Figure 7: Unfavorable macrovascular and microvascular arterial conduit in two patients with intrahepatic cholangiocarcinoma (IMAGE)
Caption
(A) Single image from proper hepatic arteriogram shows a large hypervascular iCCA (arrowheads). Cone-beam computed tomography of multiple branches (not shown) demonstrated that tumor blood supply would require treatment of non-expendable liver, which could not be adequately attenuated with distal angiosomal truncation representing unfavorable macrovascular conduit. Ablative intent radioembolization was not offered. (B) Cone-beam computed tomography of a different patient shows an iCCA in segment IVA with poor enhancement of tumor (arrowhead). (C) Bremsstrahlung SPECT/CT after radioembolization showed poor uptake of microspheres in the tumor (arrowhead), representing an unfavorable microvascular conduit.
Credit
Correspondence to - Ricardo Paz-Fumagalli - paz.ricardo@mayo.edu
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License
CC BY