Case Author(s): Edward Pinkus,M.D. and Jerold Wallis,M.D. , 2/19/02 . Rating: #D., #Q.
Diagnosis: liver metastasis from colon cancer, evaluation of the hepatic pump.
Brief history:
60 year old woman with a history of colon carcinoma with known liver matastasis.
Images:
hepatic pump perfusin scintigraphy, multiple planar images.
View main image(mc) in a separate image viewer
View second image(ct).
CT of the liver.
Full history/Diagnosis is available below
Diagnosis: liver metastasis from colon cancer, evaluation of the hepatic pump.
Full history:
60 year old woman with a history of colon carcinoma with known liver metastases. The patient is status post hepatic artery pump placement. Evaluation of placement of the hepatic arterial pump, prior to chemotherapy.
Radiopharmaceutical:
2.2 mci Tc-99m MAA
Findings:
Hepatic pump perfusion scintigraphy:
Multiple planar images of the region of the liver were obtained following injection of the hepatic artery pump reservoir.
There is visualization of the liver, with most intense tracer activity in the areas of known liver metastasis. There is no significant extrahepatic flow /perfusion, with good perfusion of both lobes of the liver.
CT of the liver:
Multiple liver metastasis.
Discussion:
The liver is a common site of metastases from cancers from most sites, but particularly from the gastrointestinal tract, since the portal vein drains into the liver. About half of all patients with colorectal cancer develop liver metastases. The response of liver metastases to systemic combination chemotherapy has improved, but the 2-year survival is only 25-30%. Hepatic-arterial infusion of chemotherapy produces higher response rates, with a 2-year survival of 50-60%. In patients who can undergo liver resection followed by hepatic-arterial infusion, the 2-year survival is 85%.
Imaging with Tc-99m MAA is done to verify catheter position placement, and to make sure that the high-concentration chemotherapy infused via the catheter will only go to the liver, and not to other gastrointestinal organs.
Lancet Oncol 2001 Jul;2(7):418-28
Hepatic-arterial chemotherapy.
Kemeny N, Fata F.
Memorial Sloan-Kettering Cancer Center, Gastrointestinal Oncology Service, New York, NY 10021, USA.
ACR Codes and Keywords:
References and General Discussion of Liver-Spleen Scintigraphy (Anatomic field:Gasterointestinal System, Category:Neoplasm, Neoplastic-like condition)
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Case number: ls005
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