Getting tested for liver stiffness as part of your primary biliary cholangitis (PBC) care can sound intimidating. Fortunately, FibroScan isn't a complicated procedure. The test itself is short and painless, and it doesn't require any needles or sedation.

One member of myPBCteam said, “They are pretty simple and painless. It's similar to having an ultrasound, but it focuses on sound waves to determine the state of the liver.”

FibroScan measures how stiff your liver has become, which can be a sign of liver scarring, also called liver fibrosis. For people living with PBC, this noninvasive test has become a common way to help track liver health over time.

Here's what to expect before, during, and after a FibroScan, how the results fit into your broader PBC treatment plan, and how this test compares to other tools your care team might use. 

How Do You Prepare for a FibroScan?

Getting ready for a FibroScan is fairly simple. Your care team may ask you to avoid eating or drinking for a few hours before your appointment. That’s because a full stomach can affect your degree of liver stiffness.

You'll also want to wear loose, comfortable clothing that gives easy access to your right side, just below your rib cage. That's where the technician will place the probe.

“A FibroScan lasts about 15 minutes. It’s like an ultrasound, but your liver is vibrated with a brief, painless jolt. I had one this week.”

 

— A myPBCteam member

Since FibroScan doesn't involve sedation, you don't need to arrange for someone to drive you home afterward. If you have any questions before your appointment, it's a good idea to bring them up with your care team ahead of time.

What Happens During a FibroScan?

During the test, you'll lie on your back with your right arm raised behind your head. A technician will apply a water-based gel to the skin over your right side, then place a small probe against your body.

The probe sends painless vibrations, along with sound waves, into your liver tissue. Then it measures how quickly the vibrations travel. The faster they move, the stiffer — and potentially more scarred — your liver tissue is.

You might feel a brief tapping or vibration sensation, but the test itself doesn't hurt. Most FibroScan appointments take about 10 to 15 minutes from start to finish, and you'll be able to head home right afterward.

A member of myPBCteam said, “A FibroScan lasts about 15 minutes. It's like an ultrasound, but your liver is vibrated with a brief, painless jolt. I had one this week.”

What Happens After a FibroScan?

Once your FibroScan is complete, your results are typically ready right away. Your healthcare team will go over them with you and factor them into your ongoing PBC treatment plan.

Your FibroScan results can help your care team decide whether your current treatment is working well and whether anything else, like a repeat scan, might be worth discussing.

When You Might Need a Repeat Scan or Additional Testing

Your healthcare team may use FibroScan when you are first evaluated and repeat it during certain follow-up visits. Test timing can vary based on your degree of liver scarring, treatment response, and overall health. Your care team will recommend a schedule that fits your situation.

If your liver stiffness score changes significantly, or if your blood tests raise new questions, your care team might suggest additional testing. This could include imaging, like an MRI, or more rarely a liver biopsy for a closer look at your liver tissue.

A member of myPBCteam said, “I have a FibroScan every year. It's just an ultrasound with elastography. No pain. Just like a regular ultrasound. Don't be scared!”

In more advanced cases of liver scarring, your care team may discuss additional treatment options with you, including evaluation for a liver transplant. Most people with PBC won't reach this point, but it's one reason ongoing monitoring matters.

How Are FibroScan Results Interpreted for PBC?

Your FibroScan results include a liver stiffness score, which is measured in kilopascals (kPa). That number is only one piece of the puzzle, though. Your care team looks at it alongside your blood tests, symptoms like fatigue or itching, and overall health history before drawing any conclusions.

Healthcare providers can use certain liver stiffness ranges to help estimate the amount of liver scarring and the risk of PBC getting worse. In general, lower scores are linked with less risk, while higher scores can suggest more advanced scarring or a greater risk of liver problems.

Your FibroScan score needs to be interpreted alongside your blood tests, health history, and other test results. Your care team can explain what your number means for you and whether it has changed enough to affect your care plan.

What Can Affect the Accuracy of Your Results

A few factors can affect a FibroScan reading, making your liver appear stiffer or less stiff than it actually is. These factors include:

• Higher body mass index
• Fluid buildup in the belly, known as ascites
• Recent inflammation in the liver
• Liver tumors

Other things that may affect the test’s accuracy include a blockage that limits bile flow and scar tissue from prior surgery near the liver. If your results seem unclear or don't match your other test results, your healthcare team may recommend a repeat scan or a different type of imaging.

How Does FibroScan Compare to Other Liver Tests Used in PBC Care?

FibroScan is just one of several tools your care team may use to monitor PBC and other forms of chronic liver disease, such as hepatitis. Here's how it compares to some of the other tools:

• Blood tests — These check liver enzymes and other markers of liver function. They're a routine part of PBC monitoring but don't directly measure liver stiffness the way FibroScan does.
• Imaging, such as ultrasound or MRI elastography — These noninvasive options can also assess liver stiffness or structure. They may be used alongside or instead of FibroScan in certain situations.
• Liver biopsy — Doctors use this more invasive test less often now that noninvasive options like FibroScan are available. But it's still sometimes needed to confirm a diagnosis, rule out other conditions, or accurately predict the degree of liver damage.

No single test tells your care team everything they need to know. Doctors typically combine FibroScan with the other diagnostic tools above, tailoring them to your specific health history and needs.

Taking Steps Toward Better Liver Health

A FibroScan is a quick, painless way to help your care team keep an eye on your liver health as part of managing PBC. It's just one piece of a bigger picture that includes your blood tests, symptoms, and overall treatment plan.

Before your next appointment, jot down any questions you have about your FibroScan schedule or what your last set of blood tests showed. You might also want to confirm your fasting instructions ahead of time so there are no surprises on test day.

No two cases of PBC are exactly alike, so your care team is essential for turning your FibroScan results into real-world answers. By partnering closely with them, you can take the guesswork out of your scores and build a forward-looking treatment plan designed specifically for your needs.

Read more about PBC treatment options ❯