Nariman Nezami1,2, Johanna Maria Mijntje VAN Breugel3,4,5, Menelaos Konstantinidis6, Julius Chapiro7,3, Lynn Jeanette Savic3,8,9, Milena Anna Miszczuk3, Irvin Rexha3,8, Mingde Lin10, Kelvin Hong11, Christos Georgiades11. 1. Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A.; dr.nezami@gmail.com. 2. Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, U.S.A. 3. Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A. 4. Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands. 5. Medical faculty, Utrecht University, Utrecht, the Netherlands. 6. Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 7. Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A. 8. Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. 9. Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. 10. Visage Imaging, Inc., San Diego, CA, U.S.A. 11. Division of Vascular and Interventional Radiology, Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A.
Abstract
BACKGROUND/AIM: Lipiodol is the key component of conventional trans-arterial chemoembolization. Our aim was to evaluate lipiodol deposition and washout rate after conventional trans-arterial chemoembolization in intrahepatic cholangiocarcinoma and hepatic metastases originating from neuroendocrine tumors and colorectal carcinoma. PATIENTS AND METHODS: This was a retrospective analysis of 44 patients with intrahepatic cholangiocarcinoma and liver metastasis from neuroendocrine tumors or colorectal carcinoma who underwent conventional trans-arterial chemoembolization. Lipiodol volume (cm3) was analyzed on non-contrast computed tomography imaging obtained within 24 h post conventional trans-arterial chemoembolization, and 40-220 days after conventional trans-arterial chemoembolization using volumetric image analysis software. Tumor response was assessed on contrast-enhanced magnetic resonance imaging 1 month after conventional trans-arterial chemoembolization. RESULTS: The washout rate was longer for neuroendocrine tumors compared to colorectal carcinoma, with half-lives of 54.61 days (p<0.00001) and 19.39 days (p<0.001), respectively, with no exponential washout among intrahepatic cholangiocarcinomas (p=0.83). The half-life for lipiodol washout was longer in tumors larger than 300 cm3 compared to smaller tumors (25.43 vs. 22.71 days). Lipiodol wash out half-life was 54.76 days (p<0.01) and 29.45 days (p<0.00001) for tumors with a contrast enhancement burden of 60% or more and less than 60%, respectively. A negative exponential relationship for lipiodol washout was observed in non-responders (p<0.00001). CONCLUSION: Lipiodol washout is a time-dependent process, and occurs faster in colorectal carcinoma tumors, tumors smaller than 300 cm3, tumors with baseline contrast enhancement burden of less than 60%, and non-responding target lesions.
BACKGROUND/AIM: Lipiodol is the key component of conventional trans-arterial chemoembolization. Our aim was to evaluate lipiodol deposition and washout rate after conventional trans-arterial chemoembolization in intrahepatic cholangiocarcinoma and hepatic metastases originating from neuroendocrine tumors and colorectal carcinoma. PATIENTS AND METHODS: This was a retrospective analysis of 44 patients with intrahepatic cholangiocarcinoma and liver metastasis from neuroendocrine tumors or colorectal carcinoma who underwent conventional trans-arterial chemoembolization. Lipiodol volume (cm3) was analyzed on non-contrast computed tomography imaging obtained within 24 h post conventional trans-arterial chemoembolization, and 40-220 days after conventional trans-arterial chemoembolization using volumetric image analysis software. Tumor response was assessed on contrast-enhanced magnetic resonance imaging 1 month after conventional trans-arterial chemoembolization. RESULTS: The washout rate was longer for neuroendocrine tumors compared to colorectal carcinoma, with half-lives of 54.61 days (p<0.00001) and 19.39 days (p<0.001), respectively, with no exponential washout among intrahepatic cholangiocarcinomas (p=0.83). The half-life for lipiodol washout was longer in tumors larger than 300 cm3 compared to smaller tumors (25.43 vs. 22.71 days). Lipiodol wash out half-life was 54.76 days (p<0.01) and 29.45 days (p<0.00001) for tumors with a contrast enhancement burden of 60% or more and less than 60%, respectively. A negative exponential relationship for lipiodol washout was observed in non-responders (p<0.00001). CONCLUSION: Lipiodol washout is a time-dependent process, and occurs faster in colorectal carcinoma tumors, tumors smaller than 300 cm3, tumors with baseline contrast enhancement burden of less than 60%, and non-responding target lesions.
Authors: T Imaeda; Y Yamawaki; M Seki; H Goto; G Iinuma; M Kanematsu; R Mochizuki; H Doi; S Saji; K Shimokawa Journal: Cardiovasc Intervent Radiol Date: 1993 Jul-Aug Impact factor: 2.740
Authors: Marco Fronda; Andrea Doriguzzi Breatta; Marco Gatti; Marco Calandri; Claudio Maglia; Laura Bergamasco; Dorico Righi; Riccardo Faletti; Paolo Fonio Journal: Eur Radiol Date: 2021-03-18 Impact factor: 5.315
Authors: Tushar Garg; Apurva Shrigiriwar; Peiman Habibollahi; Mircea Cristescu; Robert P Liddell; Julius Chapiro; Peter Inglis; Juan C Camacho; Nariman Nezami Journal: Cancers (Basel) Date: 2022-07-10 Impact factor: 6.575