Abstract
1773
Objectives: Intrahepatic chemotherapy administrated through the hepatic arterial infusion(HAI) pumps has been used in treating unresectable hepatic metastases from colorectal cancer and other unresectable hepatic or biliary tract tumors. Extrahepatic perfusion of the HAI pumps would cause serious complications. The current study was using radionuclide HAI pump(HAIP) perfusion scan to determine the presence of extrahepatic perfusion.
Methods: From November 2000 to December 2005, forty-seven HAIP perfusion scan were performed in 47 patients(male: 25, female:22). Forty-three patients are with hepatic metastases from colorectal cancer, and 4 are hepatocellular carcinoma. Radionuclide HAIP perfusion scan were performed immediately after injecting 3mCi of Tc-99m MAA through the HAIP. Planar images include the liver and lungs were obtained followed by SPECT of abdominal region.
Results: Ten out of 47 scans(21.3%) depicted abnormal perfusion. Severn scans showed extrahepatic abdominal perfusion ( 4:stomach; 2:small bowel; 1: stomach and small bowel). Three scans showed shunting of Tc-99m MAA to the lungs, including one with extrahepatic abdominal perfusion as well. One scan demonstrated dislodged catheter with no hepatic perfusion.
Conclusions: The radionuclide HAIP perfusion scans demonstrated abnormal perfusion in 21.3% of our patients. Unwanted extrahepatic gastrointestinal tract perfusion was depicted in 14.9% of patients. Shunting of administered agent to the lungs was also observed in 6.4% of patients. Thus, radionuclide HAIP perfusion scan should be used to prevent gastrointestinal toxicity before intrahepatic artery chemotherapy via HAIP.
- Society of Nuclear Medicine, Inc.