Today, your doctor can use a liver biopsy or Fibrosure and Fibroscan to see how healthy your liver is. A needle biopsy used to be the gold standard to determine the stages of cirrhosis. With newer and less invasive methods to see how sick our liver is, we have more options. I had the good old needle biopsy back in the day. It required fasting, hospitalization, and a recovery period. Let’s look at all sides of measuring your liver health.
Liver Biopsy Pros and Cons
Too many errors – The liver is the largest organ in your body. You may have fibrosis on one side, and healthy tissue on the other. It’s just not easy to be exact.
Risk of complications – People with cancer or diabetes may not be good candidates. Also patients who have high blood pressure, or frequent infections may experience discomfort or difficulties. My platelets were low, causing heavy internal bleeding. The biopsy also caused extreme pain and bruising over my stomach, chest, hip, and side. I was a rare case though.
Cost – It’s costly because it requires an outpatient hospital stay at minimum.
Liver Biopsy Pros
If a patient has more than one condition, a biopsy is a valuable tool.
Biopsies are usually required for a patient who is enrolling in a clinical trial.
After a liver transplant, a biopsy may show the cause of potential rejection.
Fibroscan
Fibroscan tests get results by measuring the liver’s stiffness through elastography. These tests have been used for several years now. Doctor’s combine this score with other liver tests to diagnosis liver disease.
FibroTest – FibroSure or Hep Score
FibroSure is easily done using your blood drawn at the lab. It’s pretty accurate look at stages of fibrosis for a patient in the early stages of liver disease.
We’ve seen more and more doctors using the blood labs with a Fibroscan to get specific markers for cirrhosis. When the results used together, the doctor will be able to see a fairly complete picture of what the liver looks like.
Downsides of Fibrosure and Fibroscan
If you have a lot of body fat, or swelling from ascites, your doctor can’t perform this test.
Upsides of a Fibrosure and Fibroscan
With no pain, and taking only minutes to perform the Fibroscan offers a lot of advantages. Using a small ultrasound probe, the wave velocity easily shows the level of stiffness in your liver. This test can also reveal portal vein hypertension. It’s a great measuring tool pre and post Hepatitis C treatment, while managing Hepatitis B, for fatty liver, PBC, and also for post transplant patients.
Cost – Because it requires no hospitalization, it’s easy on the pocketbook.
Liver Biopsy or Fibrosure and Fibroscan ?
Your medical provider will choose which is best. I’ve heard from friends here who have had all of them. As I said, my hepatologist wanted a biopsy, and that helped them decide how to treat me. Later, when they found liver cancer, they choose to get my MELD score by doing the Fibrosure and also measuring the tumor using an ultrasound, cat scan and MRI.
I write these blogs to reassure you that everything is possible. It’s been 10 years since my original diagnosis. If you have any questions or concerns, I’m happy to answer them. I hope you will place your confidence in a good doctor, and let me know how your liver is doing after your tests. All my best, xo Karen
