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Updates and locations of Fibroscan??
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Updates and locations of Fibroscan??

I live in Port St Lucie, Florida, considered the Treasure Coast. I am going to have my second liver biopsy in 2 weeks. The first one hurt me so bad I have always said I'd rather die than to have another one. Well now I have to have another one and I'm not looking forward to it. They tell me they will use Versed so I won't remember the the pain, but that is worrisome too. I'd much prefer the Fibroscan! If anyone has any new info on this procedure please let me know! Has it been approved or are they still doing trials? I heard there is a Dr. Schiff in Miami that does them? Are the insurance companies covering this yet? Any info would be helpful!!
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Avatar_f_tn
Last I paid attention, yes, Dr. Schiff had one and may have been the first to have one in the U.S., possibly along with HR (Hepatitis Researcher), who bought his from France. I recall about five were available when I treated (Ahdfal, etc.). I think FlGuy knows about this stuff.

This recent study says: "Discordances of at least two stages between transient elastography and histological assessment were observed in 28 cases (11%)." :(

http://onlinelibrary.wiley.com/doi/10.1002/hep.22748/abstract

Maybe someone who's more familiar with this will step in.  It may be that it's more accurate for only part of the spectrum of fibrosis and misleading for the others.

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Avatar_m_tn
yes there are only around 5 in the USA and has yet to be approved by FDA. After the last data on them not sure it will ever be approved. the data showed that it was not good at staging the middle stages. Not much better then a fibrosure blood test. And again test is only as good as the operator performing it.

insurance companies will not pay for something unless it is FDA approved. the way most people get them are by seeing one of the big name docs who has it in their office. I had one when I saw Dr Afdhal in Boston.

Good luck if you end up having the biopsy.
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Avatar_f_tn
Did fibroscan stage you correctly?
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96938_tn?1189803458
My understanding is that Shiff (and his gang of liverheads) at U.M. in Miami were participating in the Fibroscan trial.  The intent was to compare the result of biopsy with the result of firbroscan in people who had both within a 6 month window.  Although I went to UM (I'm in Palm Beach) for a consult I did not get a fibroscan. I assume that they still have it and use it but I'm not sure - or if its used as a part of their diagnosing scheme.
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Avatar_m_tn
FlG you are correct the protocol was to have or had a BX within 6 months.

tash, actually the fibroSCAN had me the highest at between stage 2-3. The fibroSURE had me stage 0 and the BX was stage 1.

I drove 600 miles to boston to see Dr Afdhal and mainly have a FibroScan hoping to avoid a BX. In order to get the scan I had to agree to have a BX within 6 months. To be truthful I wasn't going to get the BX but after seeing the scan result was so different from the fibroSURE blood test I ended up having the BX a few months later which was closer to the fibrosure test.

I personally lost some confidence in the FibroSCAN test. Just like the non-invasive FibroSURE blood test it is good at diagnosing no fibrosis or cirrhosis but not good at  middle stages

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Avatar_f_tn
thanks for that....I thought that was the issue with it, good at the two ends but unreliable in the middle...just couldn't remember for sure.
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Avatar_f_tn
Looks like fibrosure was closer to the reality than fibroscan.
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Avatar_m_tn
i used all three tests to decide I was probably a stage 1-2.
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Avatar_m_tn
I have heard NY Mt. Sinai has one. I haven't  confirmed yet.

http://www.mountsinai.org/profiles/douglas-dieterich?id=0000072500001497131492&officeDrawer=biz
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979080_tn?1323437239
like every tool it is about how it is used.
I am using FibroScan to monitor changes.
Just did three of them before and during tx all had same result 5.6 kPa
I will repeat same FS when I reach EOT and six months after

b
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Avatar_n_tn
I just had fibroscan a couple wks ago at UM.. My hep doc is there, professor. They do them free on Tues. from what I understand- part of a trial. I will have another in 3 mo. I am not candidate for bx, I have medical issues that wont allow. Instead they are sending me for endoscopy, MRI and NASH Fibrosure..I hope it gives me a better outlook than Fibroscan, that score was 15.1 and kinda scary.. Hope it all works out for you.
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Avatar_f_tn
it would be a better test if fibrosis were the only cause of liver stiffness - but its not - and fibroscan measures liver stiffness - which adds to the margin of error for this test
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Avatar_f_tn
Well, in our case we know what the cause of stiiffness is-chronic hepatitis C.  
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979080_tn?1323437239
FibroScan is most accurate at the ends of the spectrum F0-F1 or F3-F4.
If the FS reading indicates inbetween stages or cirrhosis it is advisable to treat or
to do bx to confirm.

Forget about FibroSure bloodmarker. I once did a bunch of those they varied
as much as 1 stage in 1 week.Out of all tests I find FibroSure most unreliable.
The first hepatologist I ever met said it was not worth the paper it is printed on.
All just personal experiences....
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1409552_tn?1281483061
Thanks tashka and everyone who put in positives for this! BillM57 are you on all the boards? LOL!
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