FibroScan Interpretation: CAP 221 dB/m and E 5.0 kPa
Your FibroScan results indicate no significant hepatic steatosis and no significant liver fibrosis—this represents a normal or near-normal liver assessment.
Steatosis Assessment (CAP 221 dB/m)
Your CAP value of 221 dB/m falls below the threshold for hepatic steatosis. According to EASL guidelines, CAP values above 275 dB/m are used to diagnose steatosis with over 90% sensitivity 1. More granular research data supports this interpretation:
- CAP <240 dB/m indicates absence of significant steatosis (S0) 2
- Your value of 221 dB/m is well below even the most sensitive cutoffs
- Research using CAP ≥222 dB/m as a threshold for "increased CAP" demonstrates you fall just below this early indicator level 3
Clinical significance: You do not have hepatic steatosis by non-invasive criteria. This CAP value is consistent with normal liver fat content (<5% hepatocyte steatosis).
Fibrosis Assessment (LSM 5.0 kPa)
Your liver stiffness measurement of 5.0 kPa indicates no clinically significant fibrosis. Both major guidelines converge on this interpretation:
- EASL guidelines recommend LSM by TE <8 kPa to rule out advanced fibrosis in NAFLD 1
- The Gastroenterology Clinical Care Pathway uses 8.0 kPa as the low cutoff to exclude clinically significant fibrosis (F2-F4) with 93% sensitivity 4
- Your value of 5.0 kPa is substantially below this threshold
Fibrosis stage interpretation:
- F0-F1 (no to minimal fibrosis): <8.0 kPa 4
- F≥F2 (significant fibrosis): ≥8.2 kPa 2
- F≥F3 (advanced fibrosis): ≥9.7 kPa 2
- F4 (cirrhosis): ≥13.6 kPa 2
Your 5.0 kPa result places you firmly in the F0-F1 category with no evidence of significant liver scarring.
Clinical Management Recommendations
For patients with LSM <8.0 kPa and normal CAP:
- Repeat surveillance testing in 2-3 years if you have risk factors for liver disease 4
- No need for hepatology referral at this time
- No indication for liver biopsy
- Continue routine metabolic health monitoring (BMI, lipids, glucose) as CAP correlates with metabolic parameters even at normal values 3
Important Caveats
These results should be interpreted in clinical context:
- Ensure at least 1 week of alcohol abstinence before the test if you consume alcohol, as alcohol can falsely elevate LSM 1
- Active liver inflammation (elevated ALT/AST) can artificially increase LSM independent of fibrosis
- If you have chronic hepatitis C with sustained virologic response (SVR), these cutoffs may not apply—post-SVR patients require different interpretation 1
- Obesity (high BMI) can affect CAP measurements, though modern XL probes have improved reliability 5
Your results indicate a healthy liver with no evidence of steatosis or fibrosis by non-invasive testing.