Fibroscan 11.0 K

[Livelife777]

Good Morning everyone.  Asked this question in the Hep C community and just realized it may be better addressed in the Cirrhosis Community.  Wondering if Fibroscan 11.0 K is F3 or F4?
Thanks in advance for any responses.
......Kim

[Livelife777]

Berry.  I read this on another post of mine that you responded to and wanted to thank you for that encouraging outcome that you experienced.  It does show that if you stop the progression in its tracks before to much liver damage is done there is hope for renewal and in your case reversal.  I know relatively speaking for this to occur you must have adhered to a liver friendly lifestyle.  
Thank you for sharing
.....Kim

[ppmguy]

     i had cirrhosis in 2012, and i cleared the virus by end of 2012.

    had fibroscan 3-4-2015.  result  4.5 kpa =  < f 1   NORMAL

    had ultrasound to cross referrence fibroscan 6-14-15

    results;  echogenicity normal,  liver surface smooth

    liver appears NORMAL.
    barry

[fntn]

It would be interesting to see if one of the leading serum-based, fibrosis models, APRI for example, does a decent job wrt indicating the direction that a patient's liver is heading. Not whether it predicts the actual fibrotic stage, only that it does show direction, recuperation vs further deterioration. Any currently active liver insults would likely throw this off of course, but a healthy and relatively stable patient might work.

[Livelife777]

Ralph I read that periodical up, down, sideways, and backwards and could not understand what any of it meant.  It appears the scoring goes up to 10 on the chart, but then talked about a guy that was 11.(My #) Hopefully when MREs become standard procedures they will have some info that laymen can understand.  Don't see my Dr for another 6 months, hopefully!
Stay well
.....Kim

[Livelife777]

Thanks in return Ralph too.
....Kim

[ralph2014]

Hi Kim
the whole paper is here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093963/

To be honest it does seem pretty confusing on some points, there appears to alot of overlapping with the stages, it looks like 1 reading was over 10kpa but was F3. Some in F4 appear to on par with F1, MRE is a good test so im pretty confused.

Perhaps you could have a think about what questions you want to ask at the clinic and write them down for next time.  I kicked myself when I had my meeting with a Hep Doc, after as my anxiety calmed down I thought of a dozen questions.

Hector is right, you don't have a previous scan to compare, you could well have been 13kpa before, try and keep your great attitude.  When I was so terrified I couldnt sleep, your kind and encouraging words helped me so much, thanks xxx

[Livelife777]

Ralph thanks for your help.  It's hard to understand how you can feel so good and have a liver so scarred.  I naively thought this situation would resolve over time.
Having a hard time coming up with data associated with an MRE.  Know it's relatively a new technique with limited locations utilizing the technology. If you should come across any charts or graphs would you mind sharing?  Since I've never had a biopsy so I had high hopes that my liver wasn't truly cirrhotic, until now.  Kinda a contradiction perhaps as I'm also a realist!  
Be well
......Kim

[ralph2014]

sorry my response wasnt good news Kim.  Regeneration is one thing, the breaking down of scar tissue another, I have heard of some getting better results 5 years later

[Livelife777]

Thank you both Hector and Ralph for your responses.  Have to say I'm kinda bummed as I was hoping for some indication of regression but never having an MRE do not have any comparisons.
Hector after reviewing the MRE chart it appears F4 seems to start at 8 and go up to approximately 10 or so.  How is it that I seemed to exceed the maximum # and find myself at 11.  This is somewhat disturbing as I have thought that I was doing so well.  Have you ever seen an MRE indicate a score greater then 11?  Now I understand from your Medscape article that regeneration if any is noted after 36 months or more.  Guess patience is a virtue and perhaps I need more of it but it's discouraging to some degree.  Know this damage to my liver took years to occur and I shouldn't be to surprised that reversal still eludes me.
As always thank you for any replies.
.....Kim

[HectorSF]

Did you have a previous MRE?
IS there an improvement since your last MRE since SVR?
Remember cirrhosis often takes years to reverse itself after achieving SRV. Like liver disease it takes time for the liver to heal.

"Cirrhosis Regression in Hepatitis C Patients With Sustained Virological Response After Antiviral Therapy"
A Meta-analysis
Liver International. 2015;35(1):30-36.

Methods A systematic literature search was performed to identify studies that assessed the association between SVR and cirrhosis regression. The main outcome studied was cirrhosis regression in patients with a SVR as compared with patients without a SVR. Six studies totalling 443 patients were included. Dichotomous outcomes were reported as risk ratios (RR) with 95% confidence intervals (CI).

Conclusions Our results suggest that the majority of patients with cirrhosis who achieve a SVR develop cirrhosis regression. Time between biopsies appears to be an important determinant of the likelihood of cirrhosis regression.

http://www.medscape.com/viewarticle/839337

Using MRE or FibroScan more incremental regression can be detected than using liver biopsy as in the above meta-analysis.
I assume Mayo will periodically monitor your liver with MRE to see the regression of your cirrhosis over time.

While the risk of developing HCC (liver cancer) is greatly reduced there is still a higher risk than in someone who has never had advanced liver disease so be sure to have your doctor follow the AASLD/IDSA "Recommendations for Testing, Managing, and Treating Hepatitis C"

Recommended follow-up for patients who achieve a sustained virologic response (SVR).

"Surveillance for hepatocellular carcinoma with twice-yearly ultrasound testing is recommended for patients with advanced fibrosis (ie, Metavir stage F3 or F4) who achieve an SVR."

Keep living a liver healthy lifestyle and you should see improvement over time. Remember SVR lowers your risk of developing liver cancer and other conditions. Being SVR is a win-win.

Best-
Hector

[Livelife777]

As always Hector thank you for answering my question with a detailed explanation.  I did want to also say that the test was done at Mayo Clinic with an MRE.  Is this equivalent to a Fibroscan and/or more accurate?
If so I would be thrilled since prior to curing my Hep C I was F4.
Thanks for all you do for this community.
......Kim

[HectorSF]

Hi and welcome to the cirrhosis community.

According to the FibroScan Scoring Card 11.0  kPa for hepatitis C infection is equivalent to F2-F3 on the Metavir grading system.

Metavir grading system
F0= no fibrosis
F1= minimal fibrosis
F2= fibrosis has occurred and spread inside the areas of the liver including blood vessels
F3= fibrosis is spreading and connecting to other liver areas that contain fibrosis
F4= cirrhosis or advance liver fibrosis

A person with chronic hepatitis C and a liver stiffness more then 14 kPa has approximately a 90% probability of having cirrhosis, while patients with liver stiffness more then 7 kPa have around an 85% probability of at least significant fibrosis.

However, research has shown Fibroscan accuracy in assessing lower degrees of liver fibrosis (F1-F2) is not as reliable compared to diagnosing advanced fibrosis and cirrhosis (F3/F4)

For more details please see...
http://www.hepatitiscnewdrugresearch.com/fibroscan-results-the-scoring-card.html

Hope this helps.
Hector