Fibroscan referrals

[Curtis60]

My wife and I took advantage of a Fibroscan Roadshow this week. Mine was normal but wife has reading of 12.2 kPa and an 1QR 47. The clinician who took my wife’s reading had a great deal of difficulty in getting the right position to get a reading from her liver. It took over 10 minutes!

The results were a real shock as we are both healthy , not obese, exercise daily and eat healthily. We both enjoy a drink but only at weekends.

We spoke to the liver nurse at British Liver Trust and explained that the figure of 1QR 47% was a measure of the accuracy of the Fibroscan reading, which has to 1QR 30% or lower for an accurate reading?? Can we conclude now that my wife’s liver is in the clear??

To frustrate matters further we handed in the standard referral letter from the British Liver Trust, to our GP practice, recommending that further tests/investigations are carried out by our Doctor. Unfortunately we have had no response from the practice since handing it in?

Do I detect some hostility by GPS to third party intervention/diagnostics?

In the meantime what should we do?

[MINTVCX]

Indeed IRQ/median should be below 30% for more accurate result. Above probability of false positive result is higher.

"The final value given was the average of 10 measurements. Criteria for exclusion were an inability to obtain 10 valid measurements and/or an interquartile range/liver stiffness measurement ratio greater than 30%"

As I understand your wife has no indication of liver problem "we are both healthy , not obese, exercise daily and eat healthily". So her fibroscan (performed as screening test as I undestand) is false positive with high probability. Statistically.

However besides above 2 facts it is a good idea to do other tests ordered by hepatologist to rule out serious liver issue (although it is much less likely).

Meanwhile you both should calm down. Alone fibroscan cannot diagnose anything. It might be some indication sometimes but it must be confirmed by other tests.

[kurtymac]

Definitely possible to get a false positive. But given that it did happen, I'd see a specialist, get some LFTs done through blood and another fibroscan. Chances are nothing to worry about as the specificity seemed very low on the accuracy. But a follow up fibroscan and if still high then an MRI/CT scan would be in order. Liver disease is called the silent killer for a reason. Many dont know they have it until it's too late.

[confused71 in reply to kurtymac]

I am one of those people --I didnt have symptoms of anything and after blood tests had a biopsy which showed Nash liver disease ---have to work hard now to slow down progression --I didnt drinlalcohol so never expected a liver issue ---I was alsi diagnosed with a genetic liver disease Alpha Antytrisin deficiency on the same day

[Curtis60]

many thanks for the replies

[BritishLiverTrust1 Partner British Liver Trust]

Dear Curtis60,

Thanks for visiting the roadshow and taking the time to find out more about your liver health. As you probably saw on the day, the Love Your Liver roadshow events are a public awareness raising initiative and because the scans are not performed under clinical conditions, if there is any indication that something could need further checking the team provide a letter to take to your GP for follow-up.

In some cases, it can be difficult to obtain a scan reading and it sounds as though this was the case with your wife. The liver health risk profile that would have been completed before the scan is also a useful indication of any lifestyle-related factors.

We know that the level of GP knowledge regarding liver health can vary but we would recommend continuing to push the surgery to arrange follow-up investigations and a referral if you have any concerns.

Best wishes,

British Liver Trust

[Aotea2012]

Book an appointment with your GP. Ask them to run some blood tests and ask for advise on what next. I wouldn’t read anything into no response to handing in the paper work. GPs are incredibly busy at the moment and it will be an oversight.

[Curtis60]

thanks for the replies. My wife has booked an appointment with her GP to discuss the referral letter.

[Curtis60]

My wife decided to have a repeat Fribroscan at the Chester Road show on Monday. This time the reading was 10.4 kPa with an IQR 12%

Am I correct in concluding this is a more accurate result. We are both very concerned and have appoint to see her GP on 12th October. In the meantime should she avoid alcohol and stop taking her statins?

[AyrshireK in reply to Curtis60]

Alcohol yes providing she isn't a heavy drinker where alcohol withdrawal needs to be carefully managed. Statins no - not until discussed with a doctor because she's obviously on those for a reason. If she has high cholesterol then she is maybe needing to look at diet and exercise as a means of protecting her liver and potentially reducing the level of fibrosis.

Katie

[MINTVCX]

You wrote "stop taking her statins" so as I assemue she has some issue with high cholesterol which can be connected to fatty liver (although not always). So she has some possible factor that can damage her liver.

However more tests are needed so for sure fibroscan result should be confirmed but other tests.