Wang Chen, Wang Wansheng, Shen Jian, Ren Baosheng, Zhu Xiaoli, Ni Caifang
Department of Interventional Radiology, First Affiliated Hospital, Soochow University, No. 188 Shizi Road, Suzhou, 215006, China.
Department of Vascular and Interventional Radiology, Third Affiliated Hospital, Shihezi University, Shihezi, 832000, China.
Cardiovasc Intervent Radiol. 2019 Jan;42(1):121-129. doi: 10.1007/s00270-018-2059-0. Epub 2018 Aug 30.
To evaluate the feasibility of helical iodine-125 (I-125) seed portal vein implantation.
Helical I-125 seed implants were placed into the portal vein of healthy pigs through the transjugular (n = 3) or percutaneous transhepatic (n = 3) route. Six pigs received follow-up at 9 weeks after implantation. Blood tests were performed preimplantation, and at 1 and 9 weeks after implantation. Contrast-enhanced computed tomography (CT) and single-photon emission computed tomography combined with CT (SPECT-CT) were acquired after implantation. Post-implantation CT was imported to the treatment planning system (TPS) for dose verification. At 9 weeks after implantation, another CT was performed before histopathological examination.
All implantations were successful, and the helical implants were fixed to the portal vein. CT showed no implant migration or portal vein thrombosis. The average dose to 90% of the target volume calculated from TPS was 68.4 Gy. SPECT-CT revealed an irregular isodose around the implant, in which the hottest spot was near the central portal vein lumen. All pigs were in good condition at the 9-week follow-up. Histopathology studies confirmed no portal vein thrombosis. Pigs showed no signs of bleeding, necrosis, or perforation of the peripheral tissue or organs. Intimal hyperplasia was observed at the two ends of the implant. A mild inflammatory response was detected in the bile duct and adjacent liver tissues, yet there was no apparent inflammation of the hepatic arteries.
The helical I-125 seed implants can be inserted into the portal veins of healthy pigs.
评估螺旋碘-125（I-125）粒子门静脉植入的可行性。
通过经颈静脉途径（n = 3）或经皮肝穿刺途径（n = 3）将螺旋I-125粒子植入健康猪的门静脉。6只猪在植入后9周接受随访。在植入前、植入后1周和9周进行血液检查。植入后进行对比增强计算机断层扫描（CT）和单光子发射计算机断层扫描联合CT（SPECT-CT）。将植入后的CT图像导入治疗计划系统（TPS）进行剂量验证。在植入后9周，在组织病理学检查前进行另一次CT检查。
所有植入均成功，螺旋形植入物固定在门静脉上。CT显示无植入物移位或门静脉血栓形成。根据TPS计算，靶体积90%的平均剂量为68.4 Gy。SPECT-CT显示植入物周围有不规则等剂量区，其中热点靠近门静脉中央管腔。所有猪在9周随访时状况良好。组织病理学研究证实无门静脉血栓形成。猪未出现外周组织或器官出血、坏死或穿孔的迹象。在植入物两端观察到内膜增生。在胆管和相邻肝组织中检测到轻度炎症反应，但肝动脉无明显炎症。
螺旋I-125粒子可植入健康猪的门静脉。
