AN UNUSUAL PERFUSION PATTERN OF HEPATIC METASTASES

A 47-year-old woman with hepatic metastases from colon adenocarcinoma underwent hepatic arterial perfusion scintigraphy (HAPS) to confirm ca theter placement before initiation of intra-arterial chemotherapy. Aft er Tc-99m macroaggregated albumin (MAA) infusion, two discrete foci of activity were seen within the right upper quadrant, bur the liver par enchyma was not delineated. A Tc-99m albumin colloid scan localized th e foci within the right lobe of the liver and defined the liver parenc hyma not seen on the MAA study. The foci of MAA deposition correlated with ef evidence of hepatic metastases. The unusual pattern of activit y seen on HAPS reflects altered hepatic arterial hemodynamics secondar y to lesion hypervascularity and surgically altered hepatic arterial s upply.