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Understand your report

How to Read Your FibroScan Report: CAP and kPa Explained

A FibroScan gives you two numbers. CAP, in dB/m, is how much fat is in your liver. kPa is how stiff the liver is, which tells you how much scarring has formed. The scarring number is the one that matters most: a kPa under 8 effectively rules out advanced scarring in fatty liver, while a CAP of 248 dB/m and up means fat is present. Read the stiffness first, then the fat.

Reviewed by Dr. Rejeesh Menon, MBBS, MD, FACP, Internal Medicine (TCMC Reg. 40073). Last reviewed 24 October 2026.

CAP · dB/m

The fat number

CAP measures liver fat. Fat weakens the ultrasound beam, so the more the signal is dimmed, the higher the CAP and the more fat is present. It confirms and sizes the fat, but on its own it does not decide treatment.

kPa

The scarring number

kPa measures stiffness. The probe sends a shear wave into the liver and times it; a scarred, stiffer liver carries the wave faster. This is the number that predicts long-term risk, so it is the one to read first.

Your CAP score (dB/m): how much fat

CAP sorts liver fat into four bands. The cut-offs below are the most-cited set, from a 2,735-patient analysis (Karlas 2017), but treat them as estimates: published CAP thresholds move by roughly 10 to 20 dB/m between studies and machines, and the fat percentages are approximate.

FibroScan CAP steatosis bands in dB/m
GradeMeaningCAP (dB/m)Approx. liver fat
S0 None / minimal Under 248 dB/m Under 5% of liver cells
S1 Mild 248 to 267 dB/m Roughly 5 to 33%
S2 Moderate 268 to 279 dB/m Roughly 34 to 66%
S3 Severe 280 dB/m and above Roughly 67% or more

Your kPa score: stiffness and the F0 to F4 stages

Stiffness is the number with the strongest evidence and the one that drives whether you are referred. These are the fatty liver (MASLD) values from EASL 2024 and AASLD 2023, which are different from the numbers used for viral hepatitis.

FibroScan liver stiffness bands in kPa for MASLD
StageMeaningStiffness (kPa)What it means for you
F0 to F1 None to mild Under 8 kPa Advanced scarring effectively ruled out. Keep working on the metabolic drivers.
F2 Significant 8 to 9.9 kPa A grey zone. Read it alongside a FIB-4 score, repeat the scan, or get a specialist opinion.
F3 Advanced 10 to 12 kPa Likely advanced scarring. This is a hepatology assessment, not a wait-and-see.
F4 Cirrhosis 12 kPa and above Suggests advanced chronic liver disease. Above 15 kPa it is highly suggestive. Needs a liver specialist.
Read the two numbers together. A high CAP with a low kPa means plenty of fat but no meaningful scarring yet, and that is the reassuring picture, because fat responds well to weight loss. The combination that matters is a climbing kPa. Fat you can lose; scarring is the thing worth catching early.

FibroScan cost in India and Kerala

A FibroScan scan in India generally costs about 2,000 to 5,000 rupees. Standalone diagnostic centres sit at the lower end; some super-speciality hospitals quote up to around 7,000 rupees. This is a one-time diagnostic test fee, not a recurring cost. Prices in Kerala vary by centre, so confirm the exact charge with the facility before you book.

One thing to check on a high quote: a blood-panel fibrosis test (sometimes sold under a similar name) is a different thing from the scan and is often priced higher. If you are unsure which you are being quoted for, ask whether it is the probe-on-the-skin scan that gives a CAP and a kPa number.

How to prepare, and when the number can be wrong

Fast for at least 3 hours before the scan. A recent meal raises blood flow through the liver and can push the stiffness reading up falsely. The test itself is painless, takes 5 to 10 minutes, uses no needles and no sedation.

A FibroScan can read falsely stiff during an acute liver flare (a big jump in SGPT and SGOT), with heart-failure congestion of the liver, or with a blocked bile duct. People with a larger body size need the XL probe rather than the standard M probe, because a thicker chest wall defeats the M probe; the probe used is printed on the report and changes which thresholds apply. A reliable result needs at least 10 valid readings and an IQR to median ratio under 30%. If your report does not meet that, the number should be repeated, not trusted.

How to read the numbers on your actual report

Your report prints more than the two headline numbers. Here is what each field means.

What each field on a FibroScan report means
On your reportWhat it means
Median stiffness (kPa)The main scarring result, and the number the F0 to F4 stages use.
IQR / medianThe reliability check. It should be under 30%. Higher means the readings were scattered and the result is less trustworthy.
Valid measurementsShould be at least 10. Fewer than that, and the scan should be repeated.
CAP (dB/m)The fat number, sometimes printed with its own IQR.
Probe (M or XL)XL is used for a larger body size. The stiffness thresholds are the same; the machine accounts for the probe.

