Fibroscan instead of biopsy

[Cabin3]

Hi all.  My doc wants to do a liver biopsy to find if there is inflammation.  They say that doing a fibroscan won't tell them if there is inflammation.  And without inflammation they can't treat?  Please advise if this is what I should do.  

[StephenCastlecrag]

I think measuring ALT is a easier and simple way to show whether there is inflammation. Of course inflammation should not be the only criterion to decide whether to treat or not.

[twinboys1girl4me]

I'm not sure where you are located, but I'm in the U.S. where the "gold standard" is a biopsy.  Just now they are starting to get Fibroscan's in some states, which has been elsewhere much longer.  I've never had a Fibroscan but was told we can do one in September, but I've have had 2 biopsies.  One biopsy was in 2003 and then one just last year.  In 2003, it did show 1/6 for fibrosis (from inflammation) but last year it showed 0/6 fibrosis.  Go figure on how it got better, or even if this is accurate, as I've heard that a biopsy can be 10-30% off due to them taking a super small sample (the sample looks like a worm) which may not represent the whole liver.  

Both biopsies were very easy and for me no big deal, however, they do come with risk since it is an invasive procedure.  My hepatologist said we could do Fibroscan for my next scan in September but felt it wasn't going to tell us anything new that we already didn't get from the biopsy (which lead me to believe they still prefer biopsies).  It shall be interesting.  As you probably know, Fibroscan is not invasive, so you need to decide what is right for you and if you feel comfortable with what your doctor is advising.  

[sorte]

We had similar policy in Poland now, you need to have biopsy even if you already have fibroscan. Yes, with fibroscan you can not tell if there is an inflamation, but it's not the only criteria to start the treatment.