Where can I get a Fibroscan?

[Ih8hepC]

I was told I had early cirrhosis before I started treating last year.  I finished 48 weeks of treatment on September 28th and I don't know if I'm SVR yet or not.  I'm hoping for good news as I was undetectable at 4 weeks, but as we all know anything could happen.
I've been reading on this forum about Fibroscans and I'd really like to know if I really do have cirrhosis.  The first doctor to look at my pre-treatment biopsy told me I was a grade 3, stage 3, but the doctor at the VA told me I was a 4 (from looking at the same biopsy).  I'd also like to know if the treatment produced any histological improvement to my liver.
Does anyone know where I could get one?  I live in the Tampa, Florida area.  Does insurance ever pay for these?  If not, what do they usually cost?
Kalio, I was encouraged by your good results.  It gives me hope.  
Lastly, is anyone taking Mesalazine here.  If so, do you know what the side effects are?  Would you recommend it to others with high fibrosis?

[MeganF2002]

Good Morning!

American Health Imaging offers FibroScans at a great price, only $250. The office is in Decatur across the street from Dekalb Medical. They take walk ins too.

[8hepc]

So I was wondering is there  a Fibroscan In SF bay area. Thnankyou for taking the time!

[Kalio1]

Additional positive info. regarding Fibroscan


http://clinicaloptions.com/Hepatitis/Conference%20Coverage/Boston%202006/Capsules/231.aspx?Track=HCV%20Treatment

[sfbaygirl]

As to whether Fibroscan is a good tool to measure fibrosis, I believe it is. As the comparison to biopsy and fibrosure results show. I am not going to post links etc. I don't have the energy. But I know I COULD NOT get a biopsy, so I had NO way of knowing to what degree of fibrosis I had. Of course, I imagined the worst. When it came out that I was stage 1-2, I was very relieved. It verified an early biopsy 6 years ago that it had not progressed. I have heard and read that Fibroscan is 90% accurate, compared with Biopsy at 80%. I have a headache, or I would dig up the data...

HR is the real deal and much of the Fibroscan depends on who is giving the test. Apparently there can be great error with someone who does not know how to read the slides. Just having 20 slides done, compared to 1 with a biopsy is a huge deal. One person there  off tx for years was a stage 3. I watched the slides. You could see where the liver was healing from diligent diet and care over the few years off tx. Some looked like a babys liver, some had severe scarring, so all slides are not alike. A biopsy only shows one place.

I don't like seeing HR's credentials come into question either. I saw them, they are real. I would hate to see shooting the messenger keep him from coming back here.

[Eisbein]

Ditto Jim, Cuteus and Foreseegood, nothing more to add.

Ina

[Forseegood]

I agree with Cuteus and Jim, that this is a relatively "new" disease in that it's only been on the radar a "relatively" short time, along with it's treatments...and that Doctors and Experts of all kinds have disagreements in all areas vis-a-vis this disease....and that we don't necessarily have to buy into all of HR's ideas or conclusions, but it sure is nice they are available to us...I do know that he knows a dam sight more then I do, and the vast majority of posters here, and I agree that we should be happy he is here to bounce ideas off of, etc....the guy doesn't HAVE to be here, he's not selling anything ....he's doing it to hear first hand views from patients, and to help us out...for that I am very grateful and I'm sure plenty of other posters are too...

Sometimes it's not the message itself, but HOW it's delivered ...I certainly hope that HR continues to come here, for at least awhile, I like to hear his takes on things and I don't think I'm the only one...

[cuteus]

yeah, I was going to mention that he is an MD and I guess confirmed by MH to be true.

Still, we all know that even the experts make mistakes and are not infallible.  Opinions can be taken into consideration along with other factors.

what gets me sometimes, is that when a member states a true fact, someone takes it as a negative comment.  I am not talking about this thread only.  I remember one where a member posted that he/she was detectable at wk 12, and at wk 20 had not gone down much and should she/he continue and almost everyone jumped in saying be positive, you can make it, don't give up, etc.  And when someone stated the obvious, that the chances were not good, that person was called negative.  We need to assess the use of that word a little better.

[jmjm530]

It's not surprising that some may disagree with HR's opinions -- as there is much disagreement in the professional HCV community on many issues -- but as Ina suggests, this man has impressive credentials and we are extremely fortunate to have someone at his level to both learn from and bounce ideas off of. That doesn't mean we have to take everything he says in stone but IMO that really applies to any professional in the hcv field be it md, researcher or whatever.

[Eisbein]

HR is an MD as well as a researcher.
He said that to drofi in German. He was a practicing MD in Vienna before coming to the US and devoting his time mostly to research.
He has enough credentials to cover the walls of a 1000 square foot apartment.
I would say nobody here should dismiss his opinions.

