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What's difference between Fibrotest and Fibroscan?
At what point, is the Fibroscan needed? I need some questions to ask my doctor, since I had a Firbrotest done showing 0 Fibrosis but never a Fibroscan. Also, what would be a reason for them not to measure hbsag in quan? Thanks!
Dear all,
(disclaimer : I work for FibroTest/FibroSure)
I’ve read this thread recently, and as I know this subject quite well, here are a set of _validated_ data for a better understanding :
FibroTest accuracy for early stages
----------------------------------------------
FibroTest compared to transient elastography (TE) by Fibroscan is as accurate for early stages of fibrosis as for cirrhosis; TE by Fibroscan could not discriminate between early stages of fibrosis (F0, F1 , F2) because of several variability factors : operator-related, steatosis and inflammation in the liver and the body mass index of the patient. Inflammation of the liver, reflected in ALT, is directly correlated to TE, leading to false positive results for fibrosis evaluation (, World J Gastroenterol. 2008, Vergniol J Viral Hep 2009, Wong Clin Gastroenterol Hepatol. 2013) . Compared to TE, FibroTest is not sensitive to inflammation, as ALT is not included in the algorithm, and the complementary test that evaluates inflammation, ActiTest, is provided along with FibroTest is discriminating activity from fibrosis.
FibroTest accuracy for cirrhosis
-----------------------------------------
The best method to compare the accuracy for cirrhosis is using strong independent endpoints from liver biopsy : cirrhosis complications and liver-related death in long term prognosis analysis. All published studies comparing prognostic value of TE Fibroscan and FibroTest show similar accuracy for both methods with a clear advantage of applicability (reliable results) for FibroTest. Moreover in cirrhotics with ascitis TE evaluation could not be used. (Vergniol Gastroenterology 2011, deLedinghen APT 2013, Poynard J Hepatol 2014).
FibroTest has better applicability compared to TE by Fibroscan
-----------------------------------------------------------------------------------
FibroTest risk of unreliable results occurs in less than 3% (Poynard Clinical Chemistry 2010) of cases while for TE by Fibroscan occurs in 16% and 3% more of liver stiffness measurements are failures (Castera Hepatology 2010). In intention to diagnose, FibroTest has better applicability as in 97% of subjects will provide a reliable results compared to 82% for TE by Fibroscan.
Let me know if you need more informations,
Best regards,
Olivier.
(disclaimer : I work for FibroTest/FibroSure)
I’ve read this thread recently, and as I know this subject quite well, here are a set of _validated_ data for a better understanding :
FibroTest accuracy for early stages
----------------------------------------------
FibroTest compared to transient elastography (TE) by Fibroscan is as accurate for early stages of fibrosis as for cirrhosis; TE by Fibroscan could not discriminate between early stages of fibrosis (F0, F1 , F2) because of several variability factors : operator-related, steatosis and inflammation in the liver and the body mass index of the patient. Inflammation of the liver, reflected in ALT, is directly correlated to TE, leading to false positive results for fibrosis evaluation (, World J Gastroenterol. 2008, Vergniol J Viral Hep 2009, Wong Clin Gastroenterol Hepatol. 2013) . Compared to TE, FibroTest is not sensitive to inflammation, as ALT is not included in the algorithm, and the complementary test that evaluates inflammation, ActiTest, is provided along with FibroTest is discriminating activity from fibrosis.
FibroTest accuracy for cirrhosis
-----------------------------------------
The best method to compare the accuracy for cirrhosis is using strong independent endpoints from liver biopsy : cirrhosis complications and liver-related death in long term prognosis analysis. All published studies comparing prognostic value of TE Fibroscan and FibroTest show similar accuracy for both methods with a clear advantage of applicability (reliable results) for FibroTest. Moreover in cirrhotics with ascitis TE evaluation could not be used. (Vergniol Gastroenterology 2011, deLedinghen APT 2013, Poynard J Hepatol 2014).
FibroTest has better applicability compared to TE by Fibroscan
-----------------------------------------------------------------------------------
FibroTest risk of unreliable results occurs in less than 3% (Poynard Clinical Chemistry 2010) of cases while for TE by Fibroscan occurs in 16% and 3% more of liver stiffness measurements are failures (Castera Hepatology 2010). In intention to diagnose, FibroTest has better applicability as in 97% of subjects will provide a reliable results compared to 82% for TE by Fibroscan.
Let me know if you need more informations,
Best regards,
Olivier.
