Biopsy or Fibroscan - Was one or other required for most?
Tess1971 said
Jan 8, 2015
Hi Gator man,
At this point I don't see the point of me doing anything invasive since I have already done treatment. Whatever damage was done to my liver over the years now has a chance to heal. I have bloodwork that is good and no other health issues - take no medications and that is quite good for someone in their 60s. I do have a gastro who has been monitoring me for years as I was not interested in anything that involved interferon and made that clear.
I can already feel a difference in how I feel, even my blood pressure is lower now - ha - what a plus. I do eat VERY healthy also. Only alcohol in my diet for quite a few years was an occasional glass of wine with a holiday dinner, gave up vices re party life in my 40s also. I will be seeing gastro after the 3 month bloodwork and see what he has to say then also. Recovering from the ribavirin has been slower than I like but steady.
Good to hear all the feedback here as I have no where else to acquire that. Thanks to all and continue please.
Gator Man said
Jan 8, 2015
Hi Tess,
I've had two biopsies twelve years apart and went from a F2 to an F4 in the interim. Shortly before I started seeing a hepatologist, my gastroenterologist told me that he would be surprised if I had progressed to cirrhosis based on palpating my liver. The biopsy results proved him wrong. I wouldn't have been treated with S/O (1 year ago today start date) if I had not been an advanced F3/F4.
As I have previously mentioned, my hep doctor prefers biopsies over Fibroscans and has stated that he and the referred radiologists are "on the same page" in terms of performing the procedure. Perhaps he will change his mind as Fibroscans become more accepted in the U.S. The next time I see him in March, I am going ask him about doing a Fibroscan to satisfy my own curiosity about possible fibrosis regression. He has previously told me that since we already have an accurate staging, the only thing that matters at this point is if I start developing clinical symptoms of advancing cirrhosis. I don't think he anticipates any future problems and I only need to get HCC ultrasound screenings and continue to abstain from alcohol which I do anyway.
For whatever reason, I've never worried too much about medical procedures, even invasive ones, so long as I had faith that the doctors and technicians knew what they were doing. I had a family doctor one time that was going to do a procedure on my eye. After informing me of the potential complications including a slight risk of blindness, he told me that he had never done this procedure before but there is always a first time. Needless to say I was out the door in a flash and calling a qualified ophthalmologist to get an appointment.
-- Edited by Gator Man on Thursday 8th of January 2015 06:17:41 PM
Tess1971 said
Jan 7, 2015
I'm like you rubye..have had hepc for over 40 years. Blood tests always normal. As for biopsy I considered it too invasive for me especially since I felt fine and there is some risk even though small in biopsy. Also whether section they take is true picture of liver, and how accurate the reader of the results. This may have changed these days with advancements, but, was the case at the time
. Feeling fatigue and other manifestations of chronic hepc did not become bothersome and obvious to me until I was older and maintaining a high stress job and busy schedule. Since I considered interferon out of the question I saw no point since the fibrospect showed zero to mild fibrosis and ultra sound was good. Also surgeon who removed my gall bladder said liver appeared normal color etc at time. I watched sovaldi from the beginning through its testing with in mind that if an interferon free treatment was available I would give it a try. Being retired from my high stress job made it easier on me to handle a treatment as well.
-- Edited by Tess1971 on Thursday 8th of January 2015 01:56:58 AM
Rubye said
Jan 7, 2015
All I've ever had is ultrasounds, MRI's, and Fibrosure. I have cirrhosis, for a couple of years now at least, but was always afraid of biopsies and have never even had an endoscopy. If they have to cut or insert, other than a needle for a blood test, I refuse. I never even seriously entertained the idea of treatment until this last year, and I've had the virus for over 40 years. This is just me and my distrust of doctors.
mallani said
Jan 6, 2015
Hi Tess,
Anyone who has had HepC for more than 20 years should have their liver status assessed. Biopsy is still the most accurate, but many patients and doctors dislike it. Fibroscan is the next best option and is now available in the USA- it has been available in Europe and Australia since about 2007. Blood tests like FibroSure (FibroSpect) can give some indication but are error-prone.
Ultrasound , CT and MRI are only able to diagnose cirrhosis in advanced cases. Before the latest DAA's, virtually all patients had a liver staging procedure. Now we see many who are treated without this vital information.
Matt Chris said
Jan 6, 2015
Hey Tess
Had Fibrospect which is a Blood draw, had Biopsy , and had Fibroscan all pointed to Cirrhotic liver condition.
The Ultrasound and MRI / CT can not determined extent of fibrosis , and yes most Insurance companies will require validation of fibrosis F1, F2, F3, F3 before extending treatments for the longer durations.
matt
pl1952 said
Jan 6, 2015
Hi Tess, I had a fibroscan and subsequently an ultrasound...no biopsy
-- Edited by pl1952 on Tuesday 6th of January 2015 09:30:29 PM
Tig said
Jan 6, 2015
Hi Tess,
I've had multiple biopsies over the years, along with endoscopies and ultrasounds. I believe it's very important to know what your actual fibrosis stage is, whether its determined by biopsy or fibroscan (now). They didn't have or offer me the fibroscan option, but I'm still a fan of the actual biopsy. I think it still offers a more accurate picture of your fibrosis, but do believe the non invasive methods like fibroscan, will eventually replace them as they get better at them.
Insurance has been very demanding regarding the establishment of an accurate fibrosis stage prior to approving many of these protocols, especially Harvoni.
