Preoperative location of microcalcifications after macrobiopsy: failure of lipiodol

Accurate mark of macrobiopsy site, carried out borderline or malignant lesions, is very important for surgeons. We report a woman case, 68 year's old, who presents intraductal carcinoma diagnoses on macrobiopsy. On postbiopsy X-ray, we can note lipiodol used instead of clip to reaper macrobiopsy site. Our observation shows how lipiodol use is not adapted into this indication.     

Antitumor effect of lipiodolized doxorubicin on VX2 carcinoma in rabbits

Twelve-day-old VX2 carcinoma was inoculated in the hind leg of 24 rabbits and, after 12 days, Doxorubicin (Adriamycin) suspended in Lipiodol Ultra-Fluid (Lipiodol) was then given through the femoral artery. A selective deposit of the contrast material in the tumor for an extended time was evident on the x-rays and the antitumorous effect was remarkable. Lipiodolized antitumor agents warrant further investigation for possible clinical application.     

奥沙利铂-碘油乳剂制备比例的试验研究

目的:研究肝动脉导管注射使用的奥沙利铂-碘油乳剂中溶媒(5%葡萄糖注射液)与碘油的较佳用量比例。方法:取50mg奥沙利铂分别溶解于0.5、1、2、2.5mL的5%葡萄糖注射液中,再分别与5mL的碘油混合后置于注射器中,用"单泵法"制备乳剂;采用普通显微镜观察乳滴分布情况,37℃观察油水分层情况,透析法进行体外释放试验,用高效液相色谱法测定透析液中奥沙利铂的浓度并计算累积释放度。结果:随着奥沙利铂-碘油乳剂中5%葡萄糖注射液比例的降低,乳滴分布趋向均匀,油水分层时间延长,缓释作用延长。二者比例为0.5∶5时,乳剂乳滴分布均匀,乳剂在放置时间超过24h时未见分层,释放慢,具有良好的物理化学稳定性。结论:奥沙利铂在葡萄糖注射液-碘油(0.5∶5)乳剂中具有稳定的物理化学性质和优良的缓释作用。     

Image-guided thermal therapy with a dual-contrast magnetic nanoparticle formulation: A feasibility study

Purpose/objective: The aim of this study was to develop and investigate the properties of a magnetic iron oxide nanoparticle–ethiodised oil formulation for image-guided thermal therapy of liver cancer.

Materials and methods: The formulation comprises bionised nano-ferrite (BNF) nanoparticles suspended in ethiodised oil, emulsified with polysorbate 20 (BNF-lip). Nanoparticle size was measured via photon correlation spectroscopy and transmission electron microscopy. In vivo thermal therapy capability was tested in two groups of male Foxn1^nu mice bearing subcutaneous HepG2 xenograft tumours. Group I (n?=?12) was used to screen conditions for group II (n?=?48). In group II, mice received one of BNF-lip (n?=?18), BNF alone (n?=?16), or PBS (n?=?14), followed by alternating magnetic field (AMF) hyperthermia, with either varied duration (15 or 20?min) or amplitude (0, 16, 20, or 24?kA/m). Image-guided fluoroscopic intra-arterial injection of BNF-lip was tested in New Zealand white rabbits (n?=?10), bearing liver VX2 tumours. The animals were subsequently imaged with CT and 3 T MRI, up to 7 days post-injection. The tumours were histopathologically evaluated for distribution of BNF-lip.

Results: The BNF showed larger aggregate diameters when suspended in BNF-lip, compared to clear solution. The BNF-lip formulation produced maximum tumour temperatures with AMF >20?kA/m and showed positive X-ray visibility and substantial shortening of T1 and T2 relaxation time, with sustained intratumoural retention up to 7 days post-injection. On pathology, intratumoural BNF-lip distribution correlated well with CT imaging of intratumoural BNF-lip distribution.

Conclusion: The BNF-lip formulation has favourable thermal and dual imaging capabilities for image-guided thermal therapy of liver cancer, suggesting further exploration for clinical applications.     

榄香烯碘油抗癌药栓塞乳剂的实验研究

目的:观察ELE与LIP乳化栓塞剂不同配制比的物理稳定性,释放速率及乳粒大小,考证其临床适用性。方法:将MMC溶解于ELE或60% UR中,采用“二泵一间隔”法与40% LIP混合成不同配制比,静置于室温下,观察并记录油水分层时间。用显微镜观察不同时间油水分层和乳粒变化及特征,并用EIE乳粒定标测定不同比例的乳粒大小。用ZKS- 4智能溶出仪以浆叶法测定MMC含量,计算释放累积百分率,用紫外法测定其吸收值并与不同浓度进行线性回归,求其标准曲线方程,按PKBP- N1程序中威布尔公式计算释放参数。结果:LME4∶1和5∶1分层慢,完全分层时间为13.5 h 和8 h,乳滴稳定,大小为20～100 um ,其中4∶1 药物释放速度慢,释放半衰期长,为本实验最佳乳化比,5∶1次之。LMU5∶3 比也有理想结果。结论:乳化剂的选择与配制比例影响药物的释放速度和物理稳定性,LME4∶1和5∶1 比具有“双载体”微栓的多重作用,是肿瘤血管的理想栓塞剂。LMU5∶3比也具有理想结果,供临床应用时借鉴     

