An expert's guide to Fibroscan

Written by: Professor Aftab Ala
Published: | Updated: 28/06/2023
Edited by: Conor Dunworth

Fibroscan is a modern bedside technology used to evaluate liver health. In his latest article, internationally recognised consultant gastroenterologist and hepatologist Professor Aftab Ala explains this new technology. He explains the conditions it can detect, how it works and its advantages over a standard liver biopsy.


What diseases or conditions can Fibroscan detect?

Fibroscan technology is a key modern technology development in evaluating liver health, providing enormous benefits to patients as in many cases there are no signs or symptoms of mild, moderate or severe liver disease. 

The following categories of patients may benefit from Fibroscan:
People with potential recognised risk factors for liver disease, such as a history of heavy alcohol intake or the presence of diabetes and/ or overweight/obesity
People who have evidence of a liver condition where there is a need to work out the severity, including:

  • Non-alcoholic fatty liver disease or Metabolic associated fatty liver disease (MAFLD)
  • Alcohol-related liver disease
  • Abnormal liver tests of unknown cause
  • Autoimmune liver disease and bile duct conditions such as primary biliary cholangitis, primary sclerosing cholangitis 
  • Iron excess e.g., haemochromatosis 
  • Monitoring the liver in patients taking medication which may potentially cause liver damage (e.g., methotrexate)


How does Fibroscan work?

Fibroscan specifically uses ultrasound probe to measure the speed of a vibration (shear wave) passing through the liver. That is, the faster that the wave passes through the liver, the stiffer the liver. The liver stiffness correlates with the degree of liver damage or "fibrosis". During the examination there is a very slight vibration on the skin at the tip of the probe.

A Fibroscan is a rapid, painless, bedside procedure lasting approximately 15-20 minutes. It is carried out as an outpatient procedure with patients going home the same day. The liver scan will highlight any potential liver damage or disease, ending any unwarranted concern lifestyle may potentially impact on health.


What is a normal Fibroscan score?

A Fibroscan score is recorded as a numerical value. The stiffer the liver the higher the numerical value will be. The stiffness of the liver is an indicator that can be associated with a variety of causes. To ensure it is an effective result at least ten valid records must be taken.

A Fibroscan score is a numerical result between 2-75. A normal Fibroscan range is approximately between 2-7 with an average result being around 5. Scarring of the liver is measured by four stages:

  • F0=no scarring
  • F1=mild scarring
  • F2=moderate fibrosis
  • F3=severe fibrosis
  • F4=advanced fibrosis or cirrhosis.


Your specialist will inform you of the result instantly and discuss the implications of the results 


What advantages does Fibroscan have over a liver biopsy?

A Fibroscan is a non-invasive, quick and painless bedside test to measure the elasticity of liver tissue (or liver scarring), referred to as fibrosis. Therefore, it’s an ideal tool to assess liver damage, performed at the time of a consultation with immediate results and allows the physician to diagnose and carefully monitor disease evolution in conjunction with treatment and collateral factors. 

Moreover, due to its non-invasive assessment, it can be performed repeatedly to evaluate changes in the liver over time, be it liver fat or liver scarring.


How accurate is Fibroscan?

Fibroscan technology ensures accurate assessment of fatty liver and liver scarring from multiple causes that can damage the liver including excess alcohol, viral hepatitis, non-alcoholic/metabolic fatty liver disease and iron overload. 


Professor Aftab Ala is a leading gastroenterologist and hepatologist with private practise in Guildford & Farnham. If you would like to book a consultation with Professor Ala you can do so today via his Top Doctors profile. 

By Professor Aftab Ala

Professor Aftab Ala is an internationally recognised consultant gastroenterologist and hepatologist who specialises in liver disease, liver function tests, FibroScan, colonoscopy, gastroscopy and SIBO. His private practices is based at Nuffield Health Guildford Hospital, Mount Alvernia Hospital and Spire Clare Park Hospital, with NHS base at the Royal Surrey NHS Foundation Trust, Guildford and Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London. 

Professor Ala is highly qualified, with an MB BS from Charing Cross and Westminster Medical School (Imperial College, London) an MD (United States Medical Licensing Examination) and a PhD in hepatology from University College London, where he won a National Wellcome Trust Research Training fellowship in immune and inflammatory medicine mechanisms linking liver and gut disease. Following specialist training in global centres of excellence at King's and Royal Free Hospitals, he was awarded a Certificate of Completion of Specialist Training (CSST) in gastroenterology and internal medicine.

He undertook further focused training as advanced hepatology fellowship to Mount Sinai Hospital in New York from 2003 to 2004, building international expertise on rare liver diseases, chronic liver disease and liver/bowel transplantation. Professor Ala is a fellow of the Royal College of Physicians, London the Chair of the Gastroenterology and Hepatology, Clinical and Experimental Medicine Department at the University of Surrey and a consultant hepatologist at Royal Surrey and Kings London.

He has written and contributed to over 200 peer-reviewed original medical articles and oral presentations. He has supervised PhD students at the University of Surrey and King's College London leading research programmes supported by National (NIHR and UKRI-MRC) and International funding in genetic metabolic liver disease and inequalities of health in which he has an active track record of scientific achievement and running international and national clinical trials, including first in human studies.

He is a member of numerous scientific committees in his field, and is the lead for hepatology at the National Institute of Health and Research (NIHR) for Kent, Surrey and Sussex (South East England). Professor Ala is also a previous group member for hepato-pancreatic biliary (HPB) NHS England's South East coast Clinical Reference Group, NICE Guidelines on Hepatitis B, Clinical Advisor to the NHS England and currently British Liver Trust-

Professor Ala is a member of various professional organisations including the Royal College of Physicians London, the British Society of Gastroenterology (BSG) British Association for the Study of the Liver (BASL). He is the lead of the Wilson's Disease and Rare Liver Disease Special Interest Group for BASL, member of the American Association for the Study of the Liver (AASLD) and the European Association for the Study of the Liver (EASL).

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