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Fibroscan
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Fibroscan

I had a fibroscan last month (still have not had a liver biopsy) and am wondering what the numbers mean (my # 5.6).  Because I was part of a study, I was not privy to any explanation regarding my test results.  
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Avatar_m_tn
HR previously wrote that normal is between "4-5" although, my guess is that many adults without Hep C might score higher than that for many reasons. In any event, "5.6" is an excellent result -- probably stage 0-1, but that's a guess. I'll try and dig up some older posts. Don't know your genotype, but with a scan result like that, not sure you really need a biopsy, maybe just a follow-up scan in 6-12 months.

-- Jim
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Avatar_m_tn
Here are some Kpa values from my doc that  I jotted down when I had my scan.

KPA less than 7.5 would be stage 0 or stage 1.
KPA 7.5 to 9.5 would be stage 2
KPA 9.5 to 12.5 (or 14) would be stage 3
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Avatar_n_tn
I was sure hoping that you would answer this one.  I am a genotype 1 and at this point have no interest in treatment.  So, i was pretty happy to hear this.  The one thing the tech did tell me, my test results were better then his 7.2
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Avatar_m_tn
Interesting that you mentioned that, and I'm assuming your tech does not have Hep C.

In fact, there was an article about Fibroscan in the news recently. Apparently, one very broad application for the device will be in screening problem drinkers for potential damage. In this particular story, I believe they set up a Fibroscan in a public place and did close to 100 scans that day. Many had higher results than I had, which was around 8 if I remember correctly, but I'd have to check my notes.

BTW here's another post from HR on values:

The range for Fo-F1 is 4 to 7  Kilopascal ( even for lean Europeans, Jim )
http://www.medhelp.org/forums/hepatitis/messages/43807.html

My other post on HR's values came frm this thread"
http://www.medhelp.org/forums/hepatitis/messages/43974.html

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Avatar_m_tn
I originally referenced that last thread, but then used another "HR" thread, so probabably disregard as may be confusing. I'm sure HR will show up eventually and clarify his position as to Kpa values. I do remember, however, that he based "normal" values on his son -- who I imagine is to young to be a Fibroscan tech :)

-- Jim
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Avatar_m_tn
i still question the complete accuracy of the fibroscan. i had the FibroSCAN 8.8 kpa, fibroSURE stage F0,  and BX stage 1. all 3 tests in that order 1 month apart. i find it hard to believe with my labs etc that i'm stage 2 ("scan" result). i have to lean towards the BX & fibroSURE on this one. i think the fibroSCAN is a great tool to see no damage or to rule out or confirm cirrhosis but the accuracy of the in-between stages has yet to be determined. even the great doc in boston said something to this effect.  your result either way of 5.6 is great!
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Avatar_m_tn
Your biopsy and Scan results are only one stage off. Also it's possible you were a high stage 1 with the biopsy, or that another pathologist might have read your report differently. In any event, none of the tests suggest you have significant liver damage. As a whole they suggest a range from no damage to moderate. Personally, I'd throw out the Fibrosure as results can be wacky, so my liver specialist suggested. If you really wanted to pursue this more -- and don't think you have to -- get hold of your complete slide set, and have it evaluated by another pathologist in another hospital. BTW who read the slides that put you at stage 1? Was it Dr.A's pathologist? If not, Im sure they will give you a free read since they did the scan.
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Avatar_m_tn
copy: i think the fibroSCAN is a great tool to see no damage or to rule out or confirm cirrhosis but the accuracy of the in-between stages has yet to be determined. even the great doc in boston said something to this effect.
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While there may be some truth, I don't think this accuratly reflects Dr. A.'s take, not as I understand it to be. Of course, more data will be coming in as the trial results are analyzed.
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Avatar_n_tn
Thanks for the info and the past threads.  The doc were I had my fibroscan also said the same thing about the accuracy.  No damage cool-cirrhosis confirmed but in-between still a puzzle.
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Avatar_m_tn
Is there anywhere in the eastern US where a patient can easily set up an appointment and have a Fibroscan done?
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Avatar_m_tn
may i ask what city you had the scan done? just curious because your doc said the same thing about accuracy in the middle stages. wanted to see if it was the same doc.
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Avatar_m_tn
Try contacting Dr. Afdhal at Beth Israel Medical Center in Boston, or Dr. Eugene Schiff in Miami. Afdhal runs the U.S. trials, which you may or may not qualify for. Alternatively, you might be able to get a scan as a private patient, not sure. I believe Schiff has a private machine.
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Avatar_n_tn
I really don't know about FS.
I have had four in the last 2 years. The first one was 4.7 KPA so my doc told me to go about my bussiness without worrying. 8 months afterwards I was 9.7KPA and the third was 10. I started treating immedialtely (i was scared ********)
Then I got one right after tx and was still 10.
I always wondered if is biologicaly possible to go from a 4.7 to a 10 in 8 months (meaning from F0-F1 to F3)...So I have to admit that my first reading was bogus..
I keep pushing my doc to have a BX done and he says what for? you're already SVR..
In fact I'm planning to go the States and get me a good ol BX for peace of mind
I think the FS is not all that reliable after all
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Avatar_m_tn
i think it is good if it is used along with other tests i.e. bx, fibrosure, US,CT, bloodwork, etc. i do not think any test is 100% realible by itself INCLUDING the "gold standard" biopsy.
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86075_tn?1238118691
if in situations like these, the fact that HR does a fibroscan differently (does relatively the whole liver instead of just a small sample, like a biopsy)....gives a patient a more accurate reading of one's liver fibrosis level?...if you were to get a fibroscan on just a small sampling of the liver (like a biopsy) wouldn't the chance of being off be a little greater?

I'm tired and I didn't word those sentences correctly, but I'm too tired to change them...

HR gives me a fibroscan, and on some of my liver it's practically virgin...on other parts of my liver it's a high one, on other parts it's a middle one...etc etc...I should think that fibrosis damage is not uniform, for the most part...on most patients...

so you could get a biopsy on one sample of your liver, and it comes up a two - perhaps on other samples of your liver it comes up a 1?  but they are not going to poke around with a bunch of samples on your liver like that with a biopsy, cause who could take it? I understand some people's liver damage is more uniform...

Wouldn't these sampling equations enter into a fibroscan from a tech? And not so much with HR's methods?  The tech *is* doing smaller samples then HR, as in biopsy sampling....., something I've always wondered about.
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Avatar_m_tn
My trial Fibroscan tech told me that the scan's were surprisingly similar wherever the probe was put, as long as it was placed properly, i.e. no bone in the way or not too much fat, etc.
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Avatar_n_tn
I had my scan done at Duke NC

Through out all my tests and studies I can tell you there are no "Gold Stantards"  only tarnished ones.  One test reads one way, another the other way.  That is why I have choose to go by the least invasive route.

What it boils down to for me is I have the virus, no getting around that.  So, to treat or not to treat that is the question.  If I were in the later stage by gollly...I am sure I would know it.. So, I eat healthy, do meditation twice a day, yoga several times a week, don't drink (I do miss my glass of wine/cold beer in the summer), take my supplements and just pray they come up with better options just incase I choose to put my body through hell....Thanks always for all the good info
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Avatar_n_tn
How much does a fibroscan cost vs a Biopsy?  Anyone?
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Avatar_m_tn
hey Nick, the fibroscan cost $0. It is still in trials and not FDA approved therefore can not charge for it. It should be approved next year and start to be available in many more places. I would imagine it would cost about the same as an ultrasound, very similar type test.
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86075_tn?1238118691
also, the fibroscan in LA is not cost prohibitive...
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Avatar_n_tn
Copyman has it right...
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