My Liver test have been somewhat elevated for many years and they finally decided to do a fibroscan . It was 15 and the Doc said I have Cirrhosis and I need a Biopsy. He then said in can be inaccurate with Fatty Liver which is what they say I have. I don't drink, I eat better than most, organic, greens , fruits etc. Don't take any OTC's and I don't smoke. I go in next week for the Biopsy.
Has anyone had a Fibroscan that was wrong and received better news after the Biopsy?
There are couple of models of Fibroscan. The newer ones measure fat too. it is given as db and scarring(stiffness) as kpa.
Elevated enzymes are never a good thing, its means damage is occurring. They need to get to the bottom of what is causing the damage. It could be what they call Metabolic syndrome.
How have they diagnosed the fatty Liver? what scans did they use?
When you say elevated, by how much?
Inflammation of the Liver(high enzymes) can cause the Fibroscan to give a higher reading than normal, but I wouldn't expect this to exceed 2.5kpa above the correct number. I think the Fibroscan that cant measure fat may also give a higher reading instead, but again I don't think a combination of these is enough to give a false number to tune of 15kpa. There is high chance that you do have some significant scarring and its likely Cirrhosis as your doctor has concluded.
here is a scoring card for the different causes of scarring:
commons.wikimedia.org/wiki/...
sorry I cant tell you better news.
One other thing is the IQR reading, this determines if the readings are accurate, im assuming they were for them to go with the results.
I haven't yet heard of the Fibroscan being proved wrong by a biopsy. There is more chance of the biopsy giving a false negative, it looks at 1/50000th of the Liver, Fibroscan 1/500th.
What a biopsy will yield is some actual liver cells which may be able to help with treatments plans and the cause of the inflammation.
hope you can find some answers soon
My alt and ast have fluctuated per below at the highest they checked for chromatosis. I have had ultrasounds showing fatty liver. The only symptoms I have are that my feet swell during the day (I sit fro 8 hours or more) and it is worse when hot. Diuretic sometimes help. I don't eat packaged food, I eat a lot of greens and I juice. When I juice it goes down. I exercise everyday. with all that I cannot get the 15 lbs off that's needed and this is why they finally chose to do further testing . It also shows my platelets have slowly gone down over the years but are still normal so my primary doc was not worried. They were at 140 in april. Bottom side of normal. I do not think they tested for Hep C but I am not at risk either. The wikipedia chart puts me in stage 4 thats what is freaking me out
NameASTNameALT
Standard range10 - 40 U/LStandard range0 - 36 U/L
6/14/2006226/14/200639
3/15/2010462/18/201091
10/25/2011373/15/2010112
5/19/201313610/25/201173
5/21/2013785/19/2013229
4/7/2014415/21/2013138
4/13/2015504/7/201463
4/30/2015524/13/201590
4/30/201582
Also the score on the screen was 2.5 and a 15. I dont know what that means
I think I can just about make those numbers out. That is some pretty substantial Liver inflammation since 2006. It seems obvious it is more than just simple fatty liver. With nearly a decade of inflammation it adds some weight to the Fibroscan score, im sorry to say. The Platelets dropping to 140k and the swelling ankles also are strongly supporting the emergence of a struggling Liver. So sorry but all this information is bringing up a major red flag for me. Obviously im no doctor, so consult with you doctor now you have some information.
Im baffled as to why they have only given you an ultrasound, at the very least you should have be submitted for a CT or MRI some years ago!
Are you seeing a Liver specialist ? If your not you need to see one asap. Im starting to think that who ever has been dealing with this since 2006 is incompetent !
15kpa is not what we ever want to see, but keep in mind if it confirmed as Cirrhosis, its fairly early and you are compensated at the moment.
You life style appears to be very good, I cant see what else you can do to improve things. It is becoming a matter or urgency that the doctors try and find some answers and a way forward, even if that means considering a transplant in the future.
Hi, when you said LFT''s were elevated, do you know how high and for how long? Also, we're there any symptoms leading up to this finding? I'm seeing specialist next week to get to the bottom of some weird results recently. One set said ggt was 385 and 2 weeks later had ggt of 159.
Good luck with the tests.
My test have gone up and down for 9 years. Never anything they seemed concerned with until now. Still not that high. i will see what the biopsy brings. I just do not have faith in alot of the medical world these days. To many what if's. My doc basically said it looks like you have stage 4 cirrhosis from the scan BUT they can be wrong so lets do biopsy. Also all my reading points to inaccuracy if you have a higher BMI or waist circumference., Which I do all my weight gain is in my stomach. Working on getting it off but that's half the reason for checking as no matter how well I eat and how much I exercise it is not coming off. I am working with a trainer now doing different approaches. I hope you find out what yours is.
