Diagnosis of Pulmonary Embolism on 99mTc-Labeled Macroaggregated Albumin Lung Imaging After Hepatic Arterial Injection for Planning of Radioembolization

A 54-year-old man with hepatocellular carcinoma from alcohol-induced cirrhosis presented with hepatic encephalopathy and refractory ascites related to decompensated liver disease. MRI confirmed disease progression adjacent the site of prior radiofrequency ablation, performed 2 years prior, with associated right hepatic vein tumor thrombus. Tc-99m-labeled macroaggregated albumin lung shunt imaging performed before Y-90 radioembolization identified a left lower lobe wedge-shaped defect, confirmed as pulmonary embolism on CT pulmonary angiography and MRI.

Automated summary

This case report describes a patient with hepatocellular carcinoma and decompensated liver disease, whose disease progressed and resulted in the formation of hepatic abscess and pulmonary embolism detected before treatment.