Table 2.

Technical solutions for eight cases of extrahepatic ^99mTc-MAA deposition

Patient no.	Diagnosis	Vascular anatomy	Coiled arteries	Injection site	Site of extrahepatic deposition	Cause	Solution
1	HCC	Normal	GDA	RHA	Duodenum	Suboptimal coiling GDA with proximal branch	Selective catheterization: more distal in RHA (lobar)
2	Liver metastasis of neuroendocrine pancreatic tumor	Right-hepatic artery originating from SMA: 2 sessions	GDA	RHA	Duodenum/head of pancreas	Injection through glide-catheter, no microcatheter; injection too proximal?	New 99mTC-MAA injection with microcatheter to bifurcation right and median hepatic
				LHA	None
3	CRCLMs + left-sided hemihepatectomy	Trifurcation of the proper hepatic artery	GDA	Proper hepatic artery	Head of pancreas	From proper hepatic three vessels: no extra coiling performed	New 99mTC-MAA injection with selective catheterization in three segmental branches (3 injections)
4	CRCLMs + left-sided hemihepatectomy	Normal	GDA	RHA	Duodenum/ head of pancreas	Small branch to duodenum: too small to coil	New 99mTC-MAA injection: distal from branch
5	CRCLMs	Normal	GDA and right gastric artery	Two sessions: small branch to duodenum
				RHA	Duodenum/ head of pancreas	Small branch to duodenum (accountable for deposition)	Coiling duodenal branch
				LHA
6	ACUP	Normal	GDA and right gastric artery	Proper hepatic artery	Duodenum	Small branch to duodenum: too small to coil	New 99mTC-MAA injection with selective catheterization in two phases: no extra hepatic deposition in either
7	HCC	Normal	GDA	RHA	Head of pancreas	Small branch to head of pancreas: too small to coil	New 99mTC-MAA injection: more distal from branch
8	HCC	Normal, numerous side branches	GDA, cystic artery, & duodenal branch	Proper hepatic artery	Gallbladder/gastric wall	Numerous side branches	No 90Y-RE possible: TACE

CRCLMs colorectal carcinoma liver metastasis, ACUP adenocarcinoma of unknown primary