My fibroscan was 10.1 I was told to cut sugar and fat from my diet. I lost weight and a few weeks later I had another fibroscan 7.1.
I'm waiting for another appointment to find out results from blood tests and abdomen scan to see if I need a biopsy.
I eating a sensible diet, I 've never drank alcohol, but due to a back problem I've not been able to do a lot of exercise.I now go on a small walk everyday it can be so painful but I can feel the benefit.I also have some uncomfortable/ pain in my right side,it come and goes but it's not as bad as it was.I have found this site to be most helpful.
About a month ago I placed this post on this forum for people who are trying to understand their Fibroscan results:
FIBROSCAN
If you do not understand your Metapvir score or Fibroscan results this link explains it all with regards to your particular liver disease.
click on this link or cut and paste on web browser....
hepatitiscnewdrugresearch.c...
Scroll down to photo where woman is having a scan....
click on 'Fibroscan Results: The Scoring Card....Understanding the Results...'
Hope you find this useful...
Fibrosis, cirrhosis from HCV, NAFLD, HBV, Chronic Cholestatic disease, Alcoholic disease, HCV/HIV co-infected
*To momofbbys.. as far as I know, .the fibroscan is only inaccurate if the person performing the scan is perhaps not trained properly...Also, if you are obese(not suggesting you are...this is in info) then that can affect accuracy...
If you have not already been tested for hepatitis C, B, and HIV now is a good time to request this.
Get second opinion i...another independent Fibroscan privately, if you can afford it is worth while(£100). I did this at a clinic a few months later after altering my diet and the reading was better...just...my NHS liver specialist was fine about this and used the additional information in my patient notes. I have gotten worse again since then as I have HCV and its progession has worsen since I have had it over 30 yrs.(blood transfusion) I await treatment.
The other test I would definitely have if you have not had this already is an ultra scan to actually image the shape, size and surface of your liver...and look for other explanations for your cirrhosis. I have had a few ultra sounds over the years to look for changes in my liver... it is part of my check up by my liver specialist.
A fatty liver can be managed to a degree by your diet...avoid sugary foods and drinks as well as processed foods and snacks high in fat and salt. Look out for iron content in cereals and vitamin pills..try to avoid. You already do not drink alcohol which is good. Anything that puts an extra strain on your already compromised liver would be good practice...and the extra benefits, hopefully, is that you will feel better. There is a load of information on the Hepatitis C Trust website and WebMD (free, just register) regarding your liver.
Good luck if you do decide to have the biopsy.
Hope this helps.
Yes, just under two years ago I had a fibroscan and the result was similar to yours.
My hepatologist told me he was as sure as he could be that I had cirrhosis but that only a biopsy would be determinative
I could not have
Sorry. My earlier reply was inadvertently posted before I had finished it!!
I was going to say that because of a low platelet count I could not have the "normal" biopsy but instead had a transjugular one.
This showed unusual features to my liver but no conclusive evidence of established cirrhosis
My biopsy result was initially referred to Birmingham for a second opinion and my results were then referred to Kings College London where I eventually saw Professor O'Grady; colleagues of his at Kings also looked at my results
The diagnosis I received was that I most likely had NRH ( nodular regenerative hyperplasia) - not good but nowhere near as bad as cirrhosis.
I think the moral is that fibroscan works well for some but is unreliable for others and my hepatologist has said as much.
Get the biopsy done would be my very strong advice.
PWBR
After reading way to much it does point to the inaccuracy of the fibroscan. My doc did say they can be wrong. He isnt very soothing so he freaked me out. My primary calmed me down I will know after next week. I guess thats all you can do is wait.
Did you figure out what yours is?
I have been reading the other posts on this topic. With all due respect to those who appear to have great faith in fibroscans, I can only say that I do not share your faith.
I was worried about the possibility of a false negative from the biopsy but was reassured that with good core samples to analyse, this was unlikely.
Based on my personal experience, IMO a fibroscan can and does offer the possibility of a false positive in just the same way as a biopsy offers the possibility of a false negative.
But don't forget that with a biopsy, actual samples of the liver are viewed by a liver pathologist, something which does not, of course, occur with the non- invasive fibroscan.
