LET'S COMPARE KILOPASCAL VALUES (FIBROSCAN)

[JazzCat]

Hepatitisresearcher wrote in a thread below:

'Normal' people have a kilopascal value between 4 and 5. I saw some age dependence - kids have a really soft liver - look at calf liver vs beef liver and you can relate that fact.



My kPa score was 4.9 -- so according to hepresearcher, that's "normal."  I'm interested in what kinds of scores others here have based on their Fibroscan tests.

[jmjm530]

I'm not sure if all the trial locations do the same blood tests, but I just figured they might. My guess is that they will use different markers than Fibrosure. I'm sure they will give them to you if you request. What to make of them may be a little less clear, but hey, why not keep them on file.

-- Jim

[copyman]

great article jazzy. i have been saying all along that the "gold standard" biopsy is on its way out. lol, i like the last paragraph about the sharks circling.

[Eisbein]

The biopsy is on it's way out, you can bet on that.
But the hepatologists will beef and balk, you can bet on that too.
There goes $2000 right out of their pockets, and if they can't make at least a little money of us that way, they won't be interested in us at all. They shove our tx mostly into the hands of NP's already, who will be left to look after us.

Ina

[JazzCat]

Recently, Dr. de Ledinghen and colleagues reported that FibroScan detects liver fibrosis and cirrhosis in patients coinfected with HIV and HCV (See Reuters Health report, "Elastography noninvasively assesses hepatic fibrosis in HIV/HVC patients" 2006-02-24 13:16:48.)

In the current study, the researchers investigated the accuracy of the system in detecting cirrhosis in 711 patients with chronic liver disease. Median liver stiffness was significantly higher in patients with cirrhosis (31.1 kilopascals) than in patients with severe fibrosis (18.7 kPa), the authors report.

Based on the stiffness measurement distributions, the researchers established cutoff levels of 7.2 kPa for moderate fibrosis, 12.5 kPa for severe fibrosis, and 17.6 kPa for cirrhosis. "With a cutoff value of 17.6 kPa, negative and positive predictive values for the diagnosis of cirrhosis were 92% and 91%, respectively," the team writes.

For patients with severe fibrosis, the investigators also established cutoffs for the presence of stage 2/3 esophageal varices (27.5 kPa), cirrhosis Child BC (37.5 kPa), hepatocellular carcinoma (53.7 kPa), and esophageal bleeding (62.7 kPa).

[jmjm530]

Jazz: My kPa score was 4.9
-----------------------

Stop bragging :) I have mine buried somewhere but it wasn't calf liver :) In any event, first kPa score (mid treatment) correlated with stage 3, second (5 months post tx) correlated with a low stage 2. If I can dig up my kPa's I'll post.

-- Jim

[JazzCat]

I found this article written last year by Dr. A, titled:

"Staging Liver Fibrosis: Time to Abandon Liver Biopsy?"


Interesting read.


Here's the link to it:

http://archive.mail-list.com/hbv_research/msg08481.html

[JazzCat]

Sorry!  Didn't mean to rub it in.  I just got a bit giddy when I read Hepresearcher's comment about "normal".  I knew that 4.9 was a good score, but I didn't realize it was THAT good!

[jmjm530]

Sounds like whatever you're doing, just keep doing it. I was just kidding of course, I'm very happy with my scores after 35 odd years with the virus, especially what appears to be a downward curve after SVR. After a quick look through a pile of stuff, I think it's just going to be easier to call the doctor's office for my scores. Did they do any special blood tests for you? If so, post the scores if you have them, and if not you might want to find out, although probably just experimental stuff.

[JazzCat]

I'm glad you reminded me about the blood tests they took at Dr. A's office.  I need to contact them for a report on that.  I'm not even sure what tests they ran with my blood.  Do you know?  It is something similar to the Fibrosure?

[Forseegood]

Brilliant point my dear...proctologists make 3 times the dough...

[GoofyDad]

Is that dough or fudge? Could be brownie mix.

If that proctologist <a href="http://www.toycon.com/papo/images/standardbearer1.jpg"> comes at you<a/> with a gold (or blue) standard, time to buy some KY, Baby!  

[Forseegood]

you oughta know, done your Polup Hunt yet? gotta talk to your mom about what happened in your toilet training...must of been interesting...

[GoofyDad]

Actually, I just got home tonight to find the doc sent me this  video of <a href="http://video.google.com/videoplay?docid=-6870899549229826076&q=colonoscopy">my recent bung exploration</a>.

BTW, I'm now looking for a new doctor if you hear of once taking patients......

[GoofyDad]

<a href="http://video.google.com/videoplay?docid=-2416852008863680346&q=colonoscopy">Check this out<a>. Ewwwwwie!

[GoofyDad]

Damn I love this stuff. Hey forseehottubber, <a href="http://video.google.com/videoplay?docid=659618519268873452&q=diarrhea">I think I see a resemblance....</a>

[dancegirl54]

I guess I got a little anxious reading this. My first Fibroscan was a 7 and the researcher said it supported what the biopsy said which was stage 0 grade 0-1. From these posts that doesnt sound like they were telling the truth if a 7 is moderate fibrosis shouldnt my biopsy be higher on the fibrosis scale? My second Fibroscan was 6.7.  
What questions shouls I ask?

[JazzCat]

I understand your concern, but try not to panic.  I suggest you contact the facility that performed the test and ask for further clarification.  Good luck.

[JazzCat]

My IQR is 0.3

Do you know what this means?

[jmjm530]

One of the purposes of collecting data for the FDA trials in the U.S. is to establish correlations between Fibroscan and liver biopsy in large group of *American* patients.

I believe the numbers recently cited here are from European studies, where patients may have different values for a number of reasons including variances in body mass, i.e. Americans are chubbier on the whole :)

Dr A has probably scanned hundreds -- if not more -- American patients by now -- not to mention scans at the other American centers -- I would therefore go with the Fibrosis conversion given to you by Dr A. I can see no reason he would mislead you. If you're still uncomfortable, why don't you just discuss the numbers cited here with DR A for further clarification, however I think they will tell you something similar to above.

Bottom line "6.7" is a real nice scan number on any scale. I forgot my actual number but I know it wasn't that low.

Be well,

-- Jim

[JazzCat]

Jim's comments sound reasonable to me.  Sorry if I created unnecessary worry by posting the cut-off ranges without understanding the broader context for them.

[jmjm530]

Jazz: My IQR is 0.3
----------------------------
Geez, you seemed a lot more intelligent than that?




Just kidding, sorry couldn't help myself :) Presumably you're talking about IQR (interquartile range) in terms of your scan results. IQR is a statistical measurement of range/dispersion and that is about as far as I can go. Guessing -- it seems low so I guess that is good.

Be well and work on those puzzle-solving skills :)

-- Jim

[JazzCat]

Okay, now I'm red-faced.  Statistics wasn't part of my college curriculum when I majored in english literature at a liberal arts college. My reading skills are pretty good, though!  Writing skills are okay, too.  Maybe I can write a "Interquartile Ranges for Dummies" book.

Thanks Jim.

[jmjm530]

I had a problem with statistics as well. Just didn't have the patience or something (and definitely a hard course to "cram" for :))  Same with math, except Physics where I excelled. Not sure why one is easy and the other more difficult. I like your book title btw. It should would get people to pick it up!

-- Jim

[JazzCat]

Oh boy...now I really am red-faced.  I just got your joke!  An IQ of 0.3   Very funny!

I thought you meant you I was demonstrating my lack of intelligence because I didn't know what IQR was.  

Now I really do feel stupid!