Tig
Tess1971 said
Jan 6, 2015
Have most people on this site had one or the other? Just curious as all I ever had a number of years ago was a ultra sound of liver. Also did some of those fibrospect blood tests back when. I was told that some insurance require them.just curious. I did have blood work regularly for many years though since I had hcv for decades.
Hi Gator man,
At this point I don't see the point of me doing anything invasive since I have already done treatment. Whatever damage was done to my liver over the years now has a chance to heal. I have bloodwork that is good and no other health issues - take no medications and that is quite good for someone in their 60s. I do have a gastro who has been monitoring me for years as I was not interested in anything that involved interferon and made that clear.
I can already feel a difference in how I feel, even my blood pressure is lower now - ha - what a plus. I do eat VERY healthy also. Only alcohol in my diet for quite a few years was an occasional glass of wine with a holiday dinner, gave up vices re party life in my 40s also. I will be seeing gastro after the 3 month bloodwork and see what he has to say then also. Recovering from the ribavirin has been slower than I like but steady.
Good to hear all the feedback here as I have no where else to acquire that. Thanks to all and continue please.
Hi Tess,
I've had two biopsies twelve years apart and went from a F2 to an F4 in the interim. Shortly before I started seeing a hepatologist, my gastroenterologist told me that he would be surprised if I had progressed to cirrhosis based on palpating my liver. The biopsy results proved him wrong. I wouldn't have been treated with S/O (1 year ago today start date) if I had not been an advanced F3/F4.
As I have previously mentioned, my hep doctor prefers biopsies over Fibroscans and has stated that he and the referred radiologists are "on the same page" in terms of performing the procedure. Perhaps he will change his mind as Fibroscans become more accepted in the U.S. The next time I see him in March, I am going ask him about doing a Fibroscan to satisfy my own curiosity about possible fibrosis regression. He has previously told me that since we already have an accurate staging, the only thing that matters at this point is if I start developing clinical symptoms of advancing cirrhosis. I don't think he anticipates any future problems and I only need to get HCC ultrasound screenings and continue to abstain from alcohol which I do anyway.
For whatever reason, I've never worried too much about medical procedures, even invasive ones, so long as I had faith that the doctors and technicians knew what they were doing. I had a family doctor one time that was going to do a procedure on my eye. After informing me of the potential complications including a slight risk of blindness, he told me that he had never done this procedure before but there is always a first time. Needless to say I was out the door in a flash and calling a qualified ophthalmologist to get an appointment.
-- Edited by Gator Man on Thursday 8th of January 2015 06:17:41 PM
I'm like you rubye..have had hepc for over 40 years. Blood tests always normal. As for biopsy I considered it too invasive for me especially since I felt fine and there is some risk even though small in biopsy. Also whether section they take is true picture of liver, and how accurate the reader of the results. This may have changed these days with advancements, but, was the case at the time
. Feeling fatigue and other manifestations of chronic hepc did not become bothersome and obvious to me until I was older and maintaining a high stress job and busy schedule. Since I considered interferon out of the question I saw no point since the fibrospect showed zero to mild fibrosis and ultra sound was good. Also surgeon who removed my gall bladder said liver appeared normal color etc at time. I watched sovaldi from the beginning through its testing with in mind that if an interferon free treatment was available I would give it a try. Being retired from my high stress job made it easier on me to handle a treatment as well.
-- Edited by Tess1971 on Thursday 8th of January 2015 01:56:58 AM
All I've ever had is ultrasounds, MRI's, and Fibrosure. I have cirrhosis, for a couple of years now at least, but was always afraid of biopsies and have never even had an endoscopy. If they have to cut or insert, other than a needle for a blood test, I refuse. I never even seriously entertained the idea of treatment until this last year, and I've had the virus for over 40 years. This is just me and my distrust of doctors.
Hi Tess,
Anyone who has had HepC for more than 20 years should have their liver status assessed. Biopsy is still the most accurate, but many patients and doctors dislike it. Fibroscan is the next best option and is now available in the USA- it has been available in Europe and Australia since about 2007. Blood tests like FibroSure (FibroSpect) can give some indication but are error-prone.
Ultrasound , CT and MRI are only able to diagnose cirrhosis in advanced cases. Before the latest DAA's, virtually all patients had a liver staging procedure. Now we see many who are treated without this vital information.
Hey Tess
Had Fibrospect which is a Blood draw, had Biopsy , and had Fibroscan all pointed to Cirrhotic liver condition.
The Ultrasound and MRI / CT can not determined extent of fibrosis , and yes most Insurance companies will require validation of fibrosis F1, F2, F3, F3 before extending treatments for the longer durations.
matt
Hi Tess, I had a fibroscan and subsequently an ultrasound...no biopsy
-- Edited by pl1952 on Tuesday 6th of January 2015 09:30:29 PM
Hi Tess,
I've had multiple biopsies over the years, along with endoscopies and ultrasounds. I believe it's very important to know what your actual fibrosis stage is, whether its determined by biopsy or fibroscan (now). They didn't have or offer me the fibroscan option, but I'm still a fan of the actual biopsy. I think it still offers a more accurate picture of your fibrosis, but do believe the non invasive methods like fibroscan, will eventually replace them as they get better at them.
Insurance has been very demanding regarding the establishment of an accurate fibrosis stage prior to approving many of these protocols, especially Harvoni.
Tig
Have most people on this site had one or the other? Just curious as all I ever had a number of years ago was a ultra sound of liver. Also did some of those fibrospect blood tests back when. I was told that some insurance require them.just curious. I did have blood work regularly for many years though since I had hcv for decades.