PWBR
the Fibroscan is generally accurate, its proven, but obviously under certain conditions. Your supposition that the biopsy is better is not always the case, the biopsy has more chance of a false negative. The biopsy takes a tiny sample 1/50000th where the Firboscan is 1/500th of the Liver. It also depends on what is causing the damage, viral damage can be very sporadic around the Liver. I have read a fair few studys now and the failure of biopsy can be as much as 30% in viral causes and people have been given the wrong treatment path because they thought there was less scarring than what they actually had.
no test is 100% accurate, but Firboscans is around 95%, thats pretty impressive.
I can assure you, Ralph, that I was not at all keen to undergo a liver biopsy, particularly a transjugular one; but my hepatologist persuaded me that the fibroscan could not be relied upon and that the biopsy really was the road to go down.
As mentioned before, I take on board the possibility of a biopsy yielding a false negative and I accept that a biopsy carries that risk but your suggestion that fibroscan is 95% reliable is an unproven assertion.
As a matter of interest , have you ever had a liver biopsy, Ralph?
PWBR
I appreciate this as I am truly hoping mine was wrong! I have Fatty Liver. I have about 15 lbs I need to loose. I hope the fat on my midsection screwed up the test! The one time fat would be positive. I have no symptoms other then my feet swelling but I live in a very hot area 90 degrees in the daytime and I sit all day. When it is cool and I don't sit all day I don't have as much swelling . My labs have been all over the place so I am really hoping other things like exercise, foods something are making that happen as well. I appreciate the info and the support
You are ill informed. by all means people should get a 2nd Fibroscan.
But any doctor will take the whole picture into account of course. The Fibroscan is more accurate in some aspects.
Its is proven at 95%, and not an "unproven assertion" of course this doesn't mean in every test, its if the conditions are right and the operator is good etc, perhaps "up to" 95% Any result of showing scarring its then recommended to get a biopsy.
its highly doubtful a reading of 15kpa would be totally wrong, im sorry to say.
I think, Ralph, that to some extent we may have been talking at cross-purposes
I accept that a fibroscan result at a reading of 15kpa or above is a cause for very serious concern - and I certainly was very concerned when I received such a reading .I was certainly "freaked out" by the result as I had not for one moment prior to learning the result suspected I had any liver problems
My very experienced Bristol hepatologist was also very concerned and was in fact 99% convinced that ( based primarily but not solely on that reading ) I had cirrhosis but he counselled that a liver biopsy was needed in order to be definitive.
My liver biopsy was performed in Bristol by a very experienced interventional radiologist who knew that I wanted him to take sufficient liver samples in order to minimise the risk of a false negative and the results of my liver biopsy were reviewed in Bristol, Birmingham and ultimately at Kings College London and in each case the conclusion was that my liver was not cirrhotic. I was also assured that the possibility of a false negative in my case was minimal
In one of your earlier posts you stated that you had never heard of a fibroscan result being proved wrong by a biopsy.
I suppose it depends on how you define "wrong".
Assuming that the diagnosis I have received of NRH is correct then it surely demonstrates that a fibroscan reading of 15 does not automatically mean that one has cirrhosis.
The initial query posed by momoffboys asked whether anyone had experienced a fibroscan result following which better news was provided by the biopsy result.
All I was saying was "yes" I think my experience shows that can happen.
As I said before, and as I have been assured by my clinicians , having NRH is better than having cirrhosis.
I accept that a low result from a competently and successfully performed fibroscan is so reassuring as to make a liver biopsy unwarranted, and equally a very high fibroscan test result ( coupled with other indicators such as blood work) will normally point to a biopsy as the way forward.
No procedure ( fibroscan, biopsy or anything else) is foolproof and "certain diagnosis" is, I have come to learn, seldom possible. The liver is a complex organ and when if fails to perform as nature intended we can only strive to ascertain why that is.
I sincerely hope that momoffboys gets some reassuring news once further investigations have taken place
PWBR
fair enough
But I think with the information given, the fatty liver on ultrasound and the 10 years of elevated enzymes, 15kpa would point to some scarring.
I sincerely hope it is better than what the Fibroscan is suggesting. Thats what you find in the medical world, "suggestive" and "indicates" you never get a clear answer, its dam frustrating!
By wrong I meant, if its a significantly raised score there is something going on.
Hello you two. I sure hope it's all wrong...even though it's obvious something is off. I have another question, does eating before a fibroscan raise the score? I had eaten about 2 or 2.5 hours before as I was never told not to. I was thinking about that this morning
yes i believe it will, because the Liver will be slightly stiffer if it is processing food. Lets hope that with a combination of some inflammation and the food you true score can be lower.
praying you can get to bottom of this and stop this inflammation and get a recovery going.
