title: Low infusion rate digital subtraction angiography to predict regional perfusion in hepatic arterial chemotherapy.
abstract: Digital subtraction angiography (DSA) with a low injection rate of contrast (0.5 ml/sec) was studied as a means of predicting the regional perfusion of percutaneously placed catheters for hepatic arterial chemotherapy. In 64 hepatic artery catheter placements, conventional injection rate angiography (3-5 ml/sec) and low infusion rate DSA exams were compared to conventional radionuclide perfusion studies performed with Tc-99m-MAA. In 58 of 64 cases (90.6%) the conventional arteriogram correctly predicted the extent of hepatic perfusion, whereas in 63 of 64 cases (98%), the low flow DSA exam correctly predicted hepatic perfusion. The conventional arteriogram correctly predicted the extent of extrahepatic perfusion in 32 cases (50%), with a sensitivity of 100%, but a specificity of only 39.6%. The DSA exam was correct in defining the presence or absence of extrahepatic perfusion in 57 of 64 cases for a sensitivity of 82% and a specificity of 91%. Despite the quantitative difference between the low infusion rate DSA study and the chemotherapy infusion (10 ml/hr), it is a useful tool to assist in the correct positioning of temporary catheters for hepatic arterial chemotherapy.
authors.affiliation: Department of Radiology, University of Michigan Medical School, Ann Arbor 48109.
authors.forename: J C
authors.initials: JC
authors.lastname: Andrews
authors.forename: D M
authors.initials: DM
authors.lastname: Williams
authors.forename: B
authors.initials: B
authors.lastname: Shapiro
authors.forename: W D
authors.initials: WD
authors.lastname: Ensminger
mesh_terms: D015901:Angiography, Digital Subtraction; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy*; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D000970:Antineoplastic Agents; D013668:Technetium Tc 99m Aggregated Albumin