Fibroscan Score question

[stringer]

I just recieved the results from my Fibroscan this morning. My score was 8.3. The hepa doc said I was between a stage 1 and stage 2. This seems more like a stage 2 from what I have read. Anyone know the score ranges for each stage? I have a viral load of 6.7 million IU/ml. My liver enzymes are slightly elevated. Kidney functions are normal and blood counts are normal. I will know my genotype next week.    

[HCA]

Jim,
Actually it was a trans-jugular biopsy rather the needle type.
The latest one that is-they go in through the neck.It's much less traumatic.
The radiologist told me it was a good sample.
I'm hoping to get on tri-therapy (Telaprevir) like next week but it's like negotiating a minefield of red tape and protocols!

[jmjm530]

Sounds like more stage 3 from what you post, but probably not stage 4 as the last pathologist suggested. Were they able to get a good "shot" between the ribs or was there, er, a bit of fat in the way? I say this because I've heard that  too much fat  can affect results although I'm not sure which way. In any event, good luck down the road!

-- Jim

[Willy50]

Peoples results will vary so proceed with caution.  I have heard of cases where the liver damage was spotty and a biopsy happened from a healthier area.  A subsequent biopsy later on hit a worse area and it appeared that the patient had progressed rapidly.  I think that just points out one of the possible weak points of biopsy.  It may also suggest why some people are told to "get yer affairs in order" and then proceed to live well beyond the doctors expectations.  

I had a fibrosure in 2005 and it indicated a high stage 1- early stage 2.

When I got a biopsy in June 2008 I was given a 1/6 ISHAK score.  Still a stage 1 and perhaps even less damage than the Fibrosure indicated.

Best,
Willy

[HCA]

I would like to take the upbeat view but the other diagnostics are not encouraging.
Low platelets
Enlarged spleen
Marked fibrous expansion of the portal tracts
Fibrous linking
Nodular reconstruction(in areas) on biopsy,ultrasound and MRI
On the bright side,no varices,normal liver function.
I too have had different pathologists give totally different readings of the same slide the most extraordinary was in 2003 when one came in at Stage 1 and the other at Stage 3!!!!!!!!!!!
On balance I prefer to accept that the fibroscan scores (3 of them over one year all consistent) are an undercall

[nygirl7]

I would get a biopsy to determine what really exactly is going on.  Fibro is not as reliable and there is a huge difference between a 2 and a 3 - at least if you ask me there sure is.  Personally i believe that at stage 3 you SERIOUSLY have to get the ball rollin' and start treatment.  I believe at stage 3 you've already damaged 3/4 of your liver and are 3/4 of the way to cirrhosis - treatment becomes more important.  Fibrosis might be reversed - cirrhosis will not.

I personally believe the time for watch and wait has passed.

What if you do do treatment and it does not work?  You need time to be able to find an alternate means to do something before you are cirrhotic - before you've damaged your liver to the point that no matter what you do, it cannot be repaired.

At stage 3 you are really running out of wiggle room in my opinion.  I do NOT believe in watch and wait at stage 3.  But I'm not an important researcher - it is just that to me it makes very little sense.

I was stage 3 and treated for 72 weeks.  I have been cured for two years next month.

[jmjm530]

Did you have other clinical symptons of cirrhossis such as a low platelet count, enlarged spleen, etc? The possiblity exists that the fibroscan was correct and the biopsy was wrong either due to: (1) relative sample size; (2) absolute sample size; or (3) pathologist bias. Under two of the scales mentioned above, an "8.5" would put you at stage 2. "HR's" scale, however might put you as an early stage 3. You didn't mention what stage your biopsy showed but "developing cirrhosis at least" sounds like it could have been a late stage 3. I mention all this because needle biopsies have been shown to be off as much as 2 stages because of the three factors listed or a combination. That is not to say that your conclusion isn't correct at least in your case, i.e. "I don't consider the fibroscan a reliable substitute for a biopsy." but probably best to evaluate that conclusion by analyzing all available comparision/trial data.

On a personal note -- forgetting numbers 1 and 2 (above), I had the same slides reviewed by four different pathologists at major hospitals in the U.S. I was given the following values: stage 3, stage 2, stage 2.5, stage 3. Further one pathologist told me there was no way I had cirrhosis while another said I just might have it.

The jist of all this is that there is probably no one 100% reliable marker for any of us and the best course if needed might be a combination of needle biopsy, fibroscan, as well as clinical evaluations by a good hepatologist with perhaps another hepatologist and pathologist thrown into the mix.

-- Jim