Related Experiment Videos
Variable patterns of technetium-99m MAA perfusion in the therapeutically embolized liver
J T Hall1, E E Kim, C Charnsangavej
1Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Summary
Hepatic perfusion studies with 99mTc macroaggregate albumin (MAA) can show temporary flow reversal after chemoembolization. Follow-up scans confirm proper catheter position for chemotherapy infusion.
Area of Science:
- Interventional Radiology
- Nuclear Medicine
- Oncology
Background:
- Hepatic arterial chemotherapy infusion (HAI) is used for nonresectable hepatic neoplasms.
- Transcatheter hepatic arterial chemoembolization (HACE) followed by HAI is a treatment strategy.
- 99mTc macroaggregate albumin (MAA) perfusion studies assess arterial catheter position and flow distribution for HAI.
Purpose of the Study:
- To review and correlate arteriograms and MAA perfusion studies in patients undergoing HACE followed by HAI.
- To evaluate the interpretation of MAA perfusion studies, particularly early findings.
- To determine the significance of initial flow patterns in MAA studies for HAI planning.
Main Methods:
- Retrospective review of 15 patients undergoing 21 HACE and HAI procedures.
- Correlation of arteriograms with MAA perfusion studies.
- Analysis of early (within 4 hours) and follow-up (24 hours) MAA scans.
Main Results:
- Early MAA perfusion studies showed flow reversal or reflux in 11 of 21 procedures.
- These initial findings did not necessarily indicate malpositioned catheters.
- Follow-up scans at 24 hours demonstrated restoration of antegrade flow in selected cases, confirming correct catheter placement for HAI.
Conclusions:
- MAA perfusion studies in the context of HACE require careful interpretation.
- Initial flow reversal or reflux on early MAA scans should not be immediately interpreted as catheter malposition.
- Reevaluation with follow-up scans at 24 hours is recommended to confirm antegrade flow and proper catheter positioning for HAI.