CT Scan

When do doctors typically order a CT scan?  I have seen 3 and none have mentioned it.  My treatment doctor has determined that I have stage 4 cirrhosis.  He did an ultrasound but no mention of ct scan.

[Bill1954]

I doubt CT scan would be indicated for garden variety HCV unless a U/S scan detected an anomaly; at least this was the position of both my treating doctors,

Bill

[nygirl7]

Did you have an ultrasound? That is where they usually start. Then the biopsy. But as Bill said I don't think they generally do cat scans as a part of the routine - they did not give me one either. Many people get confused when they hear that their ultrasound came back perfectly fine and mistake whether or not they have fibrosis or need the biopsy. But the US shows whether you have any tumors or such and the biopsy would show the level of fibrosis. I do not believe it is typical to get a cat scan./

[newleaf09]

Abdominal CT's were required to enter a study and also by my private physician as one of the early steps to get an idea of organ enlargement, portal vein blockage and other indications of cirrhosis.  It may be a bit of a moot point once cirrhosis has been determined by biopsy.  There are a lot of chemical indicators of cirrhosis but it's still not as good of a fibrosis diagnostic tool as a biopsy.

I had the works during the diagnosis dance but everything looked so normal on the ultrasound and CT (MRI did show fat but no tumors), that diagnosis was not a sure thing until the biopsy.

[Andiamo1]

The diagnostic most often used is an ultrasound.  Once fibrosis progresses to stage 3 or 4, a cat scan is often used to check for liver cancer if AFP is elevated.

[FloridaMouse]

I think Andiamo is right on.   I only had CT scans when my AFP was elevated so make sure there was no cancer there.

Mouse

[eureka254]

My understanding is that in the US, ultrasound is the preferred method of imaging for cirrhotics with no suspicion for tumor.  Usually CT-Scan is used if either something suspicious is seen on ultrasound and/or there is high AFP.  CT-Scan is usually only used as a surveillance tool for very high-risk situations -- my husband has them 3-4 times a year, but only because his docs assessed his particular chances of HCC within 3 years to be greater than 50%.  CT Scan is a good tool for differentiating masses in the liver, but it really is not very accurate in assessing liver damage.  (Sometimes not having to do certain tests is a good thing :D.)

[springfever]

My US was good - no cysts, masses, or calcifications.  
My AFP was 9 prior to tx and has not been tested since.  Dr wrote a note on AFP and said normal for HCV.  So I'll relax - a little.

Thanks again to all for help.