Arterial perfusion abnormalities of the liver after hepatic arterial infusion chemotherapy and their correlation with changes in the metastases: evaluation with CT and angiography.

We studied the progress of hepatic arterial perfusion abnormalities in 50 patients receiving long-term arterial infusion chemotherapy for palliative treatment of liver metastases from colorectal cancers and correlated the findings with changes in the metastases. Intraarterially and IV enhanced CT scans and digital subtraction angiograms of the liver were made in all patients before chemotherapy and at 3-month intervals during chemotherapy for 1 year. Before the chemotherapy, all patients had normal hepatic arterial perfusion. Arterial perfusion abnormalities were detected in 30 patients (60%) after 6 months of chemotherapy and in 41 patients (82%) after chemotherapy for 1 year. After 6 months of chemotherapy, 36% of the regressive and 39% of the progressive metastases were located in areas with arterial perfusion abnormalities. After 1 year of chemotherapy, 54% of the regressive and 60% of the progressive metastases were situated in portions of the liver with perfusion abnormalities. Hepatic arterial perfusion abnormalities were found to be progressive during intraarterial infusion chemotherapy. No relationship between arterial perfusion abnormalities and tumor response to chemotherapy could be detected.