Hepatic arterial perfusion scintigraphy with 99mTc-MAA for assessment of the hepatic distribution of drugs given by intrahepatic arterial infusion

Twenty-six hepatic arterial perfusion studies using 99mTc-MAA were carried out in 21 patients who underwent hepatic arterial infusion chemotherapy. Inhomogenous perfusion of the liver area supplied by the artery in which the catheter was placed was seen in 11 (42%) of 26 studies, which may be caused by poor mixing of drug with blood at infusion site. To evaluate whether pulsed arterial infusion reduces this phenomenon, 99mTc-MAA was injected with pulsatile infusion in 15 studies. Improved RI distribution of the liver was obtained in 2 of 15 studies with pulsatile infusion. Extrahepatic perfusion was noted in 6 (23%) of 26 studies. Displaced catheter was demonstrated in 3 (12%) of 26 studies. Despite the attempts to correct the arterial abnormalities to ensure homogenous perfusion of the liver in 4 patients with anatomic variants, inhomogenous perfusion was seen in 3 of 4 patients. Hepatic arterial perfusion scintigraphy by 99mTc-MAA has advantages for assessing intrahepatic distribution of the chemotherapeutic agents, in addition to helping to avoid clinical complications caused by extrahepatic perfusion. (author)