fibroscan

[Realy]

when given the test what blood levels are calculated if any for the results. And how recent must blood work be to test date ?

[AyrshireK]

You mention fibroscan - that's not calculated with bloods. It is an actual scan. It's similar to an ultrasound but takes 10 readings from across the liver. It determines 2 values - CAP which is the amount of fat built up in the liver and kPa which reveals how dense or fibrous the liver is

Blood test like the ELF test (Enhanced Liver Fibrosis) or the Fibrosure test look at specific blood biomarkers and these aren't calculated using any results from standard blood tests. They are specific blood tests on their own.

Katie

[Realy in reply to AyrshireK]

so no other parameters are used with fibroscan to use to say what level of fibrosis you have. Like recent blood work, other ultrasounds. It just fibroscan and what that results is just it? They don’t look at anything else to come up with the determination of staging of fibrosis? How would they know if inflammation or some other issues affected test?

[AyrshireK in reply to Realy]

You need to know that you don't have ongoing inflammation at the time of the scan because fibroscan has difficulty telling the difference between inflamed liver tissue and actual fibrous tissue so a recent set of bloods along with the scan are important - if inflammation markers in bloods are elevated the kPa score of the scan may be falsly high.

They also need to know what the underlying cause of any liver damage is, there are different cut off scores for the differing liver illnesses. i.e. a kPa of 14 could reveal F4/cirrhosis in someone with Non Alcohol Related Fatty Liver disease but only F3 in Alcohol Related Liver Disease - each liver condition has it's own bar on the fibroscan score chart.

Katie

[Realy in reply to AyrshireK]

ok thanks for the info, so results blood results would have to be looked at to make determination. I may be wrong but I thought I saw something that blood results would have to be within 30 days of test. Also what markers show inflammation Ast/Alt . Any others.

[AyrshireK in reply to Realy]

I think they'd need to be fairly up to date to check for any level of ongoing inflammation.

Some people can have acute rises in inflammation with things like Hep A or Hep E which are usually short lived liver conditions and would score highly on fibroscan at the acute phase but this wouldn't be an accurate fibroscan as a high kPa reading would most likely be the inflammation rather than any fibrosity.

I've no personal experience of fibroscan - hubby has cirrhosis and has never actually had one.

Katie

[Realy in reply to AyrshireK]

thanks for any info, I have heard they are good and bad with results. Also some Drs offices have someone come in with a portable machine so I’m not to sure about the accuracy with them. And as you say inflammation and other factors may give off inaccurate results.

[AyrshireK in reply to Realy]

Eating/drinking before a fibroscan can affect results too.

[Realy in reply to AyrshireK]

as well as BMI, metabolic syndrome, and other things. I had heard a Dr say he didn’t agree with a lot of its measure of accuracy. And that if a Dr uses this alone as your results that’s not the only thing to come up with a true fibrosis steatosis score.

[Kristian in reply to Realy]

Hi Realy,

Just to add a little to Ayrshire K's responses. The interpretation of the results you get given from the fibroscan will be from the doctor that referred you. They will take into account its results and interpret those against any other tests, scans or symptoms you have had to help form that view.

Blood tests will be part of that process but aren't necessary for the scan itself. There isn't a calculation where the doc would say multiply your ALT, for example, with the pressure wave scores from the fibroscan before giving a result.

Fibroscan, is one part of a bigger jigsaw puzzle, that helps steer some form of diagnosis. The same with most other tests it would rarely be an accurate assessment when taken in isolation.

The person carrying out the fibroscan may give you its results, and sometimes a broad interpretation, however, they wouldn't have the full picture for you so wouldn't generally say what the results of that test specifically meant for you. This is why generally when people get a fibroscan they are then scrabbling round and posting on forums for interpretations of the results, lol. However, for a diagnosis to be reasonably accurate it does need that bigger picture view.

[Realy in reply to Kristian]

thanks for the reply, I figured it would be more to it to get results than just the fibroscan itself alone. I hear good and bad about that test so it’s all up to good history blood and other imaging .

[Kristian in reply to Realy]

Yep, pretty much. The results of the test are what they are. But it needs that expert interpretation to form an opinion as to what they actually mean, lol.

[Realy in reply to Kristian]

I wounder how they input other factors to go along with the KPA score and cap score, to come up with a staging of steatosis fibrosis. Since the actual fibroscan doesn’t give images. I guess that why so many people get told they have certain high levels and in after further testing like MRE or biopsy or other advanced blood tests they actually don’t have the damage that was originally diagnosed. 🤷‍♂️

[Kristian in reply to Realy]

Its all just interpretation.

[Realy in reply to Kristian]

how many are interpreted incorrectly I wounder. In this area near me fibroscan is considered a new test. One dr near me questions it’s accuracy. He said slot of the higher readings it give off should be noticed in other tests that are given as in blood work and imaging .

[Kristian in reply to Realy]

Its very rare to be able to see inside the body fully or indeed inside an actual organ. Every scan, every test is just a proxy or snap shot in time and are there to get the best picture possible with the least risk necessary and yes some tests gives better pictures than others for differing things.There will always be uncertainty and yes some misdiagnosis will occur as a result. But in the main they are good enough to give a good enough degree of certainty with which to form an opinion based on all the evidence available with any degree of reasonableness.

[Realy in reply to Kristian]

yup another tool in the tool box, just so many things blood tests, imaging, biopsies, elf test, fib4, apri, fibroscan, Ct , MRE, ultrasound,. Bottom line drs say loose weight get sugar under control and you’ll see your numbers improve. It’s up to the person to do the work and get improvement.

[Kristian in reply to Realy]

Yep, but that will always be the case. Lots of things really can be that simple, whereas others may be a little more complicated.

[Realy in reply to Kristian]

I have fatty liver with some steatosis and fibrosis, dr told me loose weight and get sugar under control. Recent blood work Normal A1c and lost 45 pounds. Recent ultrasound says minimal echogenic liver parenchyma and minimal steatosis. the dr said don’t stop what your doing.