Do I Need a FibroScan? How to Know If You Should Get One

You should discuss liver elastography with your GP if any of these apply:

Your GP has ordered one: If your doctor has requested a FibroScan or referred you for liver elastography, follow through. This means your GP has identified a clinical reason — typically an indeterminate FIB-4 score or elevated liver enzymes — that makes the scan appropriate.

Your FIB-4 score is between 1.3 and 2.67: This is the indeterminate range. Australian clinical guidelines recommend liver elastography as the next step for everyone in this range. FIB-4 alone cannot rule in or rule out significant fibrosis in this group — elastography is needed.

You have type 2 diabetes and have never been assessed for MASLD: MASLD affects 65–75% of people with type 2 diabetes. If you have never had your liver health assessed, a FIB-4 score first (from your GP) — and elastography if indeterminate — is appropriate.

You are on a GLP-1 medication (Ozempic, Wegovy or Mounjaro) and have metabolic risk factors: Australian clinical guidelines recommend MASLD assessment for GLP-1 patients with metabolic risk factors. A FIB-4 score is the starting point — and if indeterminate, elastography follows.

You have elevated liver enzymes (ALT, AST, GGT) on a blood test: Elevated enzymes without a clear explanation warrant further investigation. FIB-4 first, then elastography if indicated.

You have obesity (BMI above 30) and have never had liver assessment: MASLD affects 60–80% of people with obesity. Systematic assessment is recommended in Australian guidelines.

You have a family history of liver disease, cirrhosis, or liver cancer: Family history increases personal risk. Baseline assessment is appropriate.

You drink alcohol regularly with any of the above risk factors: Combined metabolic and alcohol-related risk increases the likelihood of significant liver disease.

Australian clinical guidelines published in the Medical Journal of Australia in September 2025 recommend that all adults with type 2 diabetes, obesity, or metabolic risk factors be assessed for MASLD. Every patient prescribed a GLP-1 medication in Australia meets at least one of these criteria. Most GLP-1 prescribing platforms do not communicate this recommendation to patients at the point of prescription — which is why many patients on Ozempic, Wegovy, or Mounjaro have not had their liver assessed despite the clinical guidelines recommending it. If you are on a GLP-1 and have not had a FIB-4 score calculated, ask your GP at your next appointment.

Full guide: GLP-1 medications and liver monitoring in Australia →

You probably do not need a FibroScan if:

• You have no metabolic risk factors (normal weight, no diabetes, no elevated enzymes)
• Your FIB-4 score was below 1.3 on a recent blood test
• You had a normal FibroScan or elastography result in the past 2–3 years with no change in your clinical situation
• Your GP has reviewed your liver function and is not concerned

If you are unsure, ask your GP at your next appointment: "Should I have my liver health assessed?"

MASLD is almost always asymptomatic in its early stages. The majority of people with significant liver fibrosis have no symptoms and are unaware of the disease until it has progressed.

The clinical concern is this: MASLD can progress from early fibrosis (F2) to cirrhosis (F4) over 10–15 years in patients with ongoing metabolic risk. Cirrhosis is largely irreversible. By contrast, early fibrosis (F2–F3) can now be treated pharmacologically with semaglutide (Wegovy) under Australia's April 2026 TGA approval — making early detection genuinely useful rather than merely informational.

Not getting tested means not knowing. For most people with normal risk profiles, that is acceptable. For people with the risk factors listed above, it means potentially missing a treatable condition in its reversible stage.

Step 1 — See your GP first: Ask for a FIB-4 calculation from your routine blood panel. This is the recommended starting point — not going directly to a scan.

Step 2 — If FIB-4 is indeterminate (1.3–2.67): Your GP will refer you for liver elastography, or you can self-refer at clinics that accept patients without a GP letter.

Step 3 — Find a clinic: Use the GLP-1 Australia directory to find a liver elastography clinic near you.

Find a liver elastography clinic near you →

Cost: $150–$300 privately. No Medicare rebate currently. Some private health insurers cover the procedure — check your policy.

Several Australian clinics accept self-referred patients for liver elastography without a GP referral:

• Liver Health Scan Melbourne: "You do not require a referral from a General Practitioner."
• Moonee Valley Specialist Centre: "A liver scan is a self-referred procedure."
• Liver Scan Brisbane: "Referrals are preferred but not essential."
• LiverScan Australia: "Referrals are welcomed but not essential."

If you self-refer, bring any recent blood test results showing ALT, AST, and platelets to your appointment — this allows the clinic to calculate your FIB-4 and interpret your scan result in full clinical context.