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Author Topic: Post tx Ultra Sound or Fibro Scan?  (Read 10511 times)

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Offline hope2bcured

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Post tx Ultra Sound or Fibro Scan?
« on: December 10, 2015, 05:53:17 am »
Hi,

I have a question, I took my last Harvoni on Sept 13. I will be going for my SVR 12 was supposed to go today along with Ultrasound but, I have to reschedule.

My question is, what is a better more accurate test for the Liver? An ultrasound or the Fibro Scan? I had an ultrasound within the last 5 months. I dont understand why I am not getting the Liver scan? Is that a nuclear test? What is the prep for it? Is that what most folks get who have had 2 biopsies in past and had HCV for over 30 yrs?

Sorry for all the questions.
Thanks
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Offline gnatcatcher

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Re: Post tx Ultra Sound or Fibro Scan?
« Reply #1 on: December 10, 2015, 06:58:07 am »
The ultrasound is to look for liver swelling, any tumors, etc. If you have cirrhosis, a typical protocol is an ultrasound every six months so that any hepatocellular carcinoma is detected early. The FibroScan, which feels a lot like an ultrasound, is to assess the amount of fibrosis. I'm under the impression that most doctors wait longer post-Tx before doing a FibroScan to see if the amount of fibrosis has lessened.

Supersonic Imagine has now developed an ultrasound (ShearWave Elastography, or SWE) that detects fibrosis, thus eliminating the need for a FibroScan. Since it is new, few imaging centers would have them yet.

The prep for the ultrasound I had last month was no food or drink after midnight. Either there was no prep for my FibroScan (which the doctor offered me during my late-afternoon appointment) or enough hours had gone by since I had last eaten that it could be done right then. For both tests, you lie on an exam table while a wand is moved around your liver area. The ease and non-invasiveness of these tests has caused biopsies to go nearly extinct.

Hope this helps.

Gnatty
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9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Mugwump

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  • My number of posts means nothing, piscor ergo sum!
Re: Post tx Ultra Sound or Fibro Scan?
« Reply #2 on: December 14, 2015, 12:40:25 am »
The really good news is that new transponder heads and software for some common machines is on the horizon and you will be able to have both an abdominal ultrasound to see if there are problems and the ability to measure the density of the liver at the same time. One machine is being testing in the hospitals where I live right now and I will request to become one of the test subjects.

My regular doc and the tech that did my last ultrasound are up to speed on what is coming down the pipe in the way of diagnostics. It makes complete sense for those who are at risk of HCC, NASH and other conditions to do both types of diagnostics at the same time. It will save a fair amount of trips to the clinics,  our time and health care dollars which is a good thing :)
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Offline Lynn K

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Re: Post tx Ultra Sound or Fibro Scan?
« Reply #3 on: December 14, 2015, 01:23:57 am »
As I have cirrhosis I will be having abdominal ultrasounds and a blood test called AFP every 6 months to monitor for early signs of liver cancer as people with cirrhosis are at increased risk for HCC.

Haven't discussed with my doctor to see if I will be having occasional fibroscan tests to see if my liver stiffness improves over time now that I am cured. But if my platelets start to return to normal over time that would say my liver is improving it's function.

Do you have cirrhosis? I was diagnosed with cirrhosis in Jan 2008 with liver biopsy.

Good luck on your SVR12 test
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline moma

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  • Posts: 48
Re: Post tx Ultra Sound or Fibro Scan?
« Reply #4 on: December 21, 2015, 08:39:31 am »
Finished Harvoni treatment 7 months ago. Resent ultrasound shows changes in density
of the liver. Never had this before. I thought treatment stopped cirrhosis? Why do you think we would still be at risk of HCC?
Went in for an MRI and couldn't stay in that enclosed tight "cave like" machine for 40 minutes. I was SO out of there. I'm not sure what the next step is. I'm pretty scared of this new finding. Dealing with all the treatments through the years (44 yrs) and now still dealing with liver issues-I don't know if I the mental strength anymore.
moma
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Offline Lynn K

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Re: Post tx Ultra Sound or Fibro Scan?
« Reply #5 on: December 21, 2015, 12:07:12 pm »
Treatment and cure should stop cirrhosis from progressing unless you have additional issues hurting your liver for example fatty liver due to being overweight for people who have that issue can also cause liver damage.

