Should I ask for Fibro Scan? Going in for abdominal UltraSound Friday

[elias]

Hi again:

Recently tested positive for HCV. Had my first visit with Gastro on Monday. Took many blood samples, but not clear if those were all for genotype or fibrosis scoring as well. Nurse had said results would take ~2 weeks

Scheduled for Ultrasound  on Friday, which for some reason I thought might be that Fiber Scan people here use to arrive at their F reading (F1-F4). But I looked at the form the U/S is listed on and all it says is: "Abdominal U/S Complete". So not clear how much that will tell me about fibrosis level.

Questions:

1) Should I ask for that Fibro Scan as well?

2) Is that a test that's hard to come by?

3) Is FibroScan the most accurate way now to measure this?

4) Would the abdominal U/S show much about this?

5) Were those many vials of blood taken on Monday likely to have included some sort of blood test that would be as as accurate for Fibrosis score as a Fibroscan.

I'll probably only be seeing radiologist on Friday. So not sure she could answer all this.

Thanks:

-elias

[MommaT]

Hi Elias!
I do think the Fibroscan is available in US and most accurate next to Biopsy or MR Elasticity test (I had Fibroscan in Gastroenterologist Office) and you are right does show rate your Liver like you see F0-4. Ultrasound is also good to see your liver generally. Bloodwork does show alot-like Type of Hep c , also Liver Panel and other tests shows inflamation and level damage, too. -I wish a Moderator would answer they are better versed! Hope this helps! Terry

[elias]

Thanks MommaT

Question is how often does F level assessed by blood tests disagree with Fibrosis score by Fibroscan . and which is the more accurate?

[MommaT]

Hi Elias!  F level only with Fibroscan not bloodwork. The bloodwork shows how well you are functioning. I think all important. Like me I show mild cirrhosis from Fibroscan,  yet Doctor said my liver is functioning quite well! I think from my bloodwork and had Upper Endoscopy. Hope you can talk to your Doctor easily about questions. There seems to be a range of people with going to Gastrologist,  Blood Disorder Drs AND even just General Practitioners. I think you can ask at radiologist before hand that you want to speak to them. Write down questions you have about test. Hope this helps!  Terry

[dragonslayer]

There is one blood test which attempts to measure fibrosis called Fibrotest  (FibroSure in America). Because it's based on an algorithm which attempts to predict fibrosis based on biochemical markers in the blood, it's not generally considered as accurate as a liver biopsy.... Fibroscan is another non-invasive technique to estimate liver fibrosis by measuring the liver's stiffness via a scanning device...  These non-invasive measures have been shown to be fairly accurate in the low and high F  stage ranges, but decidedly inaccurate in the middle, making the Biopsy, since its based on true sampling, generally the most accurate, despite its potential shortcoming of possible non-representative tissue sampling.

[MommaT]

Thanks Dragonslayer! I forgot about Fibrosure! I like how well versed you are at these questions!

[elias]

Hi Dragonslayer:

Not sure if among those many vials taken for testing there was one for Fibrosis level.

Doubt they were all for genotype.  And the viral load had already been tested before. Secretary cant discuss test results by phone.

So, is it likely that if he has run test for Fibrosis level, it was that Fibrosure test you referred to. I've read there are many simpler algorithims (possibly cruder estimates even.)

Would it seem  like I'm pushing him if I ask for a FibroScan to confirm? Especially if its a scary result?

-elias

[dragonslayer]

Hi Elias,

Those blood tests the results of which youre waiting for could have been a comprehensive blood panel including liver function tests... Could also have been with CBC to get blood count analysis.... 

The temptation at this point is to get ahead of yourself..  But my advice is to work the process.. Ie, wait for the results to come back, see what you were tested for, and based on that you should get some direction from your Dr. of what to do next.

I had two biopsies done, 5 years apart , which was pretty standard a few years back.. Nowadays I see a lot more of the noninvasive approach...  Of my two biopsies, the first, done in '08 hurt a lot; they just gave me a local with a needle, and then biopsy.. I never wanted to do that again.. 5 years later in 2013, I had a new hepatologist who wanted me to get another biopsy, which he would be doing himself... This time, it was great.    I got an IV with a benzo plus a little fentanyl push, and I felt zero pain.  It was hard to believe it was the same procedure...   

The reason Im saying this is that while you can get estimates of your liver condition with Fibrosure and Fibroscan, looking at an actual tissue sample of the infected area will give them a more accurate appraisal.  According to my biopsies, the first one scored Stage 0 and Grade 0, and the second one 5 years later, done in a different hospital and different doctor, scored Stage 0-1 and Grade 0-1.. Because the results were so similar and showed only the slightest amount of increased damage, I felt pretty confident they were accurate. Ive wanted to do a fibroscan also, but I know its ability to discern a true F2 from a true F3 is not good and unless Ive somehow progressed to cirrhosis, Im probably better off trusting my two biopsies, especially since the last one, the one done in March 2013 was done only a year and a half prior to treatment, so there was not much time for my liver condition to suddenly go downhill.   

So, once you get your test results back, you can suggest a Fibroscan if you want, if indicated by your tests.   Ive seen a lot of people though who get different results than they do with biopsy, especially when stage 2 or 3 is being reported by the Fibroscan.  With the blood tests alone, even if all tests are normal, usually, the platelet count done in the CBC test, if the patient has cirrhosis, will be low.   But there are a lot of patients here who have cirrhosis who will be much better sounding boards than myself on this particular issue.

Best of luck, and let us know how it goes.