Detection of liver metastases by abbreviated MRI protocol in patient with pNET and severe chronic kidney disease

Abstract

The detection of liver metastases at an early stage is crucial to improve patients’ survival. Pancreatic neuroendocrine tumors (pNETs) and their metastases usually present as early and vividly enhancing tumors on contrast enhanced computed tomography (CECT). However, the use of contrast agents is a contraindication in patients with severely impaired kidney function. The incidence of chronic kidney disease (CKD) and malignancies increase with age, making both the treatment and imaging diagnostics a complicated process in an oncological setting among elderly patients. This case report presents the diagnostic path of an elderly patient with a long history of pNET, who developed severe CKD during treatment. The patient was diagnosed with metastatic liver disease in PET/CT and it was confirmed by an abbreviated magnetic resonance imaging (AMRI) protocol without contrast enhancement, while CECT did not show the presence of metastases. AMRI protocols without contrast enhancement can provide sufficient information about the presence of metastatic liver disease in oncological patients with comorbid CKD.

Keywords

• abbreviated mri
• cancer
• pancreatic neuroendocrine tumor
• liver metastases
• metastases surveillance