A worked read. A report saying median 5.2 kPa, IQR/median 11%, 10 valid measurements, CAP 290 dB/m, M probe is a reliable scan: plenty of fat (severe steatosis by CAP) but stiffness well under 8, so no meaningful scarring yet. The sensible response is to lose the fat before it ever becomes scar.

Who should not have a FibroScan, or when it cannot give a reading

  • Pregnancy. The scan is avoided in pregnancy because its safety there has not been established.
  • An implanted cardiac device, such as a pacemaker or a defibrillator. It is avoided because the effect of the probe's pulse on the device has not been fully assessed, so tell the centre before you book.
  • Ascites, fluid in the abdomen. Not a safety problem, but the fluid stops the wave travelling, so the scan usually cannot give a valid stiffness number and a blood-based test is used instead.

FibroScan, ultrasound, FIB-4 and SGPT: which tells you what

These tests answer different questions, and a good assessment uses them together rather than relying on any one.

How FibroScan compares with ultrasound, FIB-4 and liver enzymes
TestWhat it measuresScarring?In one line
FibroScan (this page) Fat (CAP) and scarring (kPa) Yes, directly The only one here that puts a number on scarring without a biopsy.
FIB-4 blood score Fibrosis risk from age, AST, ALT, platelets Estimates it Free, done from blood you already have, and decides who needs a FibroScan.
Ultrasound grade (1 to 3) Fat only, by brightness No Operator dependent and misses fat below about 20%. Cannot stage scarring.
SGPT / ALT (LFT) Liver inflammation enzymes No Often normal even when real scarring is present, so a normal SGPT does not clear you.

Run your FIB-4 fibrosis calculator first, see what an ultrasound grade does and does not tell you, and check why a normal SGPT / ALT result does not clear you.

When you actually need a FibroScan

EASL 2024 uses a simple two-step pathway: a FIB-4 score first, then a FibroScan for the people it flags. You are in the group that benefits from the scan if any of these fit: a FIB-4 in the grey zone of 1.3 to 2.67; type 2 diabetes with fatty liver; an SGPT that stays high without another cause; Indian-threshold obesity (BMI 25 and over) with metabolic syndrome; or fatty liver seen on an ultrasound alongside any metabolic risk factor. A FibroScan is what moves you from "you have fatty liver" to "we know whether it has started to scar."

When your result means see a specialist soon, not later

A kPa above 12 suggests advanced scarring and needs a liver specialist. Above 15 it is highly suggestive of advanced chronic liver disease, and 20 to 25 and up, especially with a low platelet count, points to raised pressure in the liver circulation and needs prompt assessment.

These are a medical emergency whatever your kPa number is: yellowing of the eyes or skin, a swelling abdomen with fluid, new confusion or drowsiness, or vomiting blood or passing black tarry stools. Go to a hospital now, do not wait for a clinic appointment. In India you can call 112.

Can your FibroScan numbers improve?

Yes, and this is the hopeful part. The fat number (CAP) falls first and fastest: as weight comes down and refined carbohydrate drops, liver fat falls, often within months. The stiffness number (kPa) moves more slowly, but early scarring is not fixed in stone. With the metabolic drivers treated and a sustained 7 to 10 percent weight loss, inflammation settles and early fibrosis can regress, so a repeat scan a year on often reads lower. Established cirrhosis, a high and confirmed kPa, is managed rather than reversed, which is exactly why catching a rising number early matters. A FibroScan is not only a verdict, it is a baseline you can move.

At DermaVue this is handled as physician-supervised metabolic health: we read your scan, treat the drivers behind it, and repeat the measurement to track real change. The full fatty liver guide sets out the treatment evidence.

Bring your FibroScan report to a physician

If you have a CAP and kPa number and are not sure what they mean for you, a physician can read them alongside your blood work, weight and blood sugar and tell you honestly what the next step is. DermaVue does not run the scanner itself; the scan is done at a diagnostic centre or hospital, and if you have not had it yet we help you arrange it at a centre near you. The review and the plan are a video consultation across South India, with home blood collection and medicine home delivery where needed.

