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Elastometry

Measuring liver stiffness by instrumental methods

Elastometry — a probe over the liver and a stiffness value in kPa

Elastometry is a non-invasive quantitative measurement of liver stiffness, expressed as a number in kilopascals (kPa). The more pronounced the fibrosis, the stiffer the tissue — so elastometry lets you assess the fibrosis stage without a biopsy.

Most often it is performed by vibration-controlled transient elastometry (the FibroScan device). In essence it is a quantitative form of elastography: elastography "draws" a stiffness map, while elastometry gives a specific value in kPa.

How it is done

A probe is placed on the skin over the liver; it sends a gentle mechanical wave and measures how fast it travels — the stiffer the tissue, the faster the wave. The result is expressed in kPa. The procedure is done on an empty stomach, is painless, involves no radiation and takes a few minutes.

Using a separate parameter (CAP), the same device can also estimate the amount of fat in the liver, which is useful in NAFLD.

What the values mean

Values are matched to the METAVIR fibrosis stages (F0–F4). As a rough guide in metabolic liver disease: below 8 kPa marked fibrosis is unlikely, 8–12 kPa is a "grey zone", above 12 kPa marked fibrosis or cirrhosis is likely. Under the Baveno VII approach, stiffness of 25 kPa and above points to a high risk of portal hypertension.

What affects the result

Stiffness can be overestimated with active inflammation and high ALT, cholestasis, venous congestion in heart failure, and also right after eating. Marked obesity and ascites make the measurement difficult. That is why the test is done on an empty stomach, and the result is interpreted together with calculated indices (FIB-4, FibroTest).

Reference ranges

A rough interpretation of liver stiffness by elastometry (FibroScan/VCTE); thresholds depend on the cause of the disease:

< 8 kPamarked fibrosis unlikely (F0–F1)
8 – 12 kPa"grey zone", further work-up needed
> 12 kPamarked fibrosis or cirrhosis likely (F3–F4)
≥ 25 kPahigh risk of portal hypertension (Baveno VII)
Important: Values are approximate, differ between devices and disease causes; a doctor interprets them together with the FIB-4 and FibroTest indices.

Calculate using this marker

Calculators where Elastometry is used directly:

Frequently asked questions

How does elastometry differ from elastography?

These are closely related concepts. Elastography is an imaging method that "shows" tissue stiffness, often as a colour map. Elastometry is a quantitative measurement of that same stiffness in numbers (kPa), as with FibroScan. In practice the terms are often used interchangeably.

Does elastometry replace a liver biopsy?

In many cases yes: it non-invasively assesses the fibrosis stage and is convenient for monitoring. But with borderline values, rare diseases or a mismatch with lab results, a doctor may still order a biopsy.

Related terms

Sources

  1. NIDDK — Diagnosis of NAFLD & NASH
  2. MedlinePlus — Cirrhosis
info
This content is educational and does not replace consultation with a physician. Reference ranges may vary depending on the laboratory and method — rely on the ranges stated on your own test report.
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