title: A comparison of three transarterial lipiodol-based formulations for hepatocellular carcinoma: in vivo biodistribution study in humans.
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.
authors.affiliation: 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. simonyu@cuhk.edu.hk
authors.forename: Simon Chun Ho
authors.initials: SC
authors.lastname: Yu
authors.forename: Thomas Wai Tong
authors.initials: TW
authors.lastname: Leung
authors.forename: Wan Yee
authors.initials: WY
authors.lastname: Lau
authors.forename: Nelson
authors.initials: N
authors.lastname: Lee
authors.forename: Edwin Pun
authors.initials: EP
authors.lastname: Hui
authors.forename: Winnie
authors.initials: W
authors.lastname: Yeo
authors.forename: Paul Bo San
authors.initials: PB
authors.lastname: Lai
authors.forename: Tony Shu Kam
authors.initials: TS
authors.lastname: Mok
mesh_terms: D000465:Algorithms; D015901:Angiography, Digital Subtraction; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media / Q000737:chemistry / Q000493:pharmacokinetics*; D000431:Ethanol / Q000493:pharmacokinetics; D005781:Gelatin Sponge, Absorbable / Q000493:pharmacokinetics; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D000431:Ethanol