Figure 3.

(A) Recurrent cholangiocarcinoma at the surgical margin of a previous left hemi-hepatectomy, seen on catheter-directed CT hepatic angiogram of the right hepatic artery. RE was performed with the catheter tip in the right hepatic artery, beyond the origin of the gastroduodenal artery. Prophylactic coil embolization of the gastroduodenal artery was not performed at the discretion of the interventional radiologist. (B) Post-RE digital subtraction angiogram with the catheter tip (“C”) position unchanged demonstrates significant vascular stasis and reflux of contrast in the common hepatic, gastroduodenal (“GDA”), and right gastroepiploic (“RGE”) arteries. (C,D,G,H) ⁹⁰Y PET/CT in trans-axial and saggital planes depict in high resolution, non-target activity in a non-random distribution conforming to the anatomy of the gastric greater curve. (E,F,I,J) ⁹⁰Y bremsstrahlung SPECT/CT shows concordant but less intense and diffuse non-target gastric activity.