My annual Fibroscan - what I learned today

[dointime]

Hi All,

During my annual fibroscan today I noticed that the pings felt more uncomfortable than I remembered from last time, like something banging on my bottom right rib.  When it came to the result I was shocked to find that the number had increased by 2 in a year.  As I am in my early 60's I am at the age when my liver fibrosis, currently stage1, could just shoot up, so I am on alert for that.  An increase of 2 or more every year from now could mean not enough liver time for the new meds to arrive.

Anyway, the front of the machine is simple to read and showed a 70% accuracy for this test.  The operator said she would be happy to do it again and this time I did not feel any discomfort with the pings.  And lo and behold, the reading for this 2nd test was the same as last year!  The accuracy on the screen showed 100%.  

We discussed the discrepancy in the numbers.  The operator said it might have been that she had the probe at the wrong angle the first time and the wave was partially hitting off my bone, skewing the result to make my liver appear stiffer than it actually was.  This is an experienced operator and the same one as I had last year.  It was late afternoon and she said that she had been working the machine all day and her arm was tired, so she could easily have got the angle wrong the first time.  These probes are large heavy things.  

So - the things to note for anybody getting a fibroscan are -
a) if the pings are uncomfortable - they shouldn't be.
b) if the accuracy on the screen is not 100%.  
Although not always possible, an accuracy reading of 100% is obviously more reliable.  There is another parameter on the screen called the variance.  On my good reading it was 0.4% meaning that all the readings were within 0.4% of each other.  The higher this figure is, the bigger the difference in each individual ping reading and the less reliable your final score.

Well hope this adds a little bit to the knowledge and good luck with your fibroscans,
dointime
    
              

[dointime]

bali05 - I've been giving your feedback some thought, ie. you think the ifn/riba might have done some harm to your liver as indicated by the fibroscan.  This is quite contrary to the old conventional wisdom that tx gives your liver a rest, even if you don't SVR.  Sounds like your liver got a beating, not a rest at all.  

Now that I think about it I can't recall any scientific evidence to back up this belief that the liver gets a rest while on tx.  And anecdotally I can't recall anybody having a biopsy before and after tx which demonstrated liver improvement.  So perhaps you are exploding this myth for the first time.  It is quite feasible that this has never been discovered because people don't generally finish tx and jump right up on to the biopsy table the next day.  The fibroscan is making that possible for the first time.  I guess we watch this space...        

Idyllic - your readings are about the same as mine for a stage 1.  I am BMI 25, not so low.  I  didn't get told to have an empty stomach for the test.  I didn't get a $1 dollar bill either:(

dointime  
                

[Idyllic]

I have had two Fibroscans & two liver biopsies and both procedures yielded the same results. My GI's participates in lots of studies & trials. He performed both of my biopsies and the same tech from his office performed both Fibroscans.

I never really thought about the implications of the results or how well they correlate with a liver biopsy. To be honest the only reason I even agreed about the Fibroscan was to participate in anonymous study.

For the Fibroscan I only had to have HCV, labs (mainly ALT, AST & PT), low BMI and an empty stomach. The first time I had to sign a ton of forms and when all was said and done I received a crumpled up $1 dollar bill :)

As Bali mentioned you do not receive a report (at least I didn't) but I wrote down the results at the time. Still, I would have to check my notes if there is an obvious error or incongruency.


Stage 1 (Grade 2) (2008 & 2011)
FibroScan kPa 3.5 (F0)/BMI 19 (2008)
FibroScan kPa 3.5 (F0)/BMI 19 (2011)

[Bali05]

"Yikes Bali - I don't want to hear it either!  Maybe it was just the blunt instrument effect and the angle of the operator"

Nope , you can trust me in that I have had enough FS experience to make sure
the operator gets a good result. I even went as far as repeating FS within
only one week and recheck with different operator same machine.
I tell all of them my previous results to compare including success rate
ect... even scan image print out from a FS I did in Germany , bloodwork
and so on...

[dointime]

My suggestions are:

Be nice and diplomatic with the operator so that you get them on your side.  Ask politely if you can see the screen after the test, and get the operator to point out the accuracy reading.  If it is 100% then you are good to go with your test result.

If the accuracy is not 100% then it's up to the operator and your powers of persuasion to do the test over until you get the best accuracy that you can get.  So it is important that you speak up at this point.  If the operator is in a rush then he/she might not be inclined to do the test over, but it's your big bucks and you have a lot riding on the result, so this is not the time to be shy.  The test only takes a few minutes so it shouldn't be impossible to repeat it.  

Good luck,
dointime  
  

      

[rivll]

I have a fibroscan scheduled for July in NYC. I appreciate what I have learned from your posts on this.
I don't have insurance so I will be paying what is for me, very big bucks and I want to get the most out of it. Any other suggestions are welcome.

[dointime]

Maybe it's not the insurance people that need to be sent off for a biopsy, maybe it's the FDA people.  Sorry, I'm not up on how it all works in the US.
dointime