title: Warming effect on miriplatin-lipiodol suspension as a chemotherapeutic agent for transarterial chemoembolization for hepatocellular carcinoma: preliminary clinical experience.
abstract: OBJECTIVE
  To retrospectively elucidate the preliminary clinical impact of warmed miriplatin-lipiodol suspension (MPT-LPD) when used as a chemotherapeutic agent for transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Between June and December 2010, TACE was performed with MPT-LPD at room temperature (RT group), and after January 2011, TACE with MPT-LPD warmed to 40 °C was performed (W group). The intraarterial appearance of MPT-LPD immediately after injection through microcatheters at the second-order branches was compared between the two groups with a 5-point grading system. Local therapeutic effects of HCCs as assessed by follow-up computed tomography (CT) obtained 1-3 months after TACE were compared between the groups with a 4-point grading system (TE1-TE4). After April 2011, angiography-assisted CT was routinely performed at TACE, and HCCs that revealed apparent corona enhancement (CE) were retrospectively selected. The degree of concordance between CE and MPT-LPD accumulation as assessed by CT immediately after TACE was assessed with a 3-point grading scale.
  
  
  RESULTS
  MPT-LPD therapy resulted in a smooth and continuous appearance in the W group (grades 1, 2, 3, 4, and 5 were, respectively, 1, 2, 11, 18, and 4) compared to the RT group (4, 0, 1, 2, and 0). The W group (TE1, TE2, TE3, and TE4 were 1, 9, 11, and 12) revealed better local therapeutic effects than the RT group (6, 3, 9, and 0) (p < 0.05). CE was found in 26 HCC nodules, and concordance between CE and MPT-LPD accumulation was observed in 66% (grades 1, 2, and 3 were, respectively, 2, 8, and 19).
  
  
  CONCLUSIONS
  Warmed MPT-LPD flowed more smoothly within vascular lumen, passed through tumor sinusoid of HCC, and had better local therapeutic effects at short-term observation than MPT-LPD at room temperature.
authors.affiliation: Department of Radiology, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
authors.forename: Shinn-ichi
authors.initials: S
authors.lastname: Kora
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Urakawa
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Mitsufuji
authors.forename: Akinobu
authors.initials: A
authors.lastname: Osame
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Higashihara
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015331:Cohort Studies; D018572:Disease-Free Survival; D004998:Ethiodized Oil / Q000627:therapeutic use*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013535:Suspensions; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D013535:Suspensions; C406530:miriplatin; D004998:Ethiodized Oil