Hepatic Arterial Infusion Pumps for Malignancy From a Molecular Imaging and Therapy Perspective Book Section


Authors: Mendoza, H. G.; Silveira, P.; Wong, T. Z.; Schöder, H.
Article/Chapter Title: Hepatic Arterial Infusion Pumps for Malignancy From a Molecular Imaging and Therapy Perspective
Abstract: Hepatic arterial infusion pumps (HAIPs) are used for the administration of targeted liver-directed chemotherapy in patients with hepatic metastases from colorectal cancer and intrahepatic cholangiocarcinoma. After HAIP placement, but prior to initiation of liver-directed chemotherapy, imaging is performed to ensure that agents injected into the pump reach the liver parenchyma, and only the liver parenchyma, to avoid damage to other organs. Distribution of chemotherapy can be simulated by the administration of a radiopharmaceutical that is also injected into the HAIP and then gets trapped in the liver. This is performed by the administration of 99mTc-macroaggregated albumin (99mTc-MAA) into the HAIP. The particles of this radiopharmaceutical are larger in diameter than capillaries (range, 10–90 μm; mean, 30–50 μm) and cannot permeate the intrahepatic capillary beds. Therefore, these particles become trapped (for some time, before their breakdown into smaller particles), providing sufficient time for imaging. 99mTc-MAA, therefore, serves as a surrogate marker for chemotherapy delivery. Images of the 99mTc-MAA distribution are acquired with single photon emission computed tomography/computed tomography (SPECT/CT) cameras. This chapter discusses the technique of radiotracer administration, imaging procedure, as well as normal and abnormal findings on SPECT/CT in this setting. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2025.
Keywords: chemotherapy; pathology; molecular imaging; liver; pumps; arterial infusion; cholangiocarcinoma; blood vessels; emission computed tomography; infusion pump; spect/ct; single photon emission computed tomography; particle beams; hepatic arterial infusion pump; liver scintigraphy; macro-aggregated albumins; single photon emission; single photon emission computed tomography/computed tomography; small particles
Book Title: Hepatic Arterial Infusion for Malignancy
ISBN: 978-303174935-3
Publisher: Springer Science + Business Media, LLC  
Date Published: 2025-01-01
Start Page: 87
End Page: 110
Language: English
DOI: 10.1007/978-3-031-74935-3_9
PROVIDER: scopus
DOI/URL:
Notes: Book chapter -- Source: Scopus
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