Figure 2: A 65 year-old male with metastatic carcinoid tumor received Y-90 microsphere therapy for hepatic metastases. (a) SPECT-CT images of Tc- 99m MAA hepatic perfusion imaging study demonstrated distribution of radiotracer in the right hepatic lobe in the segment IV, V and VI. (b) SPECTCT images of the post-therapy Y-90 imaging demonstrated distribution of radiotracer mostly in the medial aspect of the right lobe in segment IV and V. The differences in tracer distribution involved liver segment VI. (c) In the baseline angiogram, the catheter tip (thick arrow) was positioned in the right hepatic artery, with a small arterial branch nearby (thin arrow). (d) In the 2nd angiogram for Y-90 microsphere infusion, the catheter tip (thick arrow) was positioned more distally as compared to the baseline angiogram (dashed arrow). Perfusion into the small arterial branch is only minimally visualized on the 2nd angiogram.