Dosimetric assessment of radiolabelled lipiodol as a potential therapeutic agent in colorectal liver metastases using combined CT and SPECT

Perring, S.; Hind, R.; Fleming, J; Birch, Stephen; Batty, V.; Taylor, Imogen

doi:10.1097/00006231-199401000-00007

Cited by 9 publications

(4 citation statements)

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“…This explains the underestimation of the thyroid dose in the previous study. Some authors [3,4] have not visualised the thyroid on subsequent post-therapeutic scans at all. Differences in administered dose, mode of scintigraphy (planar, wholebody, duration of scanning) and scanning time point after administration may account for this.…”

Section: Discussionmentioning

confidence: 99%

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Thyroid uptake and radiation dose after 131I-lipiodol treatment: is thyroid blocking by potassium iodide necessary?

et al. 2002

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In radionuclide therapy with iodine-131 labelled pharmaceuticals, free (131)I may be released and trapped by the thyroid, causing an undesirable radiation burden. To prevent this, stable iodide such as potassium iodide (KI) can be given to saturate the thyroid before (131)I is administered. The guidelines of the European Association of Nuclear Medicine do not, however, recommend special precautions when administering (131)I-lipiodol therapy for hepatocellular carcinoma. Nevertheless, some authors have reported (131)I uptake in the thyroid as a consequence of such therapy. In this study, the influence of prophylactic KI on the thyroid uptake and dose (MIRD dosimetry) was prospectively investigated. (131)I-lipiodol was given as a slow bolus selectively in the proper hepatic artery or hyperselectively in the right and/or left hepatic artery. Patients were prospectively randomised into two groups. One group received KI in a dose of 100 mg per day starting 2 days before (131)I-lipiodol administration and continuing until 2 weeks after therapy (KI group; n=31), while the other group received no KI (non-KI group; n=37). Thyroid uptake was measured scintigraphically as a percentage of administered activity 7 days after (131)I-lipiodol ( n=68 treatments). The absorbed radiation dose to the thyroid was assessed by scintigraphy after 7 and 14 days using a mono-exponential fitting model and MIRD dosimetry ( n=40 treatments). The mean activity of (131)I-lipiodol administered was 1,835 MBq in a volume of 2 ( n=17) or 4 ( n=51) ml. Thyroid uptake was lower in the KI group, being 0.23%+/-0.06% of injected activity ( n=31) compared with 0.42%+/-0.20% in the non-KI group ( n=37); the mean thyroid dose was 5.5+/-1.6 Gy in the KI group ( n=19) versus 11.9+/-5.9 Gy in the non-KI group ( n=21). These differences were statistically significant ( P<0.001). No effect of the amount of added cold lipiodol (4 vs 2 ml total volume) or selectivity of (131)I-lipiodol administration was evident ( P>0.1). (131)I-lipiodol is associated with a generally low thyroid uptake and dose that may be significantly decreased by KI premedication. Given the low cost and the very good tolerance of the KI treatment, we believe the use of KI should be recommended in the majority of the patients.

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Section: Discussionmentioning

confidence: 99%

“…As a consequence, generally no special precautions are advocated for protection of the thyroid. Hence, several groups do not use cold iodide premedication when employing lipiodol treatment [3,4,5]. Furthermore, KI is not recommended by the guidelines of the European Association of Nuclear Medicine [6].…”

Section: Introductionmentioning

confidence: 99%

Thyroid uptake and radiation dose after 131I-lipiodol treatment: is thyroid blocking by potassium iodide necessary?

et al. 2002

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“…36 However, 131 I-lipidiol therapy has not shown promising outcomes in liver metastasis. 37 Re-188 is a highly energetic β emitter with a 15% abundance of low energy γ radiation of 155 Kev, which is used for scintigraphic imaging. This radioisotope has a maximum energy of 2.118 Mev, a physical half-life of 0.7 days, and a maximum tissue penetration range of 11 mm.…”

Section: Other Radioisotopesmentioning

confidence: 99%

Transarterial Radioembolization: Overview of Radioembolic Devices

Serhal,

Gordon,

Brown

et al. 2023

Semin intervent Radiol

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“…For metastases of colorectal cancer (CRC), mean ratios of tumor/liver uptake were 1.5-3 after 1 day and 2.6 at 3-9 days, however after exclusion of large lesions with low uptakes [23,24]. Tumor doses were 12-43 Gy/GBq, 1.2-4.7 times higher than those to the liver [24].…”

Section: Lipiocismentioning

confidence: 99%

Liver Embolizations in Oncology. A Review. Part II. Arterial Radioembolizations, Portal Venous Embolizations, Experimental Arterial Embolization Procedures

Gunvén

2007

Med Oncol

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Arterial embolization of the liver may temporarily retard the growth of its primary and secondary tumors which are both mainly nourished arterially. Addition of radioisotopes, mostly (131)I or (90)Y, results in radioembolizations which predominantly act by radiation and less by ischemia. They may therefore be utilized in the absence of portal venous flow when conventional embolization is hazardous. (131)I-oily radioembolization seems to prolong short-term survival in such patients with unresectable hepatocellular cancers, and to improve the prognosis after resection of hepatocellular cancer. The procedure does however not palliate better than "cold" chemoembolization in patients with preserved portal flow, except for having milder side effects. Embolization with (90)Y-coupled microspheres may shrink primary and secondary liver tumors but has so far unproven effects on survival. Embolization of portal venous branches gives compensatory hypertrophy of the non-embolized liver and can increase the volume of the future remnant liver before resection. This diminishes the risk for postoperative liver failure after extensive resection and/or in the presence of chronic liver disease, and permits wider surgical indications. Tumor growth may however be accelerated, and the hypertrophy is inhibited by severe liver parenchymal disease in which situation the method would be most needed. Experimental use of liver arterial embolizations includes combined arterial and portal embolizations, i.e. "chemical hepatectomy," arterial embolizations before external radiotherapy, administration of boron for neutron capture therapy, immunoembolizations, and future gene therapy.

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Dosimetric assessment of radiolabelled lipiodol as a potential therapeutic agent in colorectal liver metastases using combined CT and SPECT

Cited by 9 publications

References 0 publications

Thyroid uptake and radiation dose after 131I-lipiodol treatment: is thyroid blocking by potassium iodide necessary?

Thyroid uptake and radiation dose after 131I-lipiodol treatment: is thyroid blocking by potassium iodide necessary?

Transarterial Radioembolization: Overview of Radioembolic Devices

Liver Embolizations in Oncology. A Review. Part II. Arterial Radioembolizations, Portal Venous Embolizations, Experimental Arterial Embolization Procedures

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