathway if significant disease is found
Safety and eligibility
One of the safest tests in hepatology.
FibroScan is exceptionally safe. The practical points are the situations where the reading is unreliable, and the red flags that need onward escalation.
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Painless, radiation-free
A handheld probe — no needles, no radiation, no dye. A small tap you can feel on the skin.
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Fast 3 hours for CAP
For accurate steatosis (CAP) measurement, fast for three hours; water and medication are fine.
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Position on the couch
You lie on your back with your right arm raised above your head to open the intercostal spaces.
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Ascites limits accuracy
Significant ascites can prevent a valid FibroScan reading — MRE or ARFI may be a better route.
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Very high BMI can limit signal
A dedicated XL probe is used to reach the liver in patients with a high BMI where the standard probe cannot.
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IQR is a quality check
A wide interquartile range means the reading is unreliable and the scan is repeated.
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Not a substitute for imaging
FibroScan measures stiffness and fat — it does not exclude focal lesions; ultrasound or MRI remain the imaging tests.
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Acute hepatitis inflates kPa
Active hepatitis, cholestasis or heart failure can raise stiffness independently of fibrosis.
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Bring prior LFTs and imaging
A trend of LFTs, prior imaging and any biopsy history materially sharpens interpretation.
Red flags — escalate
- F4 cirrhosis
- Decompensated liver disease
- Ascites
- Hepatic encephalopathy
- Variceal bleed
- HCC on imaging
- Rapid rise in stiffness
- Post-transplant fibrosis
- Alcohol relapse with cirrhosis
Reading your report
A FibroScan report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and risk factors
Your details, the reason for the scan, and the metabolic, viral or alcohol risk factors that shape interpretation.
- 02 Technique
Probe used and number of valid measurements
Which probe (M or XL) was used, how many valid measurements were captured, and the interquartile range.
- 03 Findings
Median stiffness (kPa) and CAP (dB/m)
The median liver stiffness with IQR, and the CAP score for steatosis, mapped onto fibrosis and steatosis grades.
- 04 Impression
The conclusion: read this first
F stage, S grade, and the concrete next step — surveillance interval, endoscopy, or specialist referral.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about FibroScan.
Quick answers on how it compares to biopsy, fasting, kPa numbers, timing of results and how often to repeat.
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What does a FibroScan show?
FibroScan uses transient elastography to measure two things at once — how stiff your liver is (a marker of fibrosis, in kPa) and how much fat is in it (Controlled Attenuation Parameter, in dB/m). Together, these stage fibrosis (F0–F4) and steatosis (S0–S3) without a liver biopsy.
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How is FibroScan different from a liver biopsy?
A biopsy takes a physical sample of liver tissue and remains the reference standard for some questions. FibroScan is non-invasive, painless and repeatable, which makes it the first-line test for most patients with MASLD, chronic hepatitis, or alcohol-related liver disease and for monitoring over time.
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Do I need to fast before a FibroScan?
For an accurate CAP (steatosis) reading, fast for three hours before the scan. Water and your regular medication are fine. If only liver stiffness is being measured, fasting is not strictly required — but most clinics ask you to fast anyway.
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What do the kPa numbers mean?
Higher kPa values reflect stiffer, more fibrotic livers. Thresholds vary slightly by underlying disease, but broadly: under ~7 kPa is reassuring, 7–10 kPa suggests significant fibrosis, 10–14 kPa suggests advanced fibrosis, and above ~14 kPa suggests cirrhosis. Your report interprets your number against the right thresholds for your disease.
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How quickly will I get results?
A preliminary result is available on the day, and a consultant-authored written report typically follows within 24–48 hours. If your stiffness is in the cirrhosis range, we escalate onward pathways (endoscopy, HCC surveillance) immediately.
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How often should I repeat a FibroScan?
It depends on your baseline stage and disease. For MASLD without advanced fibrosis, every 2–3 years is typical. For hepatitis C after antivirals, at 12 months. For cirrhosis, alongside 6-monthly HCC surveillance. Your hepatologist sets the interval on the report.
Sources
Guidelines this page is aligned to.
- EASL clinical practice guidelines on non-invasive tests for evaluation of liver disease severity and prognosis.
- AASLD practice guidance on the clinical assessment and management of non-alcoholic fatty liver disease.
- NICE. Non-alcoholic fatty liver disease (NAFLD): assessment and management (NG49).
- British Society of Gastroenterology guidelines on the management of abnormal liver blood tests.
Last reviewed 2026-07-30 · Next review 2027-07-30 · ~5 min read
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In practice, in London
The London pathway for fibroscan
With fibroscan, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The wait for fibroscan on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
A private fibroscan pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For fibroscan specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Fit matters more than people expect. For fibroscan, the right consultant depends on what you actually need — a second opinion, a definitive diagnosis, a bridge into treatment, or reassurance that nothing’s being missed. We match on that, not on who has the biggest brochure. If a test isn’t the right next step, we’ll say so before you book anything.