Radionuclide localization of intraarterial infusions in head and neck cancer

The therapeutic advantage of intraarterial infusion chemotherapy depends upon delivery of a high drug concentration to the entire tumor bulk with maximum sparing of critical normal tissues. It is clear that successful application of regional therapy must include methodology to assess quantitatively and qualitatively the infused area. 99mTc macroaggregated albumin (Tc-MAA) injected intraarterially is held on first pass in the arteriolar capillary bed, thus providing a map of blood flow distribution. Analog and digital planar images and single photon emission computed tomography (SPECT) after Tc-MAA injections provide static and transaxial tomographic images of head and neck intraarterial infusions. SPECT can be viewed as an endless movie-type display, thus producing a "rotating cimematic display." These radionuclide localization techniques provide a three-dimensional delineation of the tissues infused, including subsurface details not appreciated with dye injection alone. These procedures should be considered an integral part of intraarterial therapy of head and neck cancer.