Have in cirrhosis and hep c did place us at risk for HCC  and being cured does greatly reduce that risk but we still must be checked every 6 months for early detection of liver cancer.

I have been having and expect to continue to have abdominal ultrasounds and an AFP blood tests for the rest of my life for this reason.

What was the status of your liver before treatment? Had you already been diagnosed with cirrhosis? I was diagnosed with cirrhosis in Jan 2008. People can continue to live a normal life for many years as long as the try to be kind to their livers and follow up with their doctors.

Wishing you the best
Lynn
« Last Edit: December 21, 2015, 12:11:43 pm by Lynn K »
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline moma

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Re: Post tx Ultra Sound or Fibro Scan?
« Reply #6 on: December 21, 2015, 08:32:18 pm »
Lynn
The doc is setting me up with a quid phase ct of the liver. Lets hope I get through this one. Cirrhosis has been suspected, but I have refused biopsies. It just seems so crazy after this long road I'd have something else happening with the liver. The last ultra sound, 6 months ago, showed nothing. All blood work has been great. It's like the rug has just been pulled out from under me!
Thanks for your expert experience advice. We all know as much if not more than the medical profession about this journey.
Moma   
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Offline Lynn K

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Re: Post tx Ultra Sound or Fibro Scan?
« Reply #7 on: December 21, 2015, 09:09:46 pm »
From my understanding ultrasound is not so much for diagnosing cirrhosis as confirming cirrhosis.

Have you had a fibrosure blood test or a fibroscan test that is similar to a ultrasound but there is a thump produced by the equipment. Those can indicate cirrhosis better than an ultrasound.

I do remember crying a bit in my doctors office when he told me that my last liver biopsy in Dec 2007 came back as F4 cirrhosis so I understand how tough that is to hear. I too had the feeling the rug had been pulled out from under me.

On thing we with cirrhosis often have as an early indication is a lowered platelet count that would be on your CBC blood test. Minimum normal is about 150 mine is around 80 to 90 and I have seen some folks say theirs was as low as 30, 40, or 50. There are other causes of low platelet count but cirrhosis is one cause. So you could take a look at you last CBC and see how your platelet count is doing.

But I am still here even though I have had cirrhosis for 8 years and I am cured of hep c so I say keep you chin up you are not done yet!

Good luck
Lynn
« Last Edit: December 21, 2015, 09:56:49 pm by Lynn K »
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline moma

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  • Posts: 48
Re: Post tx Ultra Sound or Fibro Scan?
« Reply #8 on: December 22, 2015, 11:23:31 pm »
lynn,
It's not the cirrhosis issue that is blowing my mind right now. I'm of course thinking the worst, liver cancer. I did get an appointment tomorrow for a ct. Guess we'll just go from there.
joan
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Offline Lynn K

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Re: Post tx Ultra Sound or Fibro Scan?
« Reply #9 on: December 22, 2015, 11:46:10 pm »
OK I can see why you would be worried but I believe the report would say something about a mass as opposed to a change in density.

Can you post the exact text of you ultrasound report so those with more knowledge of ultrasound terminology than me can help you with the reports findings? Has you doctor said anything about this report looking like an indication of HCC?

How is your AFP test result?

I did find this link:

http://samples.jbpub.com/9780763765583/65583_CH01_5378.pdf

If I am understanding correctly but not an expert by any stretch of imagination I believe a possible tumor or cyst would be a localized area of low density. So I think generalized higher density just goes with the territory of having cirrhosis.

Best of luck with the CT but I am betting you are OK
Lynn
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline moma

  • Member
  • Posts: 48
Re: Post tx Ultra Sound or Fibro Scan?
« Reply #10 on: December 23, 2015, 12:57:00 am »
Lynn,
I'll post tests and doc letter tomorrow. Have paper work in the car so I don't forget to bring it with me tomorrow (just in case) and don't want go outside and get it because it's snowing right now! The link you sent was very helpful, thank you for caring.
Joan
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