Hi, I was waiting for Over a year for nhs Fibroscan so paid to go private. Private scan took 10 readings and gave me a score of 3.94 which I was very happy with. A few days after, the nhs scan appointment came through so I went for this as well as didn’t want to remove myself from the nhs system. I’ve just got the nhs result back and it says it’s 7.5??? How can they be so different? The nhs one only took a reading from one place and was over and done with in under a minute. The scans were done days apart both after fasting and no alcohol involved. I expected them to be a bit different but that is a massive difference. I have sent the nhs scan results to my private consultant for his opinion but it sure I will get an answer unless I pay for another appointment. Anyone else had completely different results? Thank you
Two different Fibroscan results from p... - British Liver Trust
Two different Fibroscan results from private and nhs scans
I too have had different results. I am not sure I trust the fibroscan as they are prone to operator error. I have had 2 that had to be repeated because of invalid study. The last one I had I could tell the tech was not experienced and I had her repeat the test. My KPA went from 7.3 to 6.4. They threw the first test out and said she was hitting my ribs and not my liver. However when she did the second test I know the prob was not in the usualspot they place it. She had it more toward the center of my abdomin and not the sude, so I don’t think that was accurate either. I would call and ask to speak to whoever interpreted the test and ask them to take another look and make sure it was valid. Do you have a copy of your results? If so what was your KPA IQR med? Anything over 30% is most likely an invalid study.
Hi, thank you for your reply. I do not have a copy of the results just the score in a letter. There is no mention anywhere of kpa or iqr the letter just said the result was 7.5 and would probably mean scarring and I should take this as a sign to stop drinking and there was nothing else they could do.
Lola in short yes, if it is in fact 7.5 that is a higher reading than you would like especially up from 3.5 which is more in the normal range, that range depends on how Dr's etc see it. Have you had blood tests ie LFT just to see if your liver is working ok? Carpe Diem is right, sometimes depending on where they take the scans can mean more or less damage, that's why they usually work on an average of 10 scans from different areas of the liver. When i looked at my report some of the areas where high, others much lower, but i also had elevated LFTs so that pointed to proof of damage for me. I would definately take some time off the drink untill you can get to the bottom of your results and that may mean another scan Im afraid otherwise its hard to say which is the real figure. If it was 3.5 and then say 3.8 etc then fine but quite a jump. get the report which should show all the areas where they got the readings..
Thank you. I will try and get the report but they’ve not been very helpful so far so don’t hold out much hope. I have had lfts and my alp was raised to around 160 (Over a year ago) but is now back to normal and my ggt is still raised although only now around 110 down from 200ish so bloods only slightly out, all other bloods within range. Whatever the outcome I am not drinking but to go from fibrosis 0 to level 2 is a big jump from scans days apart! It just makes me question everything and no idea what to rely on! Thank you for your time
Thats positive news on the bloods, It is very confusing indeed, and may require another one for peace of mind, is there any way of finding how how many pulses the NHS did ie 1 v 10. It would seem odd that they did not do a number of them to get an average but cant answer that Im afraid. As i say from my knowledge of how the scan works is that they take a number of scans from different areas and arrive at an average score, i did notice mine differed in various areas. And your right the answer you need is do you take it as being 7.5 or 3.5, quite a difference. Maybe go private again and get a third one, over here you dont need a Drs referral you can just book in, I am going to do the same this week myself as like you I need to check.. At this stage you need to get another opinion.
Variance in fibroscan is not operator error. Whilst it might seem that the NHS only did one reading, in fact they will have taken 10 and then given you the average reading- so you only see 1 number.Your liver does not necessarily scar evenly. Say they take the readings from Area 1 on the first fibroscan. The area they scanned might be less scarred and give a lower reading.
Days later, they scan a different area, Area 2, and this time you get a higher result because this area of the liver is slightly more scarred.
There is no fixed area to scan. You could have lots of scans and get different readings each time. Your liver is a big organ and since there is not a map of it, they can't possibly scan the same area each time.
It is most reliable, so I've been told, for liver damaged by alcohol, because the scarring is even across the whole liver. Scarring is not necessarily as even for different causes, which is why there is a different scale for each cause.
I hope that you can understand my explanation. Bear in mind, they are looking for trends in results and not focusing on single results.
The kPa ( KiloPascals) is just the unit of measurement and irrelevant.
Good luck😷
I think that is a very clear and concise explanation!
Thank you for your reply. I’m guessing from what you’ve said that they both took readings from different areas of the liver hence why they are so different. You’ve also said alcohol damage is even across the whole liver so I’m assuming two such different results would mean it’s not from alcohol damage? It worries me they are so different and another reading may give an even higher result. It’s all very confusing.
Yes, since there is not a set area to scan, so impossible to repeat exactly. I can only say what I've been told with regard to alcohol damage, but have no experience in this area myself. I asked a Consultant about how reliable fibroscans are & they said most reliable for alcohol damage, but more difficult to interpret for my condition( autoimmune).There are other reasons that the readings can vary such as ongoing inflammation, whether you have eaten recently etc.
It can't diagnose the cause of the scarring. They need to know the cause then match the number on the correct scale. So a reading of 5 for instance might mean one level of fibrosis for alcoholic hepatitis, but a different level of fibrosis for fatty liver.
These scans can be confusing, but this is why trends are what concern the docs and not numbers from one day. I have learnt this stuff from asking a lot of questions over a long time frame, but at the beginning it can be difficult to understand what is going on, especially since Docs don't volunteer info, but answer questions that are asked.
Keep asking for clarity, but don't fixate on the numbers. You might find doing a search on this forum helpful, because you can read other peoples' experiences of the fibroscan.
I did want to make it clear in my previous post though that anybody could carry out a fibroscan. It's literally aim probe, click, take reading, repeat 10 times. There is nothing to interpret. The machine does the calculation & that is all there is to it.
You might want to ask if they have a CAP score. I don't know anything about this but it is something to do with measuring fatty liver.
Hope that helps. Good luck🙂
Ok you are right, the scores are an average of 10 readings, you are also right in that like a biopsy ( needle) they may just hit on areas of less scarring or more depending on where they check and other variences ie fasting, alcohol etc etc. The CAP score is how much of the liver is covered in fatty tissue and can range again in stages, but a lot of the population have simple fatty liver so may have a higher CAP score than fibrosis or scarring score, in reality that is the most important one as it shows more of the scarring. Again i am not a Dr but have a lot of experiences in scanning techniques etc. In fact for me I was let go from hospital with an all clear from my liver only to discover significant damage when I did my own research. Scans should also be read in conjunction with other tests ie bloods and LFTs as each on their own cannot tell the whole story, if this all makes sense.
Apart from the CAP score, I am aware of all this. However, I was trying to keep the explanation to what was relevant and dispel the idea that the operator was at fault. It might be worth posting your response to the OP, since they are the one who is concerned. I have been to many talks with Consultants, as well as learning from many Consultants in clinic, but I did feel that clarity on the fibroscan was what was being asked. Hope you have a nice weekend. We're all trying to help each other.
Well done you are perfect in your response, I actually went down the route of training to take the scans. I like this site because it gives educated, non judgmental responses where people just like us can get the support they need, often this is the most important site they can visit. So well done, spot on, keep up the great work.
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