fibroscan reliability

[66766]

Has anyone had a fibroscan for alcoholic cirrhosis that was within normal range only to find

out later you had severe cirrhosis. Interested in results if anyone would share to include

kpa, interquartile range and cap scores.

[Millie09]

Hi 66766.

I have only ever had one fibroscan over a year now, was quite high at 27. Im hoping for another one when i go in May.

[Hidden]

P43ABSTINENCE CAN LEAD TO UNDERESTIMATION OF LIVER FIBROSIS

BY FIBROSCAN IN FORMER HEAVY DRINKERS

Alcohol and Alcoholism. 48(suppl_1):i50–i52, SEP 2013

J.B. Trabut; C. Gagni

Abstract

Introduction. Liver stiffness (LS) measurement by real-time elastography (FibroScan®, EchoSens, Paris,

France) appears as a reliable non-invasive method for fibrosis estimation in heavy drinkers. LS has been

shown to decrease after alcohol withdrawal. It is not known whether this decrease reflects fibrosis

regression.

Methods. We report the cases of two patients who had elevated LS at the time of alcohol withdrawal and

who experienced dramatic decrease of LS after protracted abstinence. Both patients had a liver biopsy

after LS decrease.

Results. The first patient (male, 57 years old) had been drinking 100 g/day of ethanol for more than 15

years when he was hospitalised for alcohol withdrawal. LS was at 21.3 kPa at that time, suggesting

cirrhosis. After 6 and 12 months of alcohol abstinence, LS was measured at 14.0 and 7.3 kPa, respectively.

The second patient (male, 37 years old) had been drinking 150 g/day of ethanol for 20 years when he was

hospitalised for alcohol withdrawal. LS was at 72.0 kPa at that time, suggesting cirrhosis. During the three

following years, he had several periods of continuous abstinence. In the same time, liver stiffness

decreased gradually (37.4, 27.7 and 12.0 kPa) to eventually reach 7.7 kPa. In both patients, a liver biopsy

performed when LS had reached its lowest value (i.e. 7.3 and 7.7 kPa) disclosed established cirrhosis.

Conclusion. Decrease of LS with alcohol abstinence is not equivalent to fibrosis regression. LS

measurement is not reliable to exclude cirrhosis after protracted abstinence in former heavy drinkers.

[Millie09 in reply to Hidden]

So in other words.. .🤔🤔. Lol. Sorry to laff but totally lost.😂😊

[L444 in reply to Millie09]

I know I’m like wth

[Millie09 in reply to L444]

Haha. Glad it isnt just me .

[Darkdog in reply to Millie09]

Lol that’s hilarious.

[Hidden in reply to Millie09]

Old post but, In other words just because the patients kpa score dropped on the fibroscan it didnt mean that their actual fibrosis lessened. Both of these patients had their fibroscan score drop significantly when they stopped drinking. It dropped to below cirrhosis ranges but a biopsy proved that they both had cirrhosis. This is why fibroscans absolutely cannot be trusted to grade fibrosis without other testing to coincide with. Inflamation and other factors can incredibly skew them upwards just the same as removal of the cause of the liver disease can bring the stiffness down incredibly. Good technicians wont even bother to do a fibroscan if the AST is 100 and above anymore.

[Hidden]

I guess there's no single fool proof diagnostic.

Doctors look at the big picture of signs, symptoms, labs and imaging in an attempt to get a proper diagnosis. Even then, they often can't tell how long a patient might remain stable/compensated.

Clean living will buy most of us time. With the non-alcoholic fatty liver epidemic in full swing, a lot of money is going into new treatment and therapies. Hep-C is already being cured. Something I never thought I'd see in my iifetime.

Let's hope they pull a rabbit out of their collective hat soon, and forums like this one will become redundant.

[Avux99]

Really interesting post by Metanoia, which, if I’m interpreting it correctly, means a hardened Liver shown through Fibroscan can become soft again, soft enough to reach almost normal levels once more, through abstinence from Alcohol.

In the situation given , whilst Cirrhosis was proven to be established through biopsy, one would still have to say the fact that the Liver had recovered most of its softened state could only be a good sign that there was still plenty of life left in it and the Liver was still fighting to regenerate & recover?

In conclusion though, it appears that a measurement of Liver stiffness alone would not be enough to rule out Cirrhosis?

[Millie09 in reply to Avux99]

In my understanding as i have f4 end stage fibrosis, a read of 27, once it has reached that stage then the liver cannot improve surely? I dont drink or smoke either.

[Avux99 in reply to Millie09]

Depends on your cause. But in any case, rate of progression from there can certainly be slowed & some would even say, halted.

[Millie09 in reply to Avux99]

It was alcohol related. Diagnosed in 2008. My first fibro scan was feb last year. I have been told (nov last year) i have a lot of fat around the liver yet i eat quite well..until 3 weeks ago where i have upper right quadrant pain and bad waves of nature. Terrible bloating tummy and indigestion at times. Many thanks for your reply back.

[Avux99 in reply to Millie09]

Hi again, yes upper right quad pain could be the Liver but if you are only getting that now after 10 years and presumably your bloods are still all ok, you aren’t doing bad imo.

Not sure why those pains happen. Presumably it’s the livers attempt to regenerate in spaces that it has to find room to expand into due to previous scarring? I get those pains too. That’s my very amateurish take on it anyway!

[Millie09 in reply to Avux99]

I used to get them when i was drinking, but as stated i dont drink any alcohol. Well 10yrs this June, all my al my LTF are within range so whatever im doing has kept me going lol. Yes its definatley in the liver area . Will mention to my hepatologist on 1st may. Many thanks.

[NaffedoffXYZ123 in reply to Millie09]

Hello Millie, what was the hepatologist view on the liver pain?

Thanks.

[briccolone in reply to Avux99]

Yes I’m no expert but I think that’s the correct conclusion