MRI对评价肝癌Lp-TACE治疗的价值

目的 通过影像－病理对照研究,探讨ＭＲＩ尤其是动态增强ＭＲＩ（Ｄ－ＭＲＩ）在肝癌Ｌｐ－ＴＡＣＥ治疗随诊中的价值以及协助临床确定Ｌｐ－ＴＡＣＥ治疗间隔的可行性。材料与方法 １０例Ｌｐ－ＴＡＣＥ治疗后手术切除的肝癌患者,术前行ＣＴ扫描、ＭＲ平扫及早期动态增强扫描、增强晚期和延迟期扫描。术后肿瘤标本作ＭＲＩ、ＣＴ扫描和软Ｘ线照相（８例）,作影像－病理对照研究。结果 （１）病理表现：１０例均发现残留的肝癌     

MSCT对原发性肝癌肝动脉化疗栓塞术后无碘油沉积区的血供研究及临床价值

目的 采用多层螺旋CT(MSCT)平扫及双期增强扫描,研究原发性肝癌(HCC)经肝动脉化疗栓塞术(TACE)治疗后无碘油沉积区的血液供应,以判断TACE后疗效,并对制定进一步治疗方案提供有价值的信息.方法 19例HCC患者(24个病灶),接受25次TACE后行MSCT平扫及增强双期扫描,根据动态增强表现将无碘油沉积区的血液供应分为四种类型:动脉供血型、门静脉供血型、双重供血型及少血供型.结果 19例患者(24个病灶),经过25次TACE后无碘油沉积区的血供情况为:动脉供血型11个病灶(45.83%),双重供血型11个病灶(45.83%),乏血供型2个病灶(8.33%);动脉期MSCTA中22个富血供型病灶中有18个病灶有明显的肿瘤供血动脉(81.8%),19例患者中发现寄生动脉5例,右膈动脉3例,胰十二指肠动脉1例,胸廓内1例.结论 MSCT三期扫描及动脉期MSCTA可以很好地评价无碘油沉积区肿瘤病灶的供血情况,对判断TACE后疗效及制定进一步治疗方案有重要意义.     

Intra‐arterial iodine‐131‐lipiodol for unresectable hepatocellular carcinoma

BACKGROUND:

Hepatic artery administration of iodine‐131‐Lipiodol serves as a modality that delivers targeted radiation therapy to hepatocellular carcinoma. Its efficacy has been promising according to trials conducted in the adjuvant setting after hepatic resection. Further investigation of its role in the palliative setting is warranted.

METHODS:

A retrospective review of 72 patients with unresectable hepatocellular carcinoma treated with iodine‐131‐Lipiodol and followed up by the St. George Hospital Sydney's hepatobiliary service was conducted. Efficacy of treatment was determined based on progression‐free and overall survival as the endpoints using the Kaplan‐Meier method.

RESULTS:

Sixty men and 12 women with a mean age of 65 years (standard deviation = 11) underwent iodine‐131‐Lipiodol treatment. Chronic viral hepatitis was present in 29 (41%) patients. Fifty (69%) patients were Child‐Pugh class A. Median progression‐free survival was 6 months, and overall survival was 14 months; the 1‐, 2‐, and 3‐year survival rates were 52%, 33% and 20%, respectively. Factors associated with survival include the American Joint Committee on Cancer stage (P = .03), Barcelona Clinic Liver Cancer stage (P = .05), Cancer of the Liver Italian Program score (P = .008), tumor size (P = .01), extrahepatic disease (P < .001), previous surgery (P = .02), and response to treatment (P < .001). The response to treatment was identified through a multivariate analysis as the single independent predictor for survival (hazard ratio, 3.5; 95% confidence interval, 2.2‐5.4; P < .001).

CONCLUSIONS:

Encouraging survival outcomes may be derived through administration of iodine‐131‐Lipiodol in patients with unresectable hepatocellular carcinoma. The overall success of treatment may be determined by the response to treatment. Cancer 2010. © 2010 American Cancer Society.     

吡柔比星-碘油乳剂不同配比特性的实验研究

目的：研究肝动脉化疗栓塞治疗肝癌时所使用吡柔比星－碘油乳剂的最佳配比方案。方法：多种水溶剂和造影剂溶解吡柔比星后以不同油水比例与碘化油制成7种乳剂。肉眼和显微镜观察各样本物理稳定性。用控制应力流变仪检测样本粘滞度。结果：吡柔比星经生理盐水和非离子型造影剂溶解后与碘化油制成的乳剂（NNTLE）性质稳定，粘滞度较其它乳剂低。油水比2：1的NNTLE稳定性最好，粘滞度适中。结论：油水比2：1的NNTLE是较为理想的吡柔比星－碘油栓塞剂配制方法，利于肝癌的肝动脉化疗栓塞治疗。     

碘油肺动脉治疗性栓塞的实验研究

为了解正常肺组织对碘油肺动脉栓塞的反应，在１９只兔子耳缘静脉推注碘化油－阿霉素乳剂。定期处死，肺标本钼靶摄片示：注射后即刻碘油沉积在兔肺动脉小分支及肺组织，随着时间推移碘油沉积量逐渐减少，术后５月碘油完全清除。病理学检查示：术后半天内主要为肺组织弥漫性炎症改变伴残留肺泡代偿性过度通气，大量碘油沉积在肺组织内，术后一天起出现明显的组织细胞反应性增生，组织细菌浆内有大量碘油颗粒，术后３周至１月炎症吸收