18F-FDG PET/CT Demonstrates Efficacy and Limitations of Hepatic Arterial Infusion Chemotherapy for Treating Colorectal Liver Metastases

Ka      Kit Wong; Kirk      A. Frey; William      D. Ensminger; Anca      M. Avram

Abstract

Hepatic arterial infusion chemotherapy (HAIC) is a palliative therapy option for advanced, unresectable liver metastases from colorectal carcinoma. A woman with multiple colorectal liver metastases was treated with HAIC and systemic chemotherapy. Serial 18F-FDG PET/CT imaging showed local therapeutic response of liver metastases to regional delivery of chemotherapy, but concurrent disease progression at extra-hepatic sites suggesting ineffective systemic chemotherapy. Hepatic disease also progressed in the caudate lobe, likely due to variable regional arterial supply. This case is illustrative of the rationale for HAIC in the management of inoperable hepatic metastases and also demonstrates limitations of this approach.

Keywords: FDG-PET/CT, hepatic arterial infusion chemotherapy, 18F-FDG PET/CT, Colorectal Liver Metastases, liver metastases, colorectal carcinoma, colorectal, neuroendocrine, hepatic neoplasm, liver disease, colorectal carcinoma HAIC, hepatic metastases, systemic chemotherapy, hepatic tissue, floxuridine, 5-fluorouracil, sigmoidectomy, colostomy, Hartmann's, rectum, leucovorin, oxaliplatin, post-radiation fibrosis, CT angiogram, 9m Tc-macroaggregated albumin, hepatic metastatic lesions, metastatic liver disease, solitary metastasis, oligometastases., radionuclide chemo-embolization therapy, celiac axis, common hepatic artery, proper hepatic artery, gastroduodenal artery, right hepatic artery, left hepatic artery, superior mesenteric artery, macroaggregated albumin