Fibroscan and Biopsy Showing Wildly Di... - British Liver Trust

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Fibroscan and Biopsy Showing Wildly Different Results

lakewoodliver profile image
26 Replies

Really could use some help!

So I've had yet another Fibroscan with the results showing the same as before, basically Level 0-1 fibrosis. Can someone please help reconcile those results with my recent liver biopsy showing Stage 3-4 advanced liver disease transitioning to cirrhosis?

My hepatologist theorizes that I developed liver disease unbeknownst to me when I was overweight 20+ years ago, which he says would explain the biopsy reading, but that since I lost all the weight years ago the fatty liver condition has disappeared, which accounts for the very low Fibroscan score.

Unless I'm missing something, this doesn't seem to make sense because don't both tests essentially measure the same thing, i.e. liver scarring, which in turn is the cause for liver stiffness?

If so, then how can it be that one test shows nearly no scarring but another shows advanced liver disease? I'm trying to wrap my head around this and feel like either my doctor is way off base or I'm missing some key information about liver disease and/or these tests.

I understand that these methods of measuring liver stiffness are very different, but they surely shouldn't be so divergent and if anything, you would think the Fibroscan to be more accurate in that it's testing stiffness throughout the entire liver when it sends the sound waves, whereas a biopsy is literally just one tiny slice from a huge organ. Moreover, even my doctor has said that the Fibroscan tends to "overstate" the fibrosis, not the other way around.

I am scheduled for an MRI with elastography next month, but this entire thing is making me very nervous because while I'm very fond of my doctor and he surely means well, all he seems able to do is guess at this point, and it's all the not knowing that's making me nervous.

Has anyone ever seen or experienced such a situation as mine?

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lakewoodliver
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26 Replies
lakewoodliver profile image
lakewoodliver

By the way, I only know about my liver disease after my surgeon noticed the scarring while removing my gall bladder a few months ago.

lakewoodliver profile image
lakewoodliver in reply tolakewoodliver

And for reference, the Fibroscan score was 100 CAP and 6.5 KpA.

Monicka profile image
Monicka in reply tolakewoodliver

Hi, this is really strange. So you know about the scarring of liver from the gallbladder removal surgery? Did the doctor performing this take also the liver biopsy samples or was the biopsy a separate act?

lakewoodliver profile image
lakewoodliver in reply toMonicka

No Only made the observation and then referred me to the hepatologist who performed the biopsy.

Monicka profile image
Monicka

May I ask you where are you from?

lakewoodliver profile image
lakewoodliver in reply toMonicka

The US.

Monicka profile image
Monicka

Why did you have your gallblader removed? Did you have any problems?

lakewoodliver profile image
lakewoodliver in reply toMonicka

Mild abdominal pain. Nothing terribly unusual.

SymbolUK profile image
SymbolUK

Hi,

I’ve had the opposite experience, Fibroscan was off the scale (314CAP 70.9KpA), CT scan showed “likely cirrhosis, endoscopy showed “nothing remarkable” and biopsy showed mild fibrosis and mild fatty liver.

I’ve never had any symptoms and LFT and all other blood work is fine, they did a lot.

I’ve asked for a repeat of the Fibroscan, the last one was May.

Since May I have quit alcohol and sugar and diet is much better, excercise 4 times a week and lost nearly 2st in weight.

Don’t know what to think, waiting to see what Fibroscan says, done by a private doctor this time. My consultant was happy to go with the biopsy diagnosis in conjunction with the CT scan and endoscopy results but I’ve insisted on another Fibroscan.

Trying not to worry too much, I had actually come to terms with cirrhosis so it’s a bit of a case of not getting my hopes up.

One of the first things some of my work colleagues said was “oh you can have a drink now!” NO! I will keep doing what I have been and see how good I can get my liver to be.

All the best.

lakewoodliver profile image
lakewoodliver in reply toSymbolUK

I am told the Fibroscan can overestimate which sounds like what you have But it shouldn't underestimate like I'm seeing

SymbolUK profile image
SymbolUK in reply tolakewoodliver

Yes you are right, it’s definitely puzzling to be that way around……

Charmy1233567 profile image
Charmy1233567

I was diagnosed with stage 4 cirrhosis after my fibro scan . They only took 3 measurements instead of at least 5. Well long story short I don’t have cirrhosis, I have systemic lupus and autoimmune thyroid disease. If I were you I would get a second opinion just to be sure. My specialist diagnosed me without even running additional tests so moral of the story. They don’t understand the liver and some doctors make educated guesses not facts. Not saying there is malice behind it because those test results don’t make sense. You gotta be your own advocate, don’t take what a doctor says as fact. Sorry I know that wasn’t the answer you were looking for but hope it gives you some peace of mind. Stay well,

