The best test?

[Woofey]

Hi, I’m new here and rather confused. My Alt has been raised these last few months and had a CT scan chest ,abdomen and pelvis all normal so all well I thought. A Fibroscan now is high and so having a USS next week. Which tests are the most reliable? I thought a CT scan would be.

Thanks

[AyrshireK]

Hi Woofey, Fibroscan can report a false high as sadly the scan has it's drawback in that it can't actually tell the difference between actual fibrotic tissue and ongoing liver inflammation - as your ALT is raised this could indicate ongoing liver inflammation and your fibroscan result could well be one of these occasions when it's returned a false high.

I would have thought CT would have been the best of the imaging scans (other than MRI).

Katie

[Woofey in reply to AyrshireK]

Thank you for the reply just as I thought as well doesn’t help the confusion though!!

[velvetunderground]

Most tests have risks of false positives and false negatives. The various tests (blood, imaging, fibroscan etc) look at the liver in different ways and it is entirely possible to have clear imaging scans and elevated liver stiffness. In my case, ultrasound and MRI were fine, but my fibroscan was not. Biopsy confirmed my diagnosis.It is really very difficult to diagnosis liver issues, which is why so many different tests are often undertaken. They need to be considered in the whole, and interpreting the results takes a lot of experience.

I wouldn't dismiss the fibroscan, and it sounds like your doctor isn't. They have a 'feature' that _when_ they give a false reading, then they typically over-read rather than under-read, but they are actually reasonably reliable when performed by someone skilled.

It's obviously important that you understand the reason for your elevated ALT result as this typically indicates the liver is under some stress.

Best of luck, I hope you get some good news soon.

Paul.