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FibroScan and liver stiffness: what your kPa number means | CION Cancer Clinics
The kPa number on a FibroScan report measures how stiff your liver is. A higher number usually means more scarring, and a very high one can point to cirrhosis. It is an estimate that your doctor reads with your blood tests and the cause of your liver disease. This page explains the report, what can push the number up, and why FibroScan cannot find cancer. At CION Cancer Clinics, our specialists help you understand your own risk and plan regular liver checks that fit it.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- What does the kPa number on my FibroScan mean?
- What can push the number up even without scarring?
- What happens at a FibroScan appointment?
- What do the other words on a FibroScan report mean?
- Four things people believe about FibroScan, and what is true
- What this page cannot tell you
- Common questions about FibroScan results
The short answer
What does the kPa number on my FibroScan mean?
The kPa number is a measure of how stiff your liver is. A healthy liver is soft. Scar tissue, which doctors call fibrosis, makes it firmer, so a higher number usually means more scarring. A very high number can point to cirrhosis, which is scarring that has spread through the whole liver.
The number is an estimate, not a diagnosis
FibroScan is a kind of elastography. A probe on your skin sends a gentle pulse into the liver and times how fast it travels. The pulse moves faster through a stiff liver than a soft one. The machine turns that speed into a stiffness reading in kilopascals, written kPa.
Your doctor reads that number alongside your blood tests, your scans and the cause of your liver disease. The same reading can mean different things in fatty liver, in hepatitis B and in alcohol-related liver disease, which is why the cut-offs printed on one report do not transfer neatly to another person's.
What FibroScan does not look for
It does not look for cancer. It cannot see a lump, a spot or a nodule. If you were told there is "a spot on the liver", that needs a different scan. Our page on what happens when a nodule is found explains the next step.
A stiffness reading tells your doctor about the background liver. It says nothing about whether a tumour is present.Why readings vary
What can push the number up even without scarring?
Stiffness is not only scar. Anything that makes the liver swollen or full can raise the reading for a while.
Active inflammation
A flare of hepatitis B, a recent hepatitis A or E infection, or heavy drinking in the weeks before the test can make the liver swollen and firm. The reading often falls once the inflammation settles.
Often shows as
- Raised SGPT or SGOT on the same week's blood test
- A reading much higher than the last one
A recent meal
Eating sends extra blood to the liver, which can stiffen it for a short time. This is why you are asked to come with an empty stomach.
Blocked bile or a congested heart
A blocked bile duct or heart failure can back up fluid into the liver and raise stiffness. Your doctor will look for these before reading the number as scarring.
Body shape and technique
A thick layer of fat under the skin makes the reading harder to take. A different probe is used for larger bodies. Fluid in the abdomen, called ascites, can stop a reading working at all.
A failed or unreliable reading is not a bad result. It just means another test is needed.Not sure whether this applies to you?
Ask an oncologistOn the day
What happens at a FibroScan appointment?
Come with an empty stomach
You will usually be asked not to eat for a few hours before. Bring your recent blood reports and any earlier FibroScan result to compare against.
Lie on your back
You lie flat with your right arm raised above your head. This opens the gaps between the ribs on your right side, where the probe sits.
The probe takes readings
You feel a light tap each time a reading is taken. It does not hurt and needs no needle. The operator takes a run of readings and the machine uses the middle value.
You get two numbers
Most machines give a stiffness number in kPa and a fat score called CAP. The whole thing usually takes a few minutes. CION arranges the test through diagnostic partners, and your doctor reads the result with you.
On your report
What do the other words on a FibroScan report mean?
- E or LSM
- Liver stiffness measurement, in kPa. This is the main number. Higher means stiffer.
- IQR/Med
- How much the separate readings disagreed with each other. A low value means the readings were consistent and the result is more trustworthy.
- Valid measurements
- How many of the taps gave a usable reading. Too few, and the result should be treated with caution or repeated.
- CAP
- Controlled attenuation parameter. It estimates how much fat is in the liver. It says nothing about scarring.
- F0 to F4
- Fibrosis stages, from no scarring to cirrhosis. Some reports convert the kPa number into a likely stage. Our page on fibrosis stages explains each one.
- M probe or XL probe
- Which probe was used. The XL probe is for people with more fat under the skin.
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Commonly believed
Four things people believe about FibroScan, and what is true
"A normal FibroScan means I cannot get liver cancer."
A soft liver lowers the risk a great deal, but it is not a promise. Some people with hepatitis B develop liver cancer without cirrhosis. If your doctor has advised surveillance scans, keep them whatever the stiffness number says.