Get your FibroScan report reviewed by a physician
FibroScan questions

Your questions about FibroScan, CAP and kPa

A FibroScan (the brand name for transient elastography) is a painless 5 to 10 minute scan. A probe on the skin over your liver sends a gentle shear wave in and times how fast it travels, which tells the machine how stiff and scarred the liver is. A biopsy takes an actual needle sample. The FibroScan reads a much larger volume of liver than a biopsy needle, carries no bleeding risk, and can be repeated, which is why it has replaced biopsy for most fatty liver patients.
CAP stands for Controlled Attenuation Parameter and it measures liver fat. Fat weakens the ultrasound beam, so more fat gives a higher CAP number. A CAP under about 248 dB/m is in the no or minimal fat range, 248 to 267 is mild, 268 to 279 is moderate, and 280 and above is severe. Treat these as study-based estimates, not hard lines, because published CAP cut-offs vary by roughly 10 to 20 dB/m between labs.
kPa (kilopascals) is the stiffness number, and stiffness tracks scarring. For fatty liver, under 8 kPa means advanced scarring is effectively ruled out (F0 to F1), 8 to 9.9 kPa is a grey zone around F2, 10 to 12 kPa points to advanced scarring (F3), and 12 kPa and above suggests cirrhosis (F4), with 15 kPa and up highly suggestive. These are the international EASL and AASLD cut-offs for fatty liver specifically, and they differ from the numbers used for hepatitis B or C.
Read the kPa number first, because scarring is what decides long-term risk. A high CAP (lots of fat) with a low kPa (under 8) is reassuring: you have fat but no meaningful scarring yet, and fat responds well to weight loss. The combination that matters is a rising kPa, with or without a high CAP. A single high kPa taken after a meal or during an illness can read falsely stiff, so an alarming number should be confirmed, not acted on alone.
The stiffness thresholds are the same worldwide: a kPa under 8 is the reassuring range for fatty liver. There is no separate validated Indian cut-off, so your centre uses the international EASL and AASLD values. What is different for many Indian patients is body type: the South Asian thin-fat pattern means significant liver fat and metabolic risk can appear at a lower body weight, so a normal looking BMI does not rule out a FibroScan being worthwhile.
A FibroScan scan in India generally costs about 2,000 to 5,000 rupees, with standalone diagnostic centres at the lower end and some super-speciality hospitals charging up to around 7,000 rupees. This is a one-time diagnostic test fee, not a monthly cost. Prices in Kerala vary by centre, so confirm the exact fee with the facility before you book. If a quote looks much higher, check whether it is for a blood-panel fibrosis test rather than the scan.
Yes. Fast for at least 3 hours before the scan. A recent meal increases blood flow through the liver and can push the stiffness number up falsely. Wear clothing that gives easy access to the right side of your rib cage. Tell the operator if you have heart failure or a current liver flare, because both can raise the reading. No needles, no sedation, and you can drive yourself home afterwards.
They answer different questions. A standard ultrasound sees fat and grades it 1 to 3 by brightness, but it is operator dependent, misses fat below about 20%, and cannot measure scarring at all. A FibroScan quantifies fat more objectively with CAP and, more importantly, measures scarring with kPa. If you only have an ultrasound grade, the honest next step is a FIB-4 score and a FibroScan to find out whether any scarring has started.
They work as a pair. FIB-4 is a free score from your age and routine blood values that triages who needs more testing: under 1.3 is low risk, 1.3 to 2.67 is a grey zone, above 2.67 is high risk. A FibroScan is the next step when FIB-4 lands in the grey zone, when you have diabetes, or when your SGPT stays high. FIB-4 narrows the field cheaply; the FibroScan gives the direct measurement. You can run your FIB-4 on this site in under a minute.
It depends on your result. A low-risk, low-stiffness scan is often repeated every 2 to 3 years in people with ongoing metabolic risk, while a grey-zone or higher result is followed more closely, often yearly, and is tracked while you are losing weight or on treatment. One quality check matters: a reliable scan needs at least 10 valid readings and an IQR to median ratio under 30%. If your report fails that, the number should be repeated, not trusted.
Keep going

Next steps

FIB-4 fibrosis calculator

The free blood-score that decides whether you need a FibroScan at all.

Ultrasound grade 1, 2, 3 explained

What your ultrasound fatty-liver grade means, and why it is only about fat.

SGPT / ALT liver function test

Why a normal enzyme report does not clear you of scarring.

Fatty Liver (MASLD): the full guide

Diagnosis, staging, and the treatment evidence in one place.
Sources

References

  1. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024;81(3):492-542. View on DOI
  2. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835. View on PubMed
  3. de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII: renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959-974. View on PubMed
  4. Berzigotti A, Tsochatzis E, Boursier J, et al. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2021;75(3):659-689. View on PubMed
  5. Karlas T, Petroff D, Sasso M, et al. Individual patient data meta-analysis of controlled attenuation parameter (CAP) for the assessment of hepatic steatosis. J Hepatol. 2017;66(5):1022-1030. View on PubMed
  6. Sandrin L, Fourquet B, Hasquenoph JM, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol. 2003;29(12):1705-1713. View on PubMed