According to the Centers for Disease Control and Prevention (CDC), approximately 25,000 men and 11,000 women are diagnosed with liver cancer each year. Early detection and treatment are key to fighting the disease.

There are several ways to test for liver cancer. FibroScan is a noninvasive imaging test that may help diagnose liver cancer. It looks for certain markers like fibrosis (liver scarring) without the need for a biopsy.

This article will take a closer look at what FibroScan is, how the test is performed, and whether or not it can accurately diagnose liver cancer.

FibroScan is an ultrasound test that uses sound waves to visualize the liver. This technology is also called transient elastography (TE).

With this test, sound waves bounce off the liver tissue and reveal signs of liver damage, like fibrosis and liver stiffness. Both scarring and stiffness may be signs of anything from liver damage to liver disease and even liver cancer.

FibroScan can diagnose and track a number of liver issues, including:

Overall, FibroScan looks for fibrosis (scarring) and more severe scarring or cirrhosis in the liver. Any condition that may affect the liver’s health — including cancer — may be detected using this technology.

If you’ve ever had a standard ultrasound, you likely won’t notice much difference between that type of test and a FibroScan. Both use probes and similar ultrasound-based technology to obtain their images. The main difference is that FibroScan may show more detail than a standard ultrasound.

FibroScan may be a useful tool for detecting liver cancer. That said, detecting cancer is not the primary use of this technology. Instead, the scan evaluates the stiffness of liver tissue and tracks changes over time.

Fibrosis is closely associated with hepatocellular carcinoma (HCC) — the most common type of liver cancer.

One study focused on cancer diagnosis in people who had hepatitis C with cirrhosis. According to this study, those who had a FibroScan and had liver stiffness of more than 24 kilopascals (kPa) were more likely to be diagnosed with cancer. The researchers concluded that FibroScan may be a useful tool for detecting HCC.

According to another study, people with FibroScan readings over 20 kPa were at risk of being diagnosed with HCC within 3 years. Those with values between 30 and 40 kPa were at the highest risk, further confirming that the level of liver stiffness (as recorded through FibroScan) may be directly related to liver cancer risk.

Overall, researchers conclude that FibroScan may be a helpful tool for detecting primary liver cancer. Currently, though, it is best used as just one tool in the diagnosis process. It can help narrow down which people need a biopsy to help determine if they have liver cancer.

A FibroScan is performed much like a standard ultrasound test. Preparation involves fasting for 3 hours before the test. This means you can only consume clear liquids, like water, for several hours before the test.

  • Before the test: You’ll want to wear comfortable, loose clothing that can be easily moved around during the test. The probe will be focused on the area around your right upper abdomen. You may be asked to rest for a few minutes before the test to allow for a clear reading.
  • During the test: The total scan time is usually between 5 and 10 minutes. During this time, you will lie down on your back with your right arm positioned over your head. The radiographer will apply gel to the probe and your skin before it is placed on your upper right abdomen — above your liver. The probe may give off vibrations as it collects images/measurements of your liver.
  • After the test: Because a FibroScan is noninvasive, there isn’t a recovery period. You can go home immediately after the test is finished. You should receive your results within a few days.

When you receive your results, you’ll see that several qualities in your liver were examined by the scan. When looking for cancer, stiffness is the primary indicator, as it shows the level of fibrosis/scarring.

Fibrosis stages

Fibrosis stages are determined as follows:

  • F0: no fibrosis (normal)
  • F1: portal fibrosis without septa (mild)
  • F2: portal fibrosis with few septa (moderate)
  • F3: numerous septa without cirrhosis (more severe)
  • F4: cirrhosis (severe)
Was this helpful?

Stiffness results are measured in the in the kPa unit of pressure. The readings may be broadly divided into the following values:

  • under 10 kPa may be normal
  • between 10 and 15 kPa may mean advanced chronic liver disease
  • above 15 kPa may mean compensated advanced chronic liver disease
  • above 20 kPa may mean clinically significant portal hypertension (CSPH)

Liver stiffness indicates scarring, which may be a sign of liver cancer. Cancer may be suspected if the reading is high, over 20 kPa. A high level of fibrosis should be continually monitored by your doctor.

Studies suggest there may be up to an 11% increase in HCC risk for each increase in your kPa number.

While these results can be helpful in determining the level of scarring and potential for cancer, researchers believe they should be combined with other testing methods for the most complete picture of liver health.

If your doctor suspects you may have liver cancer, they’ll likely order other tests, such as:

  • Imaging tests: This may include a computed tomography (CT) scan, magnetic resonance imaging (MRI), or standard ultrasound. Imaging tests can reveal a mass or other abnormality in the liver.
  • Laboratory tests: This involves taking blood samples. The alpha-fetoprotein (AFP) tumor marker test, for example, looks for the presence of AFP in the blood. Elevated levels may be a sign of cancer. A liver function test, on the other hand, looks for levels of an enzyme called alanine aminotransferase (ALT). This enzyme is usually elevated in the blood when a person has liver cancer.
  • A biopsy: A liver biopsy involves taking a sample of the liver tissue and examining it under a microscope to look for cancerous cells. A liver biopsy is typically done if other liver tests show abnormal results, or you have a mass on your liver. A biopsy can be done by inserting a long, thin needle into the liver or, less often, by threading a flexible tube through the jugular vein in the neck and into the liver. Another method involves making an incision in the stomach and using a laparoscope to get a tissue sample from the liver for biopsy.

If liver cancer is detected, your doctor may order more testing to determine the cancer stage and to see if the cancer has spread to other parts of the body. Additional CT and MRI scans may be used for this purpose. A positron emission tomography (PET) scan is an even more detailed test that can help show where malignant cells are throughout the body.

A FibroScan is just one of many diagnostic tests your doctor may order if you have liver issues. This test is noninvasive and can be performed safely to track the level of liver fibrosis, also known as scarring.

On its own, FibroScan can be an accurate indicator of your liver cancer risk. If liver scarring reaches a concerning level, your doctor will likely order additional tests, such as imaging tests, blood tests, or a biopsy.