Estimation of the kinetics of iodized oil injected into the feeding artery of hepatocellular carcinoma using dynamic computed tomography.

The distribution of iodized oil (Lipiodol) after its injection in hepatocellular carcinoma (HCC) was evaluated by dynamic computed tomography (CT) in 10 patients. Following the injection of Lipiodol into the hepatic artery, two patterns were observed. In type I (4/10 tumors) Lipiodol retention began at the tumor periphery and then spread contiguously towards the central portion. In type II (6/10 tumors), the accumulation began at the periphery, but then skipped directly to the central portion of the tumor. Hypervascular tumors were predominantly type I, and avascular or hypovascular tumors were all type II. This difference in Lipiodol kinetics suggests that lipid-based intra-arterial (i.a.) chemoembolization should precede the i.a. infusion of water-soluble chemotherapeutic agents or injection of solid embolic materials in hypervascular tumors.