"A high number means my liver is finished."
A high reading can come from inflammation that settles, and scarring itself can soften when the cause is treated. People whose hepatitis C is treated, or who stop drinking, often see their numbers fall over time.
"FibroScan has replaced liver biopsy completely."
For most people it has made a biopsy unnecessary. When results disagree, or another disease is suspected, a biopsy can still be the clearest answer.
"The CAP score shows how damaged my liver is."
CAP measures fat, not scar. A high fat score with a low stiffness number is common and is a different situation from a stiff liver. The stiffness number matters more for cancer risk.
Did you know
Doctors often start with a simple calculation from your routine blood tests and only send you for a FibroScan if that score is not low. The FIB-4 and APRI scores page explains how that first step works.
Being straight with you
What this page cannot tell you
It cannot tell you what your own number means. The cut-offs change with the cause of your liver disease, the probe used, your blood tests and whether the reading was reliable. A hepatologist or your oncologist reads all of that together. Matching your number to a chart found online is the most common way people frighten themselves, or falsely reassure themselves.
It cannot tell you whether you have cancer
Stiffness tells your doctor how likely cancer is to develop, and so who needs regular surveillance. It does not find tumours. If you have cirrhosis or a stiff liver, ask whether you need liver cancer surveillance, which uses ultrasound and blood tests.
Who this does not apply to
If cancer has spread to your liver from the bowel, breast or another organ, the background stiffness is usually much less important than the tumour itself. That is a different situation, explained by the team treating the first cancer. And if a FibroScan could not be done because of fluid in the abdomen, the fluid itself tells the doctor more than a number would.
If you have a report and do not know what it means, call the helpline. Someone will arrange for a doctor to go through it with you.Questions we are asked
Common questions about FibroScan results
Is FibroScan painful?
No. You feel a light flick against the skin each time a reading is taken. There is no needle, no injection and no radiation. You can eat, drive and go back to work straight afterwards. The only preparation most people need is an empty stomach for a few hours.
Can my FibroScan number go down?
Yes, often. When the cause is treated, such as hepatitis C with modern tablets, hepatitis B controlled with antiviral medicine, stopping alcohol or losing weight in fatty liver, stiffness can fall. Some of the early drop is inflammation settling, and some is scar slowly remodelling.
How often should FibroScan be repeated?
There is no single rule. It depends on the cause of your liver disease, the last result and whether treatment has started. Some people need it again within the year, others much less often. Your hepatologist or physician will tell you what suits your situation.
My two FibroScan results are very different. Why?
Food, a hepatitis flare, recent drinking, a different probe or an unreliable run of readings can all shift the number. Check the IQR/Med and valid measurement lines on both reports. Your doctor may repeat the test rather than trust either result alone.
Does a high CAP score mean I have cirrhosis?
No. CAP measures fat in the liver, not scarring. Many people have a high fat score and a soft liver. The stiffness number is the one that shows scarring. Our page on what fatty liver is explains the fat side.
Can FibroScan be done if I already have liver cancer?
It can, and it sometimes helps the team judge how much healthy liver is left, which matters when weighing surgery or other treatment. It does not measure the tumour. The tumour board reads it alongside scans and blood tests such as bilirubin and albumin.
Do I still need a biopsy after FibroScan?
Usually not for scarring alone. A biopsy may still be suggested if results disagree or another liver disease is suspected. Our page on liver biopsy for fatty liver or hepatitis explains what that involves.
Where can I get a FibroScan and have it explained?
CION arranges FibroScan through diagnostic partners, and a CION doctor can go through the result with you and your family. Bring earlier reports so the numbers can be compared. Call the helpline if you are not sure whether you need the test at all.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- RadiologyInfo.org (RSNA/ACR) — Elastography
- Liver UK (formerly British Liver Trust) — Cirrhosis
- NHS — Non-alcoholic fatty liver disease (NAFLD)
- AASLD — Practice Guidelines
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Fibrosis stages: F0 to F4 explainedWhat each stage on your report meansFIB-4 and APRI: scores from routine blood testsThe blood-test check that often comes before FibroScanWhat is my cancer risk with cirrhosis?What a stiff liver means for cancer riskWho needs liver cancer screening?Whether your result means you need regular scans
Talk to us
Not sure what your FibroScan number means for you?
Send us your FibroScan and blood reports and a doctor will go through them with you and your family. If you need surveillance or a further test, we will explain why and help arrange it. One helpline serves every CION centre.