Gastric and Splenic Visualization in Hepatic Artery Perfusion Scintigraphy (HAPS) Secondary to Aberrant Vascular Flow

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A 36-year-old woman with a history of colon cancer and liver metastases was receiving chemotherapy by direct hepatic artery infusion. Suspicion for inappropriate distribution of chemotherapeutic agent arose with development of gastric ulceration. A liver scan with SPECT imaging after infusion of 2.70 mCi of Tc-99m MAA into the hepatic artery catheter demonstrated radiotracer uptake in the liver, spleen, and stomach with a focal area of dense radiotracer uptake in the region of the proximal proper hepatic artery. The findings are consistent with thrombus in the proper hepatic artery and reversal of flow into the splenic and gastroduodenal arteries.

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