Figure 7. Unfavorable macrovascular and microvascular arterial conduit in two patients with intrahepatic cholangiocarcinoma.

(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.