Selective and Persistent Deposition and Gradual Drainage of Iodized Oil, Lipiodol in the Hepatocellular Carcinoma after Injection into the Feeding Hepatic Artery

Abstract

The selective and long-term deposition of iodized oil in the hepatocellular carcinoma (HCC) and its gradual drainage were clinicopathologically analyzed in 13 cases. All patients were Japanese and had an intrahepatic arterial injection of Lipiodol (LIP) mixed with Mitomycin C. The comparison among the follow-up computerized tomography (CT) findings, the observation of the soft x-ray radiogram, and histopathologic studies of the surgical or autopsy materials revealed that the selective deposition of LIP in HCC lasted for a long term, particularly in cases treated by LIP combined with transcatheter arterial embolization (TAE). Also revealed was an extremely gradual decrease of LIP from the HCC. It was thus postulated that, mainly, the accumulated macrophages surrounding LIP around the necrotic cancer tissue and, partially, the intrahepatic lymphatic system itself contributed to this drainage. Further, in histologic sections with lipid staining, x-ray microanalysis proved that the lipid droplets in the cancer tissue included highly concentrated iodine, as a deposition of LIP.

Improved stability of lipiodol–drug emulsion for transarterial chemoembolisation of hepatocellular carcinoma results in improved pharmacokinetic profile: Proof of concept using idarubicin

“…As lipiodol is retained by HCC cells for at least several weeks, while it is cleared from normal liver parenchyma within 7 days [31,32], lipiodol could be an interesting slow-releasing, tumourtargeting vector for idarubicin through a stable lipiodol/ idarubicin emulsion. Immediately after injection of the emulsion, we did not detect any idarubicin in the plasma; it took at least a few minutes for the drug to appear.…”

Intraarterial Gene Delivery in Rabbit Hepatic Tumors: Transfection with Nonviral Vector by Using Iodized Oil Emulsion

“…When injected into the hepatic artery by using a vascular catheter, iodized oil is retained in HCC for several weeks to more than a year but is cleared from normal liver parenchyma within 7 days (22). Iodized oil has three functions.…”

The Current Practice of Transarterial Chemoembolization for the Treatment of Hepatocellular Carcinoma

“…This results in the embolic effects on smaller vessels. However, Lipiodol injected into the hepatic artery of normal liver parenchyma accumulates in the portal venules by arterioportal communication and is gradually released into the systemic circulation via the hepatic sinusoids or undergoes phagocytosis by Kupffer cells and is usually cleared within a week (17, 21, 23). Lipiodol has another role as a vehicle to carry and localize chemotherapeutic agents inside a tumor.…”