inconclusive elastogrophy

[Healing24]

just recently asked my GI to perform a fibroscan that scored 18.2 kpa but my BMI is 40 and my liver enzymes were normal , fast forward they asked me to get an MRI/MRE to see where we stand and that scored a 4.2kpa (Fibrosis 3-4) but my platelets, albumin, AST /Agt and smooth Liver contour all came back normal , now they want me to do a liver biopsy b/c both tests show abnormalities and are inconclusive…. Now I did a FIB-4 test and it’s (F0-F2) ???? I’m being driven crazy right now

[Ilovejoe]

You are in the same boat that I am. It stinks when you are up inthe air about your health. My liver lab numbers have normal for twoyears(I have PBC too). My last MRE was 2.3 I believe which shows no fibrosis (F0) but the radiologist sees a not so s,other contour and is suggesting cirrhosis. My hepatologist is treating me as so (testing) twice a year. He said if I had a biopsy which he doesn’t recommend, he questioned if they would see cirrhosis. No other advice (exercise, diet,etc.). Going for a second opinion that I waited 6months! I am so sorry you are going through this. I guess you’re not alone. Please let us know after your biopsy. Ihope you healed and the MRE IS CORRECT! You can reverse that score. I did (I think)!

[nash2 Partner]

Staging is a black art still. All of the tests have significant error rates and a high BMI makes it harder. Biopsy also has error but is considered the gold standard. The Fib 4 is the least reliable so I wouldn't give that too much attention. Its real value is being tracked over a period of years to see the trends but the Fibroscan and MRE were generally in agreement that you likely have fibrosis so getting the biopsy isn't unreasonable. The MRE is probably the most accurate in your situation.

[Healing24 in reply to nash2]

Thanks so much, for your thoughts👍