Hepatic falciform ligament Tc-99m-macroaggregated albumin activity on SPECT/CT prior to Yttrium-90 microsphere radioembolization: prophylactic measures to prevent non-target microsphere localization via patent hepatic falciform arteries

Yttrium-90 (Y-90) selective internal radiation therapy (SIRT) is increasingly used to treat inoperable hepatocellular carcinoma. We describe two patients where hepatic falciform ligament Technetium-99m-macroaggregated albumin (Tc-99m-MAA) activity was identified on single photon emission computed to...

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Bibliographic Details
Published in:Annals of nuclear medicine 2011-06, Vol.25 (5), p.365-369
Main Authors: Kao, Yung Hsiang, Tan, Andrew E. H., Khoo, Li Ser, Lo, Richard H. G., Chow, Pierce K. H., Goh, Anthony S. W.
Format: Article
Language:English
Subjects:
Arteries - metabolism
Arteries - radiation effects
Case Report
Embolization, Therapeutic - adverse effects
Humans
Imaging
Ligaments - diagnostic imaging
Liver - abnormalities
Liver - blood supply
Liver - diagnostic imaging
Male
Medicine
Medicine & Public Health
Microspheres
Middle Aged
Nuclear Medicine
Radiation Dosage
Radiology
Technetium Tc 99m Aggregated Albumin
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
Yttrium Radioisotopes - chemistry
Yttrium Radioisotopes - metabolism
Yttrium Radioisotopes - therapeutic use
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Summary:Yttrium-90 (Y-90) selective internal radiation therapy (SIRT) is increasingly used to treat inoperable hepatocellular carcinoma. We describe two patients where hepatic falciform ligament Technetium-99m-macroaggregated albumin (Tc-99m-MAA) activity was identified on single photon emission computed tomography with integrated low-dose CT (SPECT/CT) scan during pre-therapy planning, and the steps taken to prevent radiation dermatitis. The first patient underwent prophylactic coil embolization of the patent hepatic falciform artery; the second patient underwent super-selective infusion of Y-90 resin microspheres to avoid the patent hepatic falciform artery. The incidence of falciform ligament Tc-99m-MAA activity detected on SPECT/CT at our institution is 10%. Tc-99m-MAA SPECT/CT scan provides valuable diagnostic information for treatment planning prior to Y-90 SIRT.
ISSN:0914-7187
1864-6433
DOI:10.1007/s12149-010-0464-9