Confused about fibroscan and lft

[Wordesley]

A couple of years ago I volunteered for a research programme for NAFLD, then because of covid it was postponed. Had a call a couple of weeks ago to start the process again. I went for a fibroscan 2 weeks ago and was given a result of 328 and 20.3 and was told I would be ideal for their NASH research. A few days later one of the doctors phoned to say that my blood tests showed my liver was functioning fine and it was too good for the programme. Alongside this I have had an intense dull pain under my right ribs which keeps flaring then dying down. I phoned for a GP appointment but have to wait 10days just to speak to a doctor on the phone. I'm concerned she is just going to look at the LFT tests and dismiss me. Is it possible to have a bad fibroscan and good LFT. My other thought is gallstones. Thanks for any observations

[AyrshireK]

Good LFT's in the case of suspected NAFLD should hopefully mean you don't have Non Alcohol Related Steatohepatitis i.e. without elevations of inflammation markers you probably don't have NASH/don't have ongoing hepatitis. However, good LFT's doesn't rule out the possibility you have actual liver damage.

I think you need a referral to a hospital liver specialist.

A CAP score of 328 means you have the most severe level of fatty liver.

Your Controlled Attenuation Parameter (CAP) score is a measurement of fat accumulation in your liver for your doctor to further determine your steatosis grade.

The CAP score ranges from 100 to 400 decibels per meter (dB/m). The table below will help you categorize your CAP scores into a certain steatosis grade and the range of percentage of fatty change.

CAP Score Steatosis Grade % of Liver with Fatty Change

238 to 260 dB/m S1 11% to 33%

260 to 290 dB/m S2 34% to 66%

Higher than 260 dB/m S3 67% or more

A kPa score of 20.3 if you have NAFLD as the underlying cause of liver damage then you need further investigation because it is possible your condition has progressed beyond just NAFLD but this would need doctors to establish for sure.

Push for further investigation as LFT's arn't revealing the full picture here if you have a fibroscan revealing potential other issues.

Katie

Fibroscan score chart with NAFLD bar at the bottom.

[Wordesley in reply to AyrshireK]

Thank you for the swift reply. My surgery are loathe to make referrals, so it's good to know that I would not be being unreasonable to insist. Thanks again

[Awagn445 in reply to AyrshireK]

I had a 22.7 kpa score. Normal liver function test. Had a biopsy. Nothing wrong, no fat no scarring. Get a biopsy. No longer faith in fibroscans.

[Wordesley in reply to Awagn445]

Thank you for this info. I will tell the GP that I want further clarification

[Ruggerhead in reply to Awagn445]

That is really interesting, might be a fault of the technican, ie hit a rib, did you have a couple? I had one done and then thought this cant be right, then asked for it to be done again and another score completely.

[Awagn445 in reply to Ruggerhead]

Had 2. The first was 12.4 then 11 months later 22.7. Either certain techs do not understand how to do their job or internally i had too much belly fat or inflammation from someting else. No clue. Only know i am relieved. Never had any symptoms except for a slight elevation in alt.

[Wordesley in reply to Ruggerhead]

The technician took his time to get the best readings, he said there was not enough space between a couple of ribs so changed position to get 10 complete responses. Thankfully the GP I saw at my surgery has referred me for an ultrasound and new blood tests without any hassle, so just waiting for dates to come through now.

[MINTVCX]

It is possible but not sure if so common. Of course your score 20.3 kpa might be false positive because of obesity or ongoing inflammation but still you can have lower fibrosis F2 for example.

If I were you I would calculate your current Fib-4 score (pretty good to exclude F3-F4). Of course it is only statistics and not accurate diagnosis.

Of course regardless your programme I would consult all with hepatologist. Better to check than ignore your fibroscan even it is overstimated somehow. Good luck.

[Wordesley in reply to MINTVCX]

Thank you. I have my telephone appt on Friday and will give her the results. I am overweight and no doubt her response will be "it's your weight/age". Thanks again

[Hidden]

Hi Wordesley, the other forum members have given you great advice - if you are in the UK and would like to talk over your concerns, our nurse led helpline is open Monday to Friday 10am to 3pm on 0800 652 7330.Trust10

[KC108]

I would suggest you get a copy of that fibroscan report. Check the iqr med. If it is over 30% the test may not be valid.

[Wordesley in reply to KC108]

Hi, I was given a copy of the results on the day - 10 valid measurements, IQR/Med 17%.

[DavyGravy]

Hi Wordesley

There are reasons why a fibroscan reading may show an elevated reading, and the bloods were done to confirm if there is any liver issues. As they seem contradictory, usually I would consider the blood tests as the better indicator because it looks for more flags, but a third test will definitely remove all doubt regardless of the result because it will support either the fibroscan result or the bloods. I'm not a gambling man but I would expect it to confirm the bloods, but I can be wrong (and I am, often) which is why a 3rd test would ease any anxiety or concerns you may have.

Dave

[Wordesley in reply to DavyGravy]

Hi Dave, thanks for the reply. From reading on here I take it that there can be some fibrosis but the liver is still functioning fine, which is what the doctor from the research programme told me. I think probably my main concern is the constant nagging pain under my right ribs which keeps flaring and then dying back. This is why I have a inkling it may be gallstones (I fit the criteria) which may be giving the pain across the liver area as well. I usually flounder when speaking to the GP but this time I've written everything down. Thanks again

[DavyGravy]

I get that discomfort... it usually plays up if i eat sugary or fatty foods. My type 2 diabetes and gallbladder biliary sludge really dislike it if I have an occasional treat. I'm not saying you may have something similar to me, but I know in my case, it is nice tasting but bad food choice that triggers mine

[Wordesley in reply to DavyGravy]

Probably going to be the same for me, my guilty pleasure is cheese

[Ruggerhead]

Ok here is my take on things having bloods every 3 months and repeated fibrascans, and what I have been told. I was released from hospital telling me my liver was fine after bloods, CT, ultrasound, MRI. I then had my own bloods taken and all my liver markers were up, so i opted for the fibrascan that showed severe fatty liver. I did a lot of research and it seems to be there are issues with all tests, scans etc. Even the biopsy can give false results depending on what part of the liver the needle penetrates. Bloods seem to be the weakest part of the puzzle as they are just a snapshot of what is happening that day, especially AST and ALT levels which tell us nothing about function, just potential damage from medications, hep, drink, etc etc.