How accurate are fibrosure serum test?

[Wolverine69]

CT scan shows hepatomegaly and Steatohepatitis with suspected cirrhosis, liver enzymes normal and fibrosure came back with no fibrosis or activity. I know I have fatty liver but could scan be wrong?

[nash2 Partner]

Well Wolverine you are in the diagnostic muddle. So CT is good at measuring liver size so it is enlarged but it is less effective at measuring steatohepatitis or fibrosis so that is a diagnosis to want to confirm. Liver enzymes are often normal unless a lot of liver cells are dying so it tells you about acute disease but not a lot about chronic or slow progression. That agrees with fibrosure which doesn't indicate advanced disease. You say you know you have fatty liver so all of that is consistent. The radiologist suspects you may be approaching advanced fibrosis so the question you should be asking is how much fibrosis damage do you have? An MRE or FibroScan can tell you more about that without going to a biopsy.

[Wolverine69 in reply to nash2]

Thank you! I have follow up with primary in January he told me to exercise more and plant based diet. Lost 8lbs in 3 weeks!! Should I ask for referral to see specialist? Thank you for all that you do! I have been an ER Nurse for 20 years and most doctors think fatty liver disease is no big thing!!!!

[nash2 Partner in reply to Wolverine69]

Thanks, I can't give you medical advice, but if it was me I'd want to know for sure what my status was. As you apparently know, most people don't find out about their situation until they get a cirrhosis diagnosis. You are doing the right things so absent liver panel changes it probably wouldn't change anything other than make things clear for you. With the enlarged liver your first concern is whether you have elevated portal pressure. Not suggested by the results you have now but something to think about.

[Wolverine69 in reply to nash2]

Thank you

[Bluegirl52 in reply to Wolverine69]

I had the Fibrosure serum test for NASH and it showed cirrhosis. My gastroenterologist said he wasn’t totally comfortable with this test alone so he scheduled me for the Fibroscan. I decided at that point to go to Duke for a second opinion. I then found out out that I should have fasted for the Fibrosure...I didn’t because no one told me. 🤔 Then I looked at the individual tests in the Fibrosure test and found out that some of the results could have been affected by all my heart failure medications. Then Duke informed me that I wasn’t a candidate for a Fibroscan because I have an implanted heart valve and the FDA hasn’t cleared using that scan because of that. Then Duke did a CT specifically looking for steatosis. They said CT scans can detect steatosis if it’s above a certain percentage. So moderate to severe fatty liver would show up. It’s the only test they will do on me except for an ultrasound. They did see that the contrast was backing up from my liver which indicates congestive hepatopathy from my heart failure. Also called cardiac cirrhosis. Sorry for the long comment, but wanted to let you know what Duke told me about the CT scan finding steatosis. It would be nice if I could get other testing to confirm, but I can’t. Hence, I’m doing the fatty liver diet just in case.

[Alterity]

You need to get a specialist. My test are different too. Ultra sounds don't say the same as MRI or the elasticity test. Biopsy says it is NASH for sure. Your GP doesn't know near as much as a specialist. They are all learning. Good Luck.