Ok just found the document. It is actually from the EASL training course for hepatologists, so no doubt in it authority:
"Comparison of transient elastography (Fibroscan®) and serum markers
In a study including 1307 patients with chronic viral hepatitis, TE was compared to the serum markers APRI, FibroTest®, FibroMeter® and Hepascore ®. For the diagnosis of significant fibrosis, all methods were comparable and had moderate diagnostic accuracies (AUROC 0.72-0.78). For the diagnosis of liver cirrhosis, TE performed very well, with diagnostic accuracies of AUROC 0.90, better than those of serum fibrosis markers (AUROC 0.77-0.86) [8]. In an additional study, the accuracy of TE for the diagnosis of significant fibrosis was improved by approximately 10% when TE was combined with serum markers [23]."
TE = Fibroscan
So no worry my friend...Fibroscan will most likely again show you have F0, or in the worst case F1 which is also no problem...but still go and do it just for your own record.
"Comparison of transient elastography (Fibroscan®) and serum markers
In a study including 1307 patients with chronic viral hepatitis, TE was compared to the serum markers APRI, FibroTest®, FibroMeter® and Hepascore ®. For the diagnosis of significant fibrosis, all methods were comparable and had moderate diagnostic accuracies (AUROC 0.72-0.78). For the diagnosis of liver cirrhosis, TE performed very well, with diagnostic accuracies of AUROC 0.90, better than those of serum fibrosis markers (AUROC 0.77-0.86) [8]. In an additional study, the accuracy of TE for the diagnosis of significant fibrosis was improved by approximately 10% when TE was combined with serum markers [23]."
TE = Fibroscan
So no worry my friend...Fibroscan will most likely again show you have F0, or in the worst case F1 which is also no problem...but still go and do it just for your own record.
With regards to the Fibrotest vs Fibroscan...read recently an article from a highly reputable experts on it. Fibrotest can be false-positive but not false-negative...and if not false-positive (in rare people with some not so common medical conditions) then it is as reliable as Fibroscan, except for diagnosis of cirhosis where Fibroscan is much better.
That implies that if someone is shown to have F0 on Fibrotest, he/she does not have strong fibrosis with a very high likelihood. Fibroscan won't thefeore be showing F2 or higher for that individual.
Saying that...Fibroscan seems to be prefered choice for most of the hepatologist...and I also thrust it more.
That implies that if someone is shown to have F0 on Fibrotest, he/she does not have strong fibrosis with a very high likelihood. Fibroscan won't thefeore be showing F2 or higher for that individual.
Saying that...Fibroscan seems to be prefered choice for most of the hepatologist...and I also thrust it more.
Jesus, pece be upon him, was one of the greatest messengers of God, but not the God Himself...
In my country there is almost every test but people dont have the money for treatment and people die like house fly here and in your your country you have money for treatment but govt won't allow to get people well so many developed Country people die like pigs and the poor countrys people die like housefly. No govt care for their citizens, they Only care about themselves. Its a strange world we live in " I say JESUS CHRIST is the ONLY answer for all the problem.
Fibrotes test is an old method and I would go to an extent that it is not that reliable as fibroscan is. Fibroscan is already approved by fda and I think many hospital has the machine in US now. Even biopsy are not reliable, in my case with US guide biopsy they could not come up with substantial results, forget about the normal biopsy.
You should do Fibroscan & ship out blood test for qhbsAg for good!
US govt is scared of losing revenue from hbv drugs maker as if people get to know that if their qhbsAg is less then 1000 iu they have the 91% chance to clear and if people get heal then its obvious that people will stop buying medicine and the revenue to govt and drugs maker will be 000000. That is why I think they done allow qhbsag test in US.
You should do Fibroscan & ship out blood test for qhbsAg for good!
US govt is scared of losing revenue from hbv drugs maker as if people get to know that if their qhbsAg is less then 1000 iu they have the 91% chance to clear and if people get heal then its obvious that people will stop buying medicine and the revenue to govt and drugs maker will be 000000. That is why I think they done allow qhbsag test in US.
If your Fibrotest was very good (F0) then most likely Fibroscan to be good as well....as both of these methods are good for detecting lower grades of fibrosis, whereas Fibroscan is better regarding cirhossis, which you don't have.
Excellent, I'm going to ask my doctor about the Fibroscan and see what he says. They did the Fibrotest but not the scan. Is it all in the USA they don't allow qHbsAg? Might be something that is controlled by some regulations here, I'm not sure. Thanks for the response.
Fibroscan is needed to monitor your liver stiffness every six months or so as liver biopsy cannot be perform at this frequent interval as with hvb one has to monitor the liver conditions. So the best tools available right now is fibroscan.
I dont get it why USA does not check qHbsAg, as we all know now that its the hbsag we want to clear out.
I dont get it why USA does not check qHbsAg, as we all know now that its the hbsag we want to clear out.
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