Technetium-99m-labeled macroaggregated albumin arteriography for detection of abnormally positioned arterial catheters during infusion chemotherapy.

The arterial catheter position of 500 courses of intra-arterial chemotherapy were monitored by intraarterially introduced Technetium-99m macroaggregated albumin (MAA) particles. Seventeen instances of abnormally positioned catheters (3.4%) were detected by MAA arterial perfusion (MAAAP). All these abnormally positioned catheters were subsequently repositioned resulting in improved tumor perfusion. Plain radiographs obtained in eight instances failed to reveal the abnormally positioned catheter in four, while all eight of these abnormally positioned catheters were detected by MAAAP. Abnormally positioned catheters detected by MAAAP were either immediately after arterial catheter placement (nine instances) or during the course of chemotherapy (eight instances). Of the right instances of displaced catheters during intra-arterial chemotherapy, six instances were accompanied by clinical signs and symptoms suggestive of displaced catheter. Arteriovenous shunting was documented in 5 of 12 hepatic MAAAP studies as evidenced by increased lung activity. When the catheters were displaced in these cases, the lung activity changed: completely disappearing in two instances; decreasing in two instances and remaining unchanged in one.