Anterior abdominal wall uptake in intrahepatic arterial brachytherapy with yttrium-90 sir spheres for hepatic malignancy.

Patients with primary or secondary liver cancer who are not suitable for surgical resection may be treated with selective internal radiation therapy with yttrium-90. This may cause down staging of the tumor to a resectable size in some patients, and in these and other patients may prolong survival. It delivers a high dose of radiation therapy directly to the tumor, thus minimizing exposure to liver sensitive to radiation. Prior scanning with Tc-99m macroaggregated albumin is performed to assess lung shunting and potential extrahepatic deposition, which can cause significant clinical sequelae. Two patients with hepatic malignancy are presented who demonstrated extrahepatic deposition of Tc-99m macroaggregated albumin in the anterior abdominal wall. This is thought to be related to a patent hepatic falciform ligament artery.