Liver MRI gadolinium dye, options.

[HidingUnderARock]

Hi, I am looking for help and advice. Please be gentle with me.

tl;dr I really don't want to have gadolinium dye for a liver MRI. Does anyone know of options, or what they did before gadolinium. I have googled around but not found much. Please don't write if you are angry that I don't want the dye.

After an "absolutely fine" ultrasound in December I got a letter for an urgent CT scan for a "probably benign haemotoma" on my liver.
Then a letter to MRI with gadolinium dye, still for the "probably benign haemotoma" but I wanted to avoid the gadolinium, so instead I had 3 month re-CT scan a couple of weeks ago.

I now have a letter saying "the liver lesion" (singular) has not grown significantly but again they want me to have the MRI with dye.
Someone just rang me to make the appointment, so I asked further because I haven't been able to actually speak to anyone since October.

The dye is required to "answer the question the dr is asking".
What's the question?
Seems there are multiple lesions and I will definitely need surgery...but still not sure what the question is. Also, reading my letter again I wonder if the booking person I spoke to misread that bit.

I'm a bit stressed.

I did read that cutting a cancer would mean no option for a later transplant as it might spread, however I also read that primary liver cancer is extremely rare, so most likely it would already have spread.

OK I'm waffling now.

[hopeonarope]

bumping this for you, op

[HidingUnderARock]

Thanks hopeonarope, I guess the knowledge just isnt out there.

[cardboard33]

The reason they use the dye is to make the scan images clearer, it's essentially a contrast. Before this was discovered they presumably just had poorer quality images to work from rather than using something else, although I don't know for sure. If surgery is required then they will likely want to know exactly where the lesions are to help them target certain areas with more precision and the images obtained using the dye will enable them to do that more effectively. Can I ask why you don't want the dye? Is there a specific reason? It's just an injection that they give you part of the way through the scan, so not painful in anyway beyond the injection itself.

I've only had MRIs on my brain but I've had a lot of them and for me there is an option to not have the dye, which they said they'd do if they needed to scan me whilst I was pregnant. However my consultant also said there would be little point doing it without the dye as the images wouldn't be as clear. If you have any issues with your kidneys I believe they can't give you the dye, so you could explore if they use an alternative then or if the images just aren't as clear.

[ipswichwitch]

Gadolinium will help visualise lesions, and particularly small/newer ones that may well be missed with MRI minus gadolinium. In people with normal renal function, 90% of the gadolinium is excreted from the body by 24 hours post injection.

I know there have been articles popping up regarding research into gadolinium toxicity (it’s bound with a cheating agent to mitigate this), but I tend to view these things with a risk/benefit approach. To my mind, the risk of having the MRI without contrast and potentially missing small lesions is greater than the risk of ill effect from gadolinium.