Elastography is a non-invasive method that measures liver stiffness. The more pronounced the fibrosis (replacement of tissue by scarring), the stiffer the liver becomes — so elastography makes it possible to assess fibrosis without a biopsy.
This is an important breakthrough: previously the stage of fibrosis could be determined accurately only with a needle puncture. Today elastography (for example, “FibroScan”) complements calculated indices such as FIB-4 and the FibroTest.
What it shows and who needs it
Elastography assesses the stage of liver fibrosis (from minimal to cirrhosis), and some devices at the same time measure the degree of fatty liver (steatosis). This helps track the course of the disease and the effect of treatment.
The method is especially useful in non-alcoholic fatty liver disease, viral hepatitis, alcohol-related damage and persistently elevated liver enzymes.
How it is done
The procedure is similar to an ordinary ultrasound: a probe is placed on the skin over the liver; it is painless, without radiation and takes a few minutes. It is more often done on an empty stomach.
Limitations: the result can be distorted by severe obesity, ascites and acute liver inflammation. That is why elastography is interpreted together with tests (ALT, GGT) and fibrosis indices.
Assess liver fibrosis from lab tests
Complement elastography with calculated liver-fibrosis indices:
Frequently asked questions
Does elastography replace a liver biopsy?
In many cases yes — it makes it possible to assess the stage of fibrosis non-invasively, without a puncture. A biopsy is still needed in complex and controversial situations, but for screening and monitoring elastography and calculated indices (FIB-4, FibroTest) are usually sufficient.
How do I prepare for elastography?
The examination is usually done on an empty stomach (4–6 hours without food) so that the result is more accurate. No special, complicated preparation is required; the procedure is painless and safe. Exact recommendations are given by the referring doctor or clinic.
What can distort the result?
Severe obesity, a buildup of fluid in the abdomen (ascites), acute liver inflammation and eating before the examination can overstate the stiffness. That is why the result is assessed in the context of tests and the clinical picture, not in isolation.
Related terms
Sources
- Liver stiffness / transient elastography (review). NCBI/PMC
- Noninvasive assessment of liver fibrosis — StatPearls (NCBI)
- MedlinePlus (NIH) — Liver Diseases