MRE Update

[mike716]

MRE Update

Hi, medhelpers! I had my MRE (magnetic resonance elastography) on Wednesday. This is an update.

This was part of a research project at the Radiology Department of Mt. Sinai Hospital in New York City. The project director is Dr. Bacir Taouli, and the coordinator is Claudia Donnerhack.

The study was done late in the evening, as the MRI machine is in normal use during the day. I was inside the machine for a total of one hour and twentry-five minutes. Quite an ordeal.

The first part, begun after I had fasted for six hours, consisted of a standard MRI of the abdomen. My entire body was inserted into the confines of the MRI tube with various apparatuses strapped to my chest and stomach, including two circular low-frequency sound transducers (one for the liver, one for the spleen) that transmit vibrations to the abdomen. This first scan took 45 minutes, during which I received instructions via headphones to alternately inhale, exhale, and hold my breath. Breathing affects the liver, so it's important to follow the instructions precisely.

The second part of the test was the elastography, and took around twenty minutes. The transducers were energized and my abdomen (and liver) were vibrated at 60 cycles/minute. Two takes each of four "slices" were done by the operator sliding me along the MRI chamber in brief increments. Then the same was done with my spleen.

When that part of the test was done, I was slid out of the MRI chamber and given two bottles of a liquid nutrient to drink. Then the second part of the test, the elastography, was repeated.

Everyone was very nice to me. They even paid me $80, which covered the cost of a taxi home. An anecdotal coincidence was that the test operator turned out to be from Buenos Aires!

I have been promised a CD with all the images (elastograms plus MRI). Meanwhile, I received an email report of Dr. Taouli's analysis of the test which I reproduce in the follow-up post below.

[mike716]

Well, ya got me there. I guess those blood marker tests aren't all they're cooked up to be. Congrats on the F0 Fibroscan!

Are you going to do occasional ultrasounds?

Cheers!

Mike

[Bali05]

Just got back from my 1.5 year post tx FibroScan.
We did 20 different readings in various spots.
Most of them around 5.3 kPa and the highest 6.1 kPa.
Diagnosis F0.
I also did a FibroSure bloodmarker test which came back F 4 - cirrhosis
based on low haptoglobin and high alpha 2 macroglobulins.
Low haptoglobin and high alpha 2 macroglobulins can be a side effect
of strenuous daily exercise which is what I like to do for many years.
So much for FibroSure.....

Cheers
b

[mike716]

Re Fibroscans, don't forget that they are inconclusive when the fibrosis is not homogeneous, as they only scan a very small part of your liver. My current ultrasound&Fibroscan Md, as well as my new hepatologist (who is the head of Hepatology at the German Hospital here in Buenos Aires), have both told me that it's a waste of time to do any more Fibroscans, since the fibrosis in the part that the Fibroscan tests is not representative of my whole liver.

The Fibrotest is much more accurate, in my opinion. So is an MRE, if there were any way to get one.

Mike

[mike716]

I signed something, maybe a waiver releasing the data to them, but they promised me a liver elastogram. That was the deal. After all, I went there asking for a liver elastogram and they offered me the trial as a way to get one for free. They owe it to me. I don't care what the fine print says.

I'm going to make as much trouble as I can until they give me what they promised.

Mike

[mike716]

Hi, Danny. Thank you for your commiseration. It looks like I was lied to just to get me into the trial. Either they never intended to produce the liver elastogram from the data, or it´s too much trouble for them to do so. Bottom line: the patient/volunteer is unworthy of any respect.

I should have learned by now not to trust doctors, but I must admit I was fooled.

I´m going to appeal to the referring MD and then make a stink at the hospital where the trial is being done. But they probably figure that since I´m back in Argentina there isn´t much I can do.

C'est la vie.

Mike

[Bali05]

Actually my Fib-4 was also lower at baseline before tx  0.74 vs. 1.02 today1.5 years post.

"during treatment and up to 6 months post treatment is not very conclusive since the meds makes your lliver a little stiffer and inflamed "

That was the argument of the Drs. when my FibroScan went up during tx
and it sounds good doesn`t it ?

The problem I have with that is that  I took ALTs same day I did Fibroscans
and it coincedentally was highest (75) on the day I got my lowest FibroScan
which was 5.9 kPa at baseline  At SVR my FS was 7.5 kPa and ALT 28.
So if ALT is an indicator for inflammation the higher FibroScan readings
@ wk48 and after tx can not be blamed on higher inflammation.



b