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    Doctors - Can you tell me about Fibroscan?
    Hopelyn726 posted:
    I have heard from other Heppers that it is better than a liver biopsy and shows so much more. Is this still in the testing phase or is it possible to find a hospital to do it? Do you know if insurances (medicare) would pay for it? It seems so good, not to have the invasiveness of a biopsy. I am so interested in this. Will you please give me you thoughts and ideas on this? And if there is anyway you know how I can find a facility in my area that is doing it? I'm in the Treasure Coast of Fla and very close to South Fla.

    Thank you!!
    oldtiff47 responded:


    Hopelyn726 replied to oldtiff47's response:
    Yes, that's great Tiff, I know you do - I've read your threads on here for years I'm interested in seeing what Dr Palmer has to say. I for one, have had a bx too and I have never experienced so much pain in my entire life and I've given birth (16 hrs of hard labor). In fact I have even said I'd rather die than to go through that kind of pain again. I have found out I can have Versed for the pain so that might help I pray and that's the only reason I will have it done again. But if I can have the Fibroscan for comparison, that'd be awesome!
    moondude replied to Hopelyn726's response:
    I also had a very painful bx , but that was in 1992 . the 2 I have had ( 1 in 2001 1 in 2005 ) were almost pain free. I could not even breathe after the first one it hurt so bad . but I think that was because they took out a piece nearly the size of my little finger. the last two were A breeze and the versed / demerol thing and its blessed amnesia are A gift from the Gods.
    billm57 responded:
    fibroscan measures stiffness of the liver only - many conditions can lead to misdiagnosis of cirrhosis - you may be referring to fibrosure or fibromax testing
    Hopelyn726 replied to billm57's response:
    I had a girl from France contact me on another board and she shared her experience with the FIBROSCAN machine. I have done some research and there is a machine that is used after at least 1 bx is done and they then can compare the two:

    Determination of the extent of progress of hepatic fibrosis is important in clinical practice, where it may reflect the severity of liver disease and predict response to treatment. Percutaneous liver biopsy is the gold standard for grading and staging of liver disease. However, liver biopsy is an invasive procedure with certain unavoidable risks and complications. Several methods have been studied in an attempt to reach a diagnosis of cirrhosis by noninvasive means. Fibroscan? has been designed to quantify liver fibrosis by means of elastography and found to have reasonably good sensitivity and specificity patterns, especially in patients with advanced fibrosis and can be used as an alternative to liver biopsy.
    Hopelyn726 replied to moondude's response:
    My first one was in 2001 with a little demerol (they said, I think it was placebo personally) Good to hear from someone who has had Versed / Demerol! I have been looking for someone who has!! So, was it like being knocked out and not remembering or was it that you were aware but forgetful (no pun intended). Thanks in advance for any info you can give me. Do you have any idea how much of each you were given and was it in your i.v.?

    I am so glad you answered my post, please write me back? Thanks.

    billm57 responded:
    "Liver stiffness measurement by FS (Fibroscan) in patients with acute liver damage overestimate the real stage of fibrosis and may erroneously suggest the presence of liver cirrhosis," the authors report. The stiffness may relate to hepatocyte swelling, cholestasis, or infiltrates of inflammatory cells in the inflamed liver, they suggest.
    "FS results need to be interpreted with caution in patients with acute liver damage and high values of liver stiffness do not predict the simultaneous presence of cirrhosis in these patients," they conclude.

    fibroscan is way too inaccurate - there are far more accurate accepted noninvasive ways to determine liver damage - i gave you the names
    billm57 replied to Hopelyn726's response:
    there are no unavoidable risks with a biopsy - if there were they couldnt do them - over 90% have no complications - many dont even get anesthesia - when done properly they are virtually painless
    billm57 replied to billm57's response:
    as far as i could find - there are only 4 machines in the usa - and its very expensive and not covered by insurance because its not fda approved - ultrasounds c-t scans and mri are covered and just as accurate - fibromax and fibrosure are also and are only a fraction of the price
    moondude replied to Hopelyn726's response:
    it is like all of a sudden you wake up on the other side and do not even know you have been out . They have to do it to me to get me in that darned MRI monstrosity too. I tend to get A wee bit panicky when I am stuck in a tube and cannot move my arms .
    I aint no little fellow and I barely fit . when i had my last bx I even
    looked for the hole to believe they actually did it.
    Trust me if you remember anything it will be very vague and foggy and you will not care.
    Good luck Sam
    Melissa Palmer, MD responded:
    A Fibroscan is a non invasive imaging study that evaluates the degree of liver stiffness, or scaring, known as fibrosis. It does this by determining the speed of sound waves through the liver utilizing a sonogram.
    Similar to blood tests such as Fibrotest and fibrosure, the fibroscan works well in determing the 2 extremes of liver disease - minimal or no scarring from cirrhosis. It does not work so well in evaluating moderately damaged livers and this scan is not yet approved in the U.S. Liver biopsy, while not perfect, still remains the gold standard for determining the stage of liver disease.
    Hopelyn726 replied to Melissa Palmer, MD's response:
    Thank you Dr. Melissa!
    Hopelyn726 replied to moondude's response:
    Sam, thank you , thank you , thank you!!
    peachymarie53 replied to Melissa Palmer, MD's response:
    Dr Palmer,
    I had a Fibroscan last mo. My score was 15.1 and my sucess rate was 63%. My IQR was 3.9. I havent had bx since 2001 which showed stage 2 grade 2, and I was treated sucessfully with Pegasys/Riba and have had SVR since 04'. I started feeling sick, fatigue etc.. hepatologist (also Columbia grad and prof. of hepatology Miami) recommended bx, but then scrubbed last minute due to my really low BP.. Im breast ca patient as well. My MRI showed nothing related to cirrhosis and NO fatty liver dis.. I've had 2 US's. One 5 yrs ago, one last mo. Both showed diffuse fatty liver dis. Could the MRI miss fat in liver, OR mistake it for early cirrhosis, CP A? Im getting NASH Fibrosure next and endoscopy. What do you recommend since bx is out of reach for now?

    thank you in advance.

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