What's the best way to detect liver metastases?

Posted by mayberries @mayberries, Feb 1, 2023

Hi, I was just diagnosed with pancreatic NET (17mm) and was told that I should get a surgery to cut it out asap. Did a bit research on the disease and understand there's a high chance of liver metastases for pNET and prognosis can be very different with or without. I've done a 68Ga scan and no spot showed up in the liver. Any other test I need to do to confirm this?

Interested in more discussions like this? Go to the Neuroendocrine Tumors (NETs) Support Group.

Hi @mayberries, welcome. I see that you have recently been diagnosed with pancreatic NET and you will soon have surgery. You may be interested in discussions about pancreatic surgery in the:
- Pancreatic Cancer Support Group https://connect.mayoclinic.org/group/pancreatic-cancer/
Will you be having Whipple surgery?

I can also see that you are someone who does their research and that you want to be sure that you do not have metastatic NETs. I'm glad that the 68Ga scan showed no spred to the liver. I'm tagging fellow NETs members like @cu2 @trivia @sandy23 @caitrina @dbamos1945 @patrick031621 @mkmn @pjsheridan2022 @immmm @gulzar @links and @kim1965, who can share their experiences and how liver metastasis was discovered and which testing or surveillance they had.

But first, mayberries, I wish you all the best with your upcoming surgery.

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@colleenyoung

Hi @mayberries, welcome. I see that you have recently been diagnosed with pancreatic NET and you will soon have surgery. You may be interested in discussions about pancreatic surgery in the:
- Pancreatic Cancer Support Group https://connect.mayoclinic.org/group/pancreatic-cancer/
Will you be having Whipple surgery?

I can also see that you are someone who does their research and that you want to be sure that you do not have metastatic NETs. I'm glad that the 68Ga scan showed no spred to the liver. I'm tagging fellow NETs members like @cu2 @trivia @sandy23 @caitrina @dbamos1945 @patrick031621 @mkmn @pjsheridan2022 @immmm @gulzar @links and @kim1965, who can share their experiences and how liver metastasis was discovered and which testing or surveillance they had.

But first, mayberries, I wish you all the best with your upcoming surgery.

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Thank you Colleen. I was told I will have a distal pancreatic surgery and that it is now a relatively safe operation to have. I've scheduled a MRI with Eovist contract to look for any potential liver mets but my radioncologiest told me 68Ga is the most accurate.

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@mayberries

Thank you Colleen. I was told I will have a distal pancreatic surgery and that it is now a relatively safe operation to have. I've scheduled a MRI with Eovist contract to look for any potential liver mets but my radioncologiest told me 68Ga is the most accurate.

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I've been told MRI with contrast is best way to detect liver matastasis. With PET/CT there can be interference with tracer uptake. I'm diagnosed with advanced metastatic paraganglioma, have had 2 robotic assisted liver debulking surgeries since 2019 in Pasadena by same Dr. and MRI was used prior to both procedures.

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@gsm13161

I've been told MRI with contrast is best way to detect liver matastasis. With PET/CT there can be interference with tracer uptake. I'm diagnosed with advanced metastatic paraganglioma, have had 2 robotic assisted liver debulking surgeries since 2019 in Pasadena by same Dr. and MRI was used prior to both procedures.

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Thanks for your reply. Which contract agent did you use for MRI? Is it Eovist as well?

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Yes, Eovist was the contrast agent.

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Sorry to hear of your condition. If you only have 1 tumor on your liver you may be lucky. I have over a dozen that I’m told are inoperable.
I have Pancreatic insulinoma that has spread to my Liver. My prognosis is terminal. I was diagnosed in March of last year and was told I would not see Thanksgiving. The Cancer I have makes my glucose [sugar] drop so that was a problem at first. Once the chemotherapy started the tumors started started to shrink and my Glucose is now under control and I feel much better, Currently on my 12th round of chemotherapy {6 months} and am run down but still above ground. It should be noted I’m on my 3rd Hospital, the first 2 just wrote me off, so get a second or third opinion if anyone is reading this. But, I have to say that Mayo is next on my list if I have to get a 4th opinion.
The Doctors can be cagey, it’s hard to get a straight answer sometimes but sometimes they don’t know how you will respond to treatment so they really can’t give you a straight answer.
I’m interested on how you make out [everyone] and what treatments you received, my Dr. seems like chemotherapy is the only treatment until I have to buy a shovel. You have to keep it light if you can, cry when know one is looking.

Good luck,

Bob T. [lastround]

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One more thing I just want to note, I had NO symptoms. I had a hernia surgery and he noticed a spot on my liver and sent me in for an MRI and discovered it.

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@gsm13161

Yes, Eovist was the contrast agent.

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MRI with contrast is the only way to go. I’m not sure the name of the contrast I have had, but I’ve had 5. The first 2 were not so good, bad then worse.
The fist one , my liver looked like a steak with mushroom cap on it. The second, you couldn’t see my liver the tumors were so big.
Since I started chemo tumors have shrunk considerably.

Bob T.
Last round

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