Hepatic artery injection of I-131-labeled lipiodol. Part I. Biodistribution study results in patients with hepatocellular carcinoma and liver metastases.

Abstract

Biodistribution of iodine-131-labeled Lipiodol Ultra-Fluide (I-131 LUF) injected into the hepatic artery was studied scintigraphically in 47 patients with hepatocellular carcinoma (n = 23), hepatic metastases (n = 14), or normal livers (n = 10). The investigation was extremely well tolerated. I-131 LUF concentrated mainly in the liver (L) and the lungs (l), with L/L + l activity ratios greater than 75% for all three groups of patients. I-131 LUF distribution was homogeneous in normal livers and heterogeneous in cirrhotic livers. I-131 LUF concentrated in the tumor with a tumorous (T) to nontumorous (NT) activity ratio (T/NT) of 4.3 +/- 3.6 for hepatocellular carcinoma and 2.4 +/- 0.7 for hepatic metastases. The effective half-life of I-131 LUF is more than 4.5 days for the three groups. It was eliminated mainly through the urine. Clearance from tumor is slower than from normal liver, as shown by the increase in T/NT at day 18. Biodistribution did not change in patients who had a second injection, which indicates that there is no saturation phenomenon. The results of this study suggest that LUF may be considered as a potential carrier vehicle for therapeutic agents.

Therapy of Hepatocellular Carcinoma with Iodine-131-Lipidiol

“…It was developed in the 1990s and was the first radiolabeled vector to be used in this setting. According to biodistribution data, more than 75% of the 131I-Lipiodol stays following the arterial administration in the liver and the remainder reaches the lungs 4 . Other tissues, including the thyroid gland, receive very little radiation.…”

“…Moreover, the clearance of Lipiodol from the tumour lasts longer than from the normal liver or from the lungs, possibly because of a lack of macrophagic cells in the tumour 3 . 131I-Lipiodol is eliminated mainly www.intechopen.com through the urinary tract, reaching 30-50% of the injected activity at day 8, but also to a small extent by way of the faeces (<3% at day 5) 4 .…”

“…Based on studies considering biodistribution of intraarterial 131I-Lipiodol in humans 4,20,21 , radiation doses for every mCi (37 MBq) of administered activity were estimated to be 31 cGy for the normal liver, 22 cGy for the lungs, and 239 cGy for a tumor with a greatest diameter of 4 cm using the formula:…”

Small hepatocellular carcinomas in cirrhotic explant livers: Identification by macroscopic examination and lipiodol localization

“…How- Green 16 13 ever, there is evidence to suggest that after Lipiodol has been Mottled 3 36 catabolized by hepatocytes, the lipid is excreted into bile Nodule in nodule 2 5 whereas the iodine moiety is excreted in the urine. 15 retention within the tumor may be because of there being no ú5 mm but°10 mm 7 19 biliary channels for its excretion. have plentiful cytoplasm and contain Mallory bodies (indicated by arrows).…”

Eradication of hepatocellular carcinoma xenografts by radiolabelled, lipiodol-inducible gene therapy

“…18 Importantly, I-131-labelled lipiodol (I-131-Lip) concentrates preferentially within hepatomas, where it is retained for significantly longer periods than in non-neoplastic tissues. [19][20][21][22] In addition, I-131 generates 606-MeV b-rays that produce a strong effect over short distances, which could therefore enhance the bystander effect through increased intracellular communication. 23 In the present study, we investigated whether combined therapy comprising transduction of the EgrTK gene and internal radiation with I-131 was able to reduce tumor development in HCC.…”