Radioiodinated fatty acid esters in the management of hepatocellular carcinoma: preliminary findings.

Radioiodinated fatty acid esters, such as lipiodol or ethiodol, are localized in the hypervascular hepatocellular carcinoma (HCC) for a long time following intra-arterial hepatic injection, enabling delivery of high internal radiation to the tumor. The desired radiation can easily be delivered to small HCC, less than 5 cm in diameter, in single or multiple procedures with an 8-week interval. For larger tumors, [131I]lipiodol or [131I]ethiodol in conjunction with chemotherapy emulsion, Ivalon embolization or all three combinations should be considered for maximal clinical results. A strong beta emitter with shorter physical half-life, i.e. 90Y will be more effective in the management of HCC if one can label lipiodol with 90Y.