Patient guide · Reviewed May 2026
Transient Elastography Explained — What It Is and How It Works
Transient elastography is a non-invasive medical test that measures the stiffness of the liver. It is the technology behind devices like FibroScan, iLivTouch, and other liver scanning systems used in Australian clinics.
If your GP or specialist has mentioned transient elastography — or if you have been told you need a liver stiffness test — this guide explains exactly what it is, how it works, what the results mean, and what to expect at your appointment.
Published 2026-05-31 · Clinically reviewed 2026-05-31
Patient guide · Reviewed May 2026
What Transient Elastography Measures
Transient elastography measures two things in a single scan session:
Transient elastography measures two things in a single scan session:
Liver stiffness (kilopascals — kPa): Stiffness is a proxy for liver scarring (fibrosis). A healthy liver is soft and flexible. As fibrosis develops, the liver becomes progressively stiffer. Transient elastography measures this stiffness by sending a controlled mechanical pulse through the liver and measuring how quickly it travels through tissue. Stiffer tissue transmits the pulse faster.
Liver fat content (CAP score — dB/m): Most modern transient elastography devices also measure liver fat content using the controlled attenuation parameter (CAP). This quantifies how much of the liver is affected by fat accumulation, expressed in decibels per metre. Some devices use a related measurement called the Ultrasound Attenuation Parameter (UAP) — the grading scale is the same even if the raw numbers differ slightly between devices.
Together, these two measurements give a comprehensive picture of liver health in a single 10–15 minute scan.
How the Scan Works — Step by Step
Before the scan: Most clinics ask you to fast for 2–4 hours. Wear loose clothing that allows easy access to the right side of your abdomen.
During the scan: You lie on your back with your right arm raised. The operator places a probe on the skin over your right lower rib cage. You will feel a mild vibration as the device sends a pulse through the liver. The scan takes 10–15 minutes. It is completely painless.
After the scan: Results are available immediately. The operator will give you a printed report showing your kPa score (liver stiffness), your CAP or UAP score (liver fat), and an IQR/median ratio indicating how reliable the measurement was.
Patient guide · Reviewed May 2026
Understanding Your Results
Liver Stiffness (kPa) — Fibrosis Staging
Liver Stiffness (kPa) — Fibrosis Staging
| kPa Score | Fibrosis Stage | What It Means |
|---|---|---|
| Below 8 kPa | F0–F1 | Normal to minimal fibrosis — reassuring |
| 8–10 kPa | F2 | Moderate fibrosis — monitor, discuss with specialist |
| 10–13 kPa | F3 | Significant fibrosis — specialist review recommended |
| Above 13 kPa | F4 | Cirrhosis range — specialist referral required |
These thresholds apply specifically to MASLD (fatty liver disease). Different thresholds are used for viral hepatitis and other liver conditions.
Liver Fat (CAP Score — dB/m)
| CAP Score | Grade | Liver Fat |
|---|---|---|
| Below 248 | S0 | Normal — less than 5% |
| 248–267 | S1 | Mild — 5–33% |
| 268–279 | S2 | Moderate — 33–67% |
| Above 280 | S3 | Severe — more than 67% |
IQR/Median Ratio — Reliability
A ratio below 30% means the scan is reliable. Above 30% means results should be interpreted cautiously — often due to body habitus or breathing during the scan. A reliable result below 30% is noted on your report.
Who Uses Transient Elastography in Australia?
Transient elastography is used by:
- Hepatologists and gastroenterologists for liver disease staging and monitoring
- GP clinics offering point-of-care liver assessment
- Imaging centres as an alternative to liver biopsy
- Hospital outpatient liver clinics for monitoring chronic liver disease
Australian clinical guidelines recommend transient elastography as the second-line non-invasive test for patients with an indeterminate FIB-4 score (1.3–2.67) — making it part of the standard MASLD assessment pathway for millions of Australians.
Patient guide · Reviewed May 2026
Do You Need a GP Referral?
In Australia, several clinics offer transient elastography to self-referred patients — no GP letter required. Others prefer or require a referral. Check with…
In Australia, several clinics offer transient elastography to self-referred patients — no GP letter required. Others prefer or require a referral. Check with your specific clinic when booking.
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Frequently asked questions
What is the difference between transient elastography and FibroScan?
FibroScan is a brand name for a specific transient elastography device made by Echosens. Transient elastography is the underlying technology. Other brands — including iLivTouch and Aixplorer — use the same principle. Results are broadly comparable but reference ranges can differ slightly between devices. Always interpret your result with the reference range provided by your specific clinic.
Is transient elastography the same as an ultrasound?
Not exactly. Standard abdominal ultrasound produces images of organ anatomy. Transient elastography uses ultrasound technology to measure liver stiffness — a functional measurement rather than an anatomical image. Some guided elastography devices combine both: real-time ultrasound imaging for probe placement guidance and transient elastography for stiffness measurement.
Does transient elastography hurt?
No. The probe is pressed gently against the skin. Most patients describe feeling a mild vibration. The procedure involves no needles, no injection, no radiation, and no preparation other than fasting.
How accurate is transient elastography?
Transient elastography has high accuracy for detecting significant fibrosis (F2 and above) with AUROC values typically above 0.85 for MASLD. Accuracy can be reduced in patients with very high BMI, significant liver inflammation, or post-meal scanning — which is why fasting and the IQR/median reliability check matter.
How much does transient elastography cost in Australia?
Approximately $150–$300 per session at private clinics. There is currently no Medicare item number for transient elastography in most MASLD indications. Some private health insurers provide rebates — check with your fund.
This article is for educational purposes only. It does not constitute medical advice. Always consult your GP or a specialist about your individual health circumstances.
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