Skip to main content
SpringerLink
Log in

A Comparison of Three Transarterial Lipiodol-Based Formulations for Hepatocellular Carcinoma: In Vivo Biodistribution Study in Humans

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

This study aimed to evaluate and compare the biodistribution properties of three transarterial Lipiodol-based therapeutic regimens in human hepatocellular carcinoma (HCC). In this prospective study with 13 patients randomly allocated to one of three study groups, each of the patients received transcatheter intra-arterial administration into a solitary HCC with one of three different Lipiodol-based formulations: Lipiodol-ethanol mixture (LEM; Group A), Lipiodol alone (Group B), and Lipiodol and gelatin pledgets (Group C). With the use of radioactive iodine-131-labeled Lipiodol, each group was assessed for (1) pattern of Lipiodol accumulation in the lungs within the first 2 weeks as evaluated by single-photon emission computed tomography and (2) decomposition of Lipiodol formulation within the first 2 weeks as evaluated by radioactivity detected in peripheral blood and urine. The degree of Lipiodol retention in the tumor within the first 4 weeks was evaluated with CT. No statistically significant difference in Lipiodol accumulation in the lungs was detected among the three groups. However, the peak accumulation in the lungs was delayed 3 days for Group A compared to Groups B and C. The degree of Lipiodol retention within the tumor in Group A was significantly greater than that in Groups B and C on day 14 (p = 0.014) and day 28 (p = 0.013). This study showed that LEM is associated with a greater embolic effect in intrahepatic HCC at 4 weeks, and a comparable degree of lung shunting and decomposition rates, compared with ethanol-free Lipiodol formulations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. El-Serag HB, Mason AC (1999) Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 340:745–750

    Article  PubMed  CAS  Google Scholar 

  2. Taylor-Robinson SD, Foster GR, Arora S, et al. (1997) Increase in primary liver cancer in the UK, 1979–94. Lancet 350:1142–1143

    Article  PubMed  CAS  Google Scholar 

  3. Neuhaus P, Jonas S, Bechstein WO, et al. (1999) Liver transplantation for hepatocellular carcinoma. Transpl Proc 31:469–471

    Article  CAS  Google Scholar 

  4. Moe E, Kaspa RT, Sheiner P, et al. (1998) Treatment of hepatocellular carcinoma associated with cirrhosis in the era of liver transplantation. Ann Int Med 129:643–653

    Google Scholar 

  5. Farmer DG, Rosove MH, Shaked A, et al. (1994) Current treatment modalities for hepatocellular carcinoma. Ann Surg 219:236–247

    Article  PubMed  CAS  Google Scholar 

  6. Strong RW (2000) Transplantation for liver and biliary cancer. Sem Surg Oncol 19:189–199

    Article  CAS  Google Scholar 

  7. Hemming AW, Cattral MS, Reed AI, et al. (2001) Liver transplantation for hepatocellular carcinoma. Ann Surg 233:652–659

    Article  PubMed  CAS  Google Scholar 

  8. Yamamoto J, Okuda S, Shimada K, et al. (2001) Treatment strategy for small hepatocellular carcinoma: comparison of long-term results after percutaneous ethanol injection therapy and surgical resection. Hepatology 34:707–713

    Article  PubMed  CAS  Google Scholar 

  9. Livraghi T, Goldberg SN, Lazzaroni S, et al. (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661

    PubMed  CAS  Google Scholar 

  10. Lencioni RA, Allgaier HP, Cioni D, et al. (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection. Radiology 228:235–240

    Article  PubMed  Google Scholar 

  11. Llovet JM, Real MI, Montana X, et al. (2002) Arterial embolisation or chemoembolisation vs symptomatic treatment in patients with unresectable HCC: a randomised controlled trial. Lancet 359:1734–1739

    Article  PubMed  Google Scholar 

  12. Lo CM, Ngan H, Tso WK, et al. (2002) Randomized controlled trial of transarterial Lipiodol chemoembolization for unresectable HCC. Hepatology 35:1164–1171

    Article  PubMed  CAS  Google Scholar 

  13. Cammà C, Schepis F, Orlando A, et al. (2002) Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology 224:47–54

    Article  PubMed  Google Scholar 

  14. Geschwind JFH, Ramsey DE, Douglas EAB, et al. (2003) Chemoembolization of hepatocellular carcinoma: results of a metaanalysis. Am J Clin Oncol 26:344–349

    Article  PubMed  CAS  Google Scholar 

  15. Iwai K, Maeda H, Konno T (1984) Use of oily contrast medium for selective drug targeting to tumor: enhanced therapeutic effect and X-ray image. Cancer Res 44:2115–2121

    PubMed  CAS  Google Scholar 

  16. Nakakuma K, Tashiro S, Hiraoka T, et al. (1985) Hepatocellular carcinoma and metastatic cancer detected by iodized oil. Radiology 154:15–17

    PubMed  CAS  Google Scholar 

  17. Matsui O, Kadoya M, Yoshikawa J, et al. (1993) Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 188:79–83

    PubMed  CAS  Google Scholar 

  18. Park JH, Han JK, Chung JW, et al. (1993) Superselective transcatheter arterial embolization with ethanol and iodized oil for hepatocellular carcinoma. J Vasc Interv Radiol 4:333–339

    Article  PubMed  CAS  Google Scholar 

  19. Ito K, Kusunoki H, Okamoto E, et al. (1994) Intra-arterial alcoholization of advanced hepatocellular carcinoma. Can Chemo Pharmacol 33(Suppl):S42–S47

    Article  Google Scholar 

  20. Cheng Y, Kan Z, Chen C, et al. (2000) Efficacy and safety of preoperative lobar or segmental ablation via transarterial administration of ethiodol and ethanol mixture for treatment of hepatocellular carcinoma:clinical study. World J Surg 24:844–850

    Article  PubMed  CAS  Google Scholar 

  21. Kan Z, Ivancev K, Lunderquist A (1994) Peribiliary plexa-important pathways for shunting of iodized oil and silicon rubber solution from the hepatic artery to the portal vein: an experimental study in rats. Invest Radiol 29:671–676

    Article  PubMed  CAS  Google Scholar 

  22. Kan Z, Wallace S (1997) Transcatheter liver lobar ablation: an experimental trial in an animal model. Eur Radiol 7:1071–1075

    Article  PubMed  CAS  Google Scholar 

  23. Yu SCH, Chan CTP (2006) Transarterial ethanol ablation of cirrhotic liver with Lipiodol-ethanol mixture: safety and efficacy study in rats. Invest Radiol 41(8):609–617

    Article  PubMed  CAS  Google Scholar 

  24. Madsen MT, Park CH, Thakur ML (1988) Dosimetry of iodine-131 ethiodol in the treatment of hepatoma. J Nucl Med 29:1038–1044

    PubMed  CAS  Google Scholar 

  25. Lau WY, Leung WT, Ho SKW, et al. (1999) Adjuvant intra-arterial iodine-131 labeled Lipiodol for resectable hepatocellular carcinoma:a prospective randomized trial. Lancet 353:797–801

    Article  PubMed  CAS  Google Scholar 

  26. Goldstein H (1995) Multilevel statistical models. In: Goldstein H (ed) Kendalls library of statistics 3. Edward Arnold, London, p 874

    Google Scholar 

  27. Ueno K, Miyazono N, Inoue H, et al. (2000) Transcatheter arterial chemoembolization therapy using iodized oil for patients with unresectable hepatocellular carcinoma:evaluation of three kinds of regimens and analysis of prognostic factors. Cancer 88:1574–1581

    Article  PubMed  CAS  Google Scholar 

  28. Ohishi H, Uchida H, Yoshimura H, et al. (1985) Hepatocellular carcinoma detected by iodized oil:use of anticancer agents. Radiology 154:25–29

    PubMed  CAS  Google Scholar 

  29. Vogl TJ, Trapp M, Schroeder H, et al. (2000) Transarterial Chemoembolization for hepatocellular carcinoma: volumetric and morphologic CT criteria for assessment of prognosis and therapeutic success—results from a liver transplantation center. Radiology 214:349–357

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong

    Simon Chun Ho Yu & Nelson Lee

  2. Department of Surgery Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong

    Wan Yee Lau & Paul Bo San Lai

  3. Department of Clinical Oncology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong

    Edwin Pun Hui, Winnie Yeo & Tony Shu Kam Mok

  4. Comprehensive Oncology Centre, Hong Kong Sanatorium Hospital, Shatin, Hong Kong

    Thomas Wai Tong Leung

Authors
  1. Simon Chun Ho Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Wai Tong Leung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wan Yee Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nelson Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edwin Pun Hui
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Winnie Yeo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Paul Bo San Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tony Shu Kam Mok
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simon Chun Ho Yu.

Additional information

This paper was presented at the 2007 CIRSE Congress.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yu, S.C.H., Leung, T.W.T., Lau, W.Y. et al. A Comparison of Three Transarterial Lipiodol-Based Formulations for Hepatocellular Carcinoma: In Vivo Biodistribution Study in Humans. Cardiovasc Intervent Radiol 31, 289–298 (2008). https://doi.org/10.1007/s00270-007-9173-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-007-9173-8

Keywords

Search

Navigation