The short answer
You need a FibroScan (or equivalent elastography) on Ozempic if your FIB-4 score is in the indeterminate range (1.3–2.67), or if you have multiple metabolic risk factors warranting baseline staging. If your FIB-4 is below 1.3 (or below 2.0 if you're 65+), routine annual LFTs are usually enough.
When elastography is clearly indicated
- FIB-4 score 1.3–2.67 (indeterminate)
- FIB-4 above 2.67 (high) — supports specialist referral
- Persistent ALT/AST elevation beyond 3 months on therapy
- Imaging shows significant fatty liver and you have metabolic risk factors
- Strong family history of advanced liver disease
What FibroScan measures
FibroScan uses a transient elastography technology — it produces a small pulse of sound waves and measures how fast they travel through the liver. Faster = stiffer = more fibrosis. The result is a number in kPa.
It also measures liver fat as CAP (Controlled Attenuation Parameter, in dB/m). Both numbers appear on your report.
kPa ranges for MASLD on Ozempic
- < 8 kPa: reassuring — minimal fibrosis
- 8–12 kPa: significant fibrosis — monitor on Ozempic, repeat at 12 months
- > 12 kPa: advanced fibrosis — specialist referral
Expected response after 12 months on Ozempic
In trial responders, kPa drops 4–7 from baseline at 12 months. CAP grade often improves by one full S-stage. ALT and AST normalise in the majority of patients. The Baveno VII criterion of ≥5 kPa change between measurements is the threshold most monitoring guidelines now use for "clinically meaningful improvement".
Frequently asked questions
Should I get a FibroScan before starting Ozempic?
If your FIB-4 is indeterminate or you have multiple metabolic risk factors, yes — a baseline is valuable. If your FIB-4 is clearly low and you have no other red flags, you can usually skip it and rely on routine annual LFTs.
Is FibroScan covered by Medicare in Australia?
No. MSAC rejected the standalone FibroScan/VCTE rebate (Application 1797) in early 2025. Scans cost $150–$330 out of pocket. Elastography performed as part of an abdominal ultrasound may have partial Medicare cover.
Will my FibroScan kPa improve on Ozempic?
Most responders see 4–7 kPa reduction at 12 months. A reduction of ≥5 kPa is considered clinically meaningful under Baveno VII criteria.
How often should I get FibroScan on Ozempic?
Baseline if FIB-4 indeterminate, then repeat at 12 months. Annual scans thereafter while at risk and on long-term therapy. More frequent scans aren't usually needed.
Find a liver elastography clinic near you
Search participating clinics across Australia, or talk to your GP about a baseline FIB-4 and elastography.
This page is educational and not medical advice. Always discuss your GLP-1 treatment and liver monitoring with your GP.