Hepatic Perfusion Scan

Indications:

predict the distribution of the intra-arterial chemotherapy prior to being infused
Contraindications:

Organ failure do to shunting

Radiopharmaceutical information:
  • Radionuclide: Tc 99m
  • Radiopharmaceutical: MAA
  • Adult dosing: 1-4mCi Tc99m in a volume of 0.2 -1ml of w
  • Pediatric dosing:
  • Method of administration: IV
  • Method of Localization: distributed and trapped by arteriolar-capillary beds of liver
  • Physical Half-life: 4hrs

Patient Preparation:

there is no patient preparation for this study

Equipment Used:
Type of Camera or Probe: Gamma Camera (single headed or dual headed)
Collimator used: LEGP

Acquisition Setup:

Dynamic: View(s)
Matrix:
Time/Frame:
Number of Frames:

Statics: View(s) : Anterior/ Posterior Rt Lateral/ Lt Lateral Ant. Chest View
Matrix: 128 x 128
Total Counts or Duration: 500k

Whole body: View(s)
Matrix:
Scan Speed:
Start/stop points:

SPECT:
180 or 90 degree configuration
Total Rotation: 180 or 360
Starting point:
Matrix
Time/Azmuiths
Number of Azmuiths:

Procedure:
Describe the procedure from verifying the requisition to completing the scan. Include any patient instructions pre- or post- injection/scan, delays between injection and imaging, and any side effects.

Today you will be injected with a small amount of radiation. Your study is to make sure that your catheter is only shunting to the liver.
The radiation dose will not make you feel any different, and you should have no side effects to this study.
We are going to inject Tc 99m MAA right into your catheter.
You will lay on the table supine, and we will begin imaging.


Normal Uptake and common varients:
Insert an image of a normal scan. Describe the normal uptake, and any normal varients visualized.
external image hs018hs178.gif
This image shows a normal hepatic perfusion scan, with no shunting.


Normal Uptake:
greater pattern of uptake in the tumors compared to the normal liver
Small Tumors - - uniform uptake throughout
Large Tumors - - increased uptake at the periphery of the tumor with decreased uptake centrally


Abnormal Uptake and causes:
Insert an image of an abnormal scan. Describe the abnormal uptake, and the cause of the abnormal uptake.

Abnormal uptake: Tc99m MAA is being shunted to other organs besides the liver
stomach
spleen
bowel
possible lungs
possible brain
Artifacts:
Insert an image with an artifact, and explain what the artifact is.

Questions asked in Patient History:
List the common questions asked when taking a patient history for this specific procedure.

Have you had any other related tests? (CT, MR, PET/CT)
Are you pregnant or breastfeeding?

References:
image from:
http://gamma.wustl.edu/hs018te178.html