Yellowsydney profile image
Yellowsydney

I had 2 biopsy both came back as inconclusive, consultant said they must have got a good spot both times. Now had a liver transplant, was told my liver was shrunken and extremely cirrhotic, never had an official Fibroscan ( they used me as a guinea pig when they first for machine and nobody knew how to use was according to numbers they got I was dead)

SymbolUK profile image
SymbolUK in reply toYellowsydney

Hi Yellowsydney,

Did you have other symptoms of cirrhosis may I ask?

What lead to the biopsy’s?

lakewoodliver profile image
lakewoodliver in reply toSymbolUK

None only the visual observation of the surgeon

Yellowsydney profile image
Yellowsydney in reply toSymbolUK

Only symptom I ever had was vomiting up blood nothing else, took several years from first vomiting up blood till I was actually given a diagnosis, had portal hypertension and portal vein thrombosis but no symptoms, I never felt ill, took several doctors to convince me I needed a transplant.

SymbolUK profile image
SymbolUK

I found it’s all a bit hit and miss, probable this likely that.

You just have to keep pushing and asking and using resources like this forum where people have been through it all before.

All the best and try not to worry too much, I used to stress a lot about everything but it doesn’t really change anything.

Easier said than done I know.

Monicka profile image
Monicka

Hi! So currently you have two different opinions. First is the surgeon observation and biopsy results that claim you have some kind of liver disease. Second is fibroscan that denies it. I understand this is baffling and stressful.

What I would do is follows: I would try to get another fibroscan preferably at some other place, I would get two ultrasounds also from two different doctors performing it, I would ask my doctor to run a whole set of blood tests. You are also awaiting MRI which is good. All those are not invasive for your body. I would be very careful with yet another biopsy as it’s very invasive. Then, and I view this as the most important part, I would start to adjust my life style significantly. I would stop any things harmful to liver (alcohol, sugar, bad fat, junk food,….) I would start moderate exercise and avoid stress. Those are things that are good for your liver and as soon as you accomodate them in your life your liver starts healing itself whatever the stage or condition it is in. This will allow you to relieve some mental stress of not-knowing.

You know, many of us with moderate liver disease are often not quite sure what stage their liver is exactly in and we often get controversial results. The least we can do is treat our liver as sensitively as we can and hope for the best😉

lakewoodliver profile image
lakewoodliver

Wonderfully appreciative advice. My underlying question is still how these two tests could be so far apart. And on the Fibroscan, I have had four tests done at different locations and the results have been the same. So Fibroscan good, biopsy bad. Really strange.

Monicka profile image
Monicka

Yes! You are right it’s strange and no wonder it’s picking your brains. My reply really doesn’t cover it🙁So how about tracking down the doctor who does the biopsy sample evaluation and present him with this controversy? And have a chat with him? Ask him how many specimen they tested, if all of them were the same level… that sort of question. Though I had no idea whether this is doable in US.

lakewoodliver profile image
lakewoodliver in reply toMonicka

Same doctor for both. Hopefully the upcoming MRI will shed some light on all this!

Monicka profile image
Monicka

Did you have your blood tested for liver functions? ALT, AST, GGT, ALP, bilirubin, albumin, etc…

lakewoodliver profile image
lakewoodliver in reply toMonicka

Yep, all numbers were perfect That was actually the first thing they did.

YvonneM60 profile image
YvonneM60

Hi , I can relate to this . Its bedn going on with me for 3 year .I have chirrosis I don't! Fibro scan reading no chirrosis whilst ct scan does show that my liver is shriveled & quite small ! Now they want me to have a biopsy to ascertain a def diagnosis .

However reading your post doesn't reassure me that a biopsy would be clear !?

It's my Gastroenterologist that is a def No !! Yet the Consultant Hepetologist He say yes ...

I can relate to your frustration and grief not knowing properly what's happening . This has been going on three year now .

Last week I was asked to consider biopsy!?

Have you had any symptoms ? Acities, jaundice ?

My LFT are ok therefore my liver is functioning so not to worry He says !

lakewoodliver profile image
lakewoodliver

Welcome to my world! I've had none of those symptoms and my liver is functioning as well!

Pheebe profile image
Pheebe

I go to a top rated hospital in Canada. They don't do Fibroscans anymore. My liver doctor told me it is not accurate.

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