Yeah well I just got labs for biopsy and my platelets feel more to 122 
Eating before a fibroscan (especially something sugary, even juice) can significantly raise the Kpa as your liver jumps in to action to break down the food which causes the tissue to stiffen temporarily. It is important to remember with ALL liver tests that they only measure a small section of your liver (mostly a few cm2 whether a biopsy or a fibroscan) at a snapshot of time. what you have eaten recently, over the past few days and many other complex variables will all affect the results which is why drawing definites from any one test alone is always risky. They can be used in conjunction to paint an accurate picture but no one text is conclusive. I know it can be frustrating to be given indefinite answers by your doctor but as this reflects the reality of how tests are used to understand a hugely complicated organ should indicate that your doctor understands the complexity. It is also their responsibility to help you understand your results.
The British Liver Trust publication - Liver Disease Tests Explained can help interpret results and is free to download on the website here: britishlivertrust.org.uk/pu...
It may also be worth remmebering that fruit juice is VERY high in sugar and though it feels healthy can put a heavy burden on the liver as it has to break down a high volume of glucose (fructose operates the same way especially in large quantities) which cannot be used immediately and must be stored as fat. Until your results have been interpreted confidently by a hepatologist (if you have not already been referred to an expert liver doctor keep asking as it is your right) it might be worth cutting down on fruit juice for the moment.
All the best, I hope your results become clear and you are referred to an expert hepatologist as soon as possible.
Glad I found this thread. I am actually in the US California. I have a lot of health issues steaming from my 35 year history with Crohns Disease. and 30 year history with Prednisone. I am a malnourished super fat person. Contradictory terms but very real with the malabsorption and steroid weight gain. I wont go in to all the dx of which there are many. Recently I had a lung CT showed enlarged liver. This diagnosis on top of everything else has pushed me over the cliff My GI is a liver specialist he did a fibroscan but has not told me the number even though I asked twice. But he did say I had cirrhosis. I see him again in 6 weeks I will insist on a number. I am an RN we need data. All of my lab values are normal I am not diabetic, do not have high cholesterol I do have HTN and a super fat stomach. So I am please to hear that a fat stomach could give a higher reading. Good luck to all
Yes, I had a fibroscan which showed 19. The nurse practitioner immediately told me I had fibrosis definitely if not cirrhosis. I was devastated. Had a biopsy which was booked as a matter of urgency. Results of this were clear with no fibrosis or cirrhosis or fat in the liver. Registrar said fibroscan results can be wrong for some reason, I never want one again
May i ask what could have caused this? Are you a larger lady?
No, not large ...9 stone. Signed off by consultant who said biopsy gold standard and not to worry now
Hi ther, my fibroscan was 21 but on another letter later on, it said that the fibroscan was only 75% successful. So I guess the 25% they couldn’t scan could be better. Unless they can do a 100%, they can’t know for sure. A biopsy’s may be a more accurate reading. I did read something on BLT that this can be the case.
I know you posted this message a long time ago and I pray that you are doing really well. I wanted to say that Fibroscan in my case was totally wrong. Biopsy confirmed that my liver is healthy and the readings were very wrong. I believe that the person who did it didn’t know what was doing. The results were 12.6 kPa . Blood test , ultrasound perfect. For other people that is going through the excruciatingly pain of not knowing how accurate this Fibroscan is , please get a biopsy and take more tests. Don’t let someone telling you otherwise until every single blood test , ultrasound and biopsy confirm the same thing. Wish you all the same luck I had .
Ive been an avid preacher to never let a diagnosis be made on a fibroscan alone, they have far to many variables involved and should only be used as a part of a diagnosis when all things point to one direction in unison. Any good doctor should know not to do this. Good post Marty!
Same here. Fibroscan 10.9kpa and biopsy results (a good sample was extracted) showed mild steatosis with no significant fibrosis. Fibroscan only one part of picture and needs complemented by other bloods (platelets, Hyrulonic Acid etc). Never panic on just fibroscan alone
Hi
I was told my fibroscan result had elevated and might have to have a biopsy. However, my so called elevated result was due to an admin error and the radiologist sorted the issue. She had no record of the higher result. Best to check with them as they have accurate results of tests that have been undertaken. I hope this helps. Persist in them double checking.
Please check yourself for HepC, my relation had it for years (non drinker, organic food , non drug taker) without any symptoms
Fibroscan
Dr advised to get a liver biopsy based on fibroscan
My Fibroscan results.
Alarming Fibroscan Results out of the blue. 
Fibroscan overestimation 