Ina

[ladybug52]

I always kind of pictured you with more hair and more casual dress.
Bug

[jmjm530]

Cut: I swear I wasn't reading over your shoulder!
-------------------------
Just in case, I moved my chair against the wall :)

---
But yes, the experts don't always agree and the experts aren't always right, and that includes HR, my big shot doctors, your big shot doctors, everyone's big shot doctors. Especially, when working on the cuting edge of viral and tx theory. This is an *emerging* field in terms of knowledge. But still, HR is the real deal and we are so fortunate to have him stop by from time to time.

[cuteus]

I swear I wasn't reading over your shoulder!

[copyman]

best of luck to you. god bless

ps, this is about as much fight you will ever get from me. get use to it. LOL

[cuteus]

for those that can have them, of course.

rev, I thought you had a truce?  changed your mind?

[cuteus]

well, fibroscan is getting mighty close to the biopsy as a diagnostic tool, but according to this abstract 221475: Diagnostic Liver Biopsy in Patients with Advanced Fibrosis and Cirrhosis. Kenneth E Sherman, Zachary D, Goodman,Sara T Sullivan, Sima Faris-Young, the best tool for dx cirrhosis is
"CONCLUSION: Biopsy in advanced liver disease more often yields larger, unfragmented samples amenable to pathologic interpretation when performed with an automated cutting needle compared to aspiration (suction) biopsy. Adoption
of this technique would facilitate accurate biopsy evaluation in patients with advanced fibrosis/cirrhosis"
it yields adequate samples in 93% of biopsies as opposed to aspiration which produces 83% adequacy.
http://stickythis.com/r035

besides the staging and grading of liver damage, biosies can dx other abnormalities in the liver.

[copyman]

Kalio, dont get discourged by negative comments. trust the fibroscan and what HR told you about it. i think your news was great and hope and pray for the best for you and all the other good people here. a bx is not without fault, the "gold standard" biopsy is 90% accurate AT BEST, most likely alot less if you account for the path who reads it, the size of sample and what part of liver the sample was taken from. the ideal biopsy would be ultrasound guided taking 3 samples from different parts of liver and measure around 25mm in lenth. this never happens so this is why a bx is 90% AT BEST. roll with the fibroscan results and believe what HR told you :-)

[Kalio1]

Comparison of Fibroscan and needle biopsy. Accuracy is excellent in advanced fibrosis/cirrhosis.

http://gut.bmj.com/cgi/content/abstract/55/3/403

[jmjm530]

Never thought you were telling me I was wrong. I was just clarifying for others who might be interested. No problems on my end.

[ladybug52]

Said: "As I understand it, basic requirements are that you have had to have had a biopsy within the last 36 months or plan on having a biopsy within the next six months, or have probable significant (stage 4) liver damage as ascertained by other markers such as spleen size, platelet count, etc."

Don't know what trial you were referring to, I was just sharing St. Louis info.

Said: "Also, I It's possible criteria differs per site, really don't know."
Well since you were giving info on the scan, I again was telling about the scan in St. Louis. Obviously basic requirements do differ. I wasn't trying to tell you you were wrong, I was just sharing what info I had from St. Louis bt calling them 3 times.

[jmjm530]

The criteria I gave you was not from the St. Louis site. Also, I It's possible criteria differs per site, really don't know. It's also possible that some of the sub-studies within the master study are closed out at various locations. Best just to call around and hear it from the horse's mouth. That's what I did, picked up the phone, made some calls, made an appointment and got scanned.

[ladybug52]

The fibroscan in St. Louis is probably closed. I couldn't get past the people at SLU who answered the phone when I called. However, the criteria is tx naive, biopsy within the last 6 months, not 36. It's not exclusive about the results of the biopsy or genotype, but like I said, I think it's closed.
Good Luck!
Bug

[Kalio1]

Yes I did have a Fibroscan and my score put me BELOW the score for cirrhosis. The score was 11.1 and he said Stage 3, still that is a lot easier to handle than cirrhosis even "early" cirrhosis. I believe the scoring for cirrhosis starts at 12.5 on a Fibroscan. I don't know if it is due to improved histology from treatment since I had the CT scan saying cirrhosis or just the Fibroscan is a better, more accurate test than the CT scan but it sure was a relief! Not that stage 3 is so great but at least I have a good shot at it healing. I first have to get rid of this pesky virus. 12 weeks to go!
Hopefully after that I can focus on improving the fibrosis. I know it takes years.
Thanks for asking. Hope you are doing well.

[sfbaygirl]

After the fibroscan Kalio showed stage 3, while the Cat scan showed early cirrhosis, just found this out...

[honey11]

Great News!!  Could be the meds reversing damage and who knows after you reach SVR,,,,maybe a stage 2 or 1 could be in the making for you!  I know you feel so much better hearing this and probably makes the meds more tolerable,,,,just knowing you are going to beat it!  Sounds like after the holidays,,,you will be a hop,,skip from finishing up! :))