Supraophthalmic chemotherapy with long tapered catheter: distribution evaluated with intraarterial and intravenous Tc-99m HMPAO.
Supraophthalmic intraarterial chemotherapy has not become popular due to a high incidence of damage to the normal brain and eye. This damage is due to inhomogeneous distribution of the agent secondary to streaming and other flow-related phenomena. To try to minimize this complication, the authors developed a catheter and studied different infusion techniques. A 4.5-F catheter tapered to 2.5 F was used to perform supraophthalmic intraarterial chemotherapy in 26 patients with malignant gliomas. Forty-one of 45 catheterizations were successful. In 17 patients (20 procedures), technetium-99m hexamethyl-propyleneamine oxime (HMPAO) was then injected through the catheter and single photon emission computed tomography was performed to assess the cerebral distribution of the radiopharmaceutical with either a pulsatile or continuous infusion technique. Diffuse and relatively homogeneous distribution of Tc-99m HMPAO was observed with fast pulsatile infusion (10 of 10 procedures); however, inhomogeneous distribution was mostly seen with slow continuous infusion (eight of 10 procedures).
Aoki
S
S
Department of Radiology, Tokyo Metropolitan Komagome Hospital, Japan.
Terada
H
H
Kosuda
S
S
Shitara
N
N
Fujii
H
H
Suzuki
K
K
Kutsukake
Y
Y
Tanaka
J
J
Sasaki
Y
Y
Okubo
T
T
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D002404:Catheterization; D002648:Child; D005910:Glioma / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000008:administration & dosage*; D010091:Oximes / Q000008:administration & dosage*; D011877:Radionuclide Imaging; D019690:Technetium Tc 99m Exametazime
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime