title: Radiolabeled lipiodol therapy for hepatocellular carcinoma in patients awaiting liver transplantation: pathology of the explant livers and clinical outcome.
abstract: BACKGROUND
  Liver transplantation has become an important curative treatment option for hepatocellular carcinoma (HCC). Criteria for transplantation are strict and, therefore, it is crucial that patients awaiting transplantation do not suffer disease progression. One of the therapeutic options to achieve disease stabilization is neoadjuvant radiolabeled lipiodol treatment. This study aimed to document the dropout rate on the waiting list, the pathological findings on the explant livers, and the long-term outcome of patients treated with radionuclide therapy while awaiting transplantation.
  
  
  METHODS
  Patients eligible for transplantation were treated with 2.1 GBq (131)I-lipiodol or 4.1 GBq (188)Re-HDD/lipiodol by transfemoral catheterization of the hepatic arteries. Tumor necrosis was assessed in the explant livers and follow-up data, such as dropout from the waiting list, recurrence, and survival following transplantation were retrospectively documented.
  
  
  RESULTS
  In 5 of 22 explants, necrosis exceeded 90%. Two patients died while on the waiting list (10%) and 4 of 20 transplanted patients (20%) suffered recurrent disease. The overall recurrence-free survival was 19.7 months (range, 1.75-56), with a mean follow-up of 20.1 months.
  
  
  CONCLUSIONS
  Our data support the evaluation on larger patient numbers to confirm the benefit of radiolabeled lipiodol in candidates for liver transplantation who are suffering from HCC.
authors.affiliation: Division of Nuclear Medicine, Ghent University Hospital, B-9000 Ghent, Belgium. Bieke.Lambert@Ugent.be
authors.forename: Bieke
authors.initials: B
authors.lastname: Lambert
authors.forename: Marleen
authors.initials: M
authors.lastname: Praet
authors.forename: Peter
authors.initials: P
authors.lastname: Vanlangenhove
authors.forename: Roberto
authors.initials: R
authors.lastname: Troisi
authors.forename: Bernard
authors.initials: B
authors.lastname: de Hemptinne
authors.forename: Filip
authors.initials: F
authors.lastname: Gemmel
authors.forename: Hans
authors.initials: H
authors.lastname: Van Vlierberghe
authors.forename: Christophe
authors.initials: C
authors.lastname: Van de Wiele
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D003287:Contrast Media / Q000627:therapeutic use*; D018450:Disease Progression; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D009336:Necrosis; D011868:Radioisotopes / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D011868:Radioisotopes; D007459:Iodized Oil