Efficacy of emulsion containing Gd-DTPA and lipiodol in hepatic transcatheter arterial embolization.

We evaluated the clinical efficacy of an embolizing emulsion produced by mixing lipiodol and Gd-DTPA, in transcatheter arterial chemoembolization (TAE). Subjects were 10 patients with hepatocellular carcinoma (HCC). The emulsion used was produced by mixing 3 ml of lipiodol and anticancer agents (mitomycin-C 10 mg and adriamycin 20 mg) dissolved in Gd-DTPA. This emulsion was infused into the proper hepatic artery. Subsequent embolization by Gelfoam was performed in eight patients. MRI and CT examinations were performed soon after TAE (1 or 2 days after) and two weeks afterwards. The position of lipiodol accumulation dipicted on CT at two weeks after TAE did not differ from the site of change in signal intensity induced by Gd-DTPA on MR images soon after TAE in any case. In almost all cases, the washout of Gd-DTPA occurred earlier than that of lipiodol. It might be suggested that Gd-DTPA, which is water-soluble, shows in vivo dynamics similar to anticancer agents rather than to lipiodol, which is oil-soluble. Since the normal tissues showed no definite signal changes, we could easily detect the site of tumors by using the emulsion containing Gd-DTPA even on MR studies immediately after TAE. In addition, the deposits of Gd-DTPA depicted on MR images created fewer artifacts than the lipiodol deposits on CT.