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Cardiolucent

Procedure

Hepatic Elastography

A noninvasive ultrasound-based test that measures the stiffness of the liver — the most reliable noninvasive marker for fatty liver disease severity and a growing component of cardiometabolic risk assessment.

What it is

Liver biopsy without the biopsy.

Hepatic elastography measures the mechanical stiffness of liver tissue using a specialized ultrasound technique. Liver stiffness rises with inflammation, steatosis, and fibrosis — the spectrum of changes that defines metabolic dysfunction-associated steatotic liver disease (MASLD, formerly called NAFLD/NASH). The result is a quantitative score that grades severity, replacing in most cases what used to require a liver biopsy. It has become an essential part of comprehensive cardiometabolic risk assessment because liver disease and cardiovascular disease share the same underlying drivers (insulin resistance, visceral adiposity, dyslipidemia), and the liver result often predicts cardiac risk independently of the standard lipid and glucose markers.

Painless, in-office, 10 to 15 minutes.

The exam is performed in the office with a specialized ultrasound probe placed against the right lower rib cage. The probe delivers a small mechanical pulse and measures how the resulting shear wave travels through liver tissue. There are no needles, no contrast, no radiation, and the exam is painless. A short fasting period beforehand improves accuracy.

Anyone with cardiometabolic risk worth quantifying.

Hepatic elastography is increasingly considered routine for adults with obesity, type 2 diabetes or insulin resistance, metabolic syndrome, abnormal liver enzymes, or imaging that has shown fatty liver. It is also a sensitive way to track the effect of weight loss, GLP-1 receptor agonist therapy, and lifestyle interventions over time — the score moves measurably when the underlying biology improves, often well before standard liver enzymes normalize.

Common Questions

Frequently Asked Questions

Is this the same as a regular ultrasound of the liver?
No. A standard abdominal ultrasound shows liver shape, size, and gross abnormalities (cysts, masses, severe fatty infiltration); it cannot quantify stiffness or fibrosis. Elastography uses a specialized probe and a different physical measurement (shear wave velocity) to produce a numerical stiffness score.
Do I need to fast?
Yes — typically a 3- to 4-hour fast before the exam improves accuracy. Water is fine.
How long does the test take?
About 10 to 15 minutes. No needles, no contrast, no radiation.
What does the result mean?
Stiffness is reported in kilopascals (kPa) along with a controlled attenuation parameter (CAP) score that estimates fatty content. Higher kPa scores indicate more fibrosis; higher CAP scores indicate more steatosis. Dr. Kedan walks through your specific values and the implications for cardiometabolic risk and treatment.
Is it covered by insurance?
Coverage is inconsistent. Cardiolucent operates outside of insurance networks; we provide documentation for out-of-network reimbursement when applicable. Many patients use HSA or FSA funds.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.