碘化油在原发性和转移性肝肿瘤化疗栓塞后的沉积和洗脱。
Lipiodol Deposition and Washout in Primary and Metastatic Liver Tumors After Chemoembolization.
机构信息
Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A.;
Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, U.S.A.
出版信息
In Vivo. 2021 Nov-Dec;35(6):3261-3270. doi: 10.21873/invivo.12621.
BACKGROUND/AIM: Lipiodol is the key component of conventional trans-arterial chemoembolization. Our aim was to evaluate lipiodol deposition and washout rate after conventional trans-arterial chemoembolization in intrahepatic cholangiocarcinoma and hepatic metastases originating from neuroendocrine tumors and colorectal carcinoma.
PATIENTS AND METHODS
This was a retrospective analysis of 44 patients with intrahepatic cholangiocarcinoma and liver metastasis from neuroendocrine tumors or colorectal carcinoma who underwent conventional trans-arterial chemoembolization. Lipiodol volume (cm) was analyzed on non-contrast computed tomography imaging obtained within 24 h post conventional trans-arterial chemoembolization, and 40-220 days after conventional trans-arterial chemoembolization using volumetric image analysis software. Tumor response was assessed on contrast-enhanced magnetic resonance imaging 1 month after conventional trans-arterial chemoembolization.
RESULTS
The washout rate was longer for neuroendocrine tumors compared to colorectal carcinoma, with half-lives of 54.61 days (p<0.00001) and 19.39 days (p<0.001), respectively, with no exponential washout among intrahepatic cholangiocarcinomas (p=0.83). The half-life for lipiodol washout was longer in tumors larger than 300 cm compared to smaller tumors (25.43 vs. 22.71 days). Lipiodol wash out half-life was 54.76 days (p<0.01) and 29.45 days (p<0.00001) for tumors with a contrast enhancement burden of 60% or more and less than 60%, respectively. A negative exponential relationship for lipiodol washout was observed in non-responders (p<0.00001).
CONCLUSION
Lipiodol washout is a time-dependent process, and occurs faster in colorectal carcinoma tumors, tumors smaller than 300 cm, tumors with baseline contrast enhancement burden of less than 60%, and non-responding target lesions.
背景/目的：碘油是传统经动脉化疗栓塞的关键成分。我们的目的是评估神经内分泌肿瘤和结直肠癌肝转移引起的肝内胆管癌患者经动脉化疗栓塞后碘油的沉积和洗脱率。
患者和方法
这是一项回顾性分析，共纳入 44 例接受传统经动脉化疗栓塞的肝内胆管癌和神经内分泌肿瘤或结直肠癌肝转移患者。在传统经动脉化疗栓塞后 24 小时内和 40-220 天内，使用容积图像分析软件对非增强 CT 图像上的碘油体积（cm）进行分析。在传统经动脉化疗栓塞后 1 个月，通过增强磁共振成像评估肿瘤反应。
结果
神经内分泌肿瘤的洗脱率较结直肠癌长，半衰期分别为 54.61 天（p<0.00001）和 19.39 天（p<0.001），而肝内胆管癌则无指数洗脱（p=0.83）。与较小肿瘤相比，大于 300cm 的肿瘤的碘油洗脱半衰期较长（25.43 天比 22.71 天）。对于增强负担为 60%或以上和小于 60%的肿瘤，碘油洗脱半衰期分别为 54.76 天（p<0.01）和 29.45 天（p<0.00001）。在无反应者中，观察到碘油洗脱呈负指数关系（p<0.00001）。
结论
碘油洗脱是一个时间依赖性过程，在结直肠癌肿瘤、小于 300cm 的肿瘤、基线增强负担小于 60%的肿瘤以及无反应的靶病变中，洗脱速度更快。
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