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Title: First Human Experience with Directly Image-able Iodinated Embolization Microbeads

Abstract

PurposeTo describe first clinical experience with a directly image-able, inherently radio-opaque microspherical embolic agent for transarterial embolization of liver tumors.MethodologyLC Bead LUMI™ is a new product based upon sulfonate-modified polyvinyl alcohol hydrogel microbeads with covalently bound iodine (~260 mg I/ml). 70–150 μ LC Bead LUMI™ iodinated microbeads were injected selectively via a 2.8 Fr microcatheter to near complete flow stasis into hepatic arteries in three patients with hepatocellular carcinoma, carcinoid, or neuroendocrine tumor. A custom imaging platform tuned for LC LUMI™ microbead conspicuity using a cone beam CT (CBCT)/angiographic C-arm system (Allura Clarity FD20, Philips) was used along with CBCT embolization treatment planning software (EmboGuide, Philips).ResultsLC Bead LUMI™ image-able microbeads were easily delivered and monitored during the procedure using fluoroscopy, single-shot radiography (SSD), digital subtraction angiography (DSA), dual-phase enhanced and unenhanced CBCT, and unenhanced conventional CT obtained 48 h after the procedure. Intra-procedural imaging demonstrated tumor at risk for potential under-treatment, defined as paucity of image-able microbeads within a portion of the tumor which was confirmed at 48 h CT imaging. Fusion of pre- and post-embolization CBCT identified vessels without beads that corresponded to enhancing tumor tissue in the same location on follow-up imaging (48 h post).ConclusionLC Bead LUMI™ image-able microbeads provide real-time feedback and geographic localization ofmore » treatment in real time during treatment. The distribution and density of image-able beads within a tumor need further evaluation as an additional endpoint for embolization.« less

Authors:
;  [1]; ; ;  [2];  [1];  [3];  [4];  [2];  [5]; ;  [1];  [6];  [1]
  1. National Institutes of Health, Center for Interventional Oncology (United States)
  2. Biocompatibles, UK Ltd, A BTG International Group Company (United Kingdom)
  3. Clinical Science IGT Systems North & Latin America, Philips, Philips, Image Guided Interventions (United States)
  4. Image-Guided Therapy Systems, Philips, Philips, Image Guided Interventions (Netherlands)
  5. Children’s National Medical Center (United States)
  6. Department of Radiology and Biomedical Imaging (United States)
Publication Date:
OSTI Identifier:
22645474
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 8; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2016 Springer Science+Business Media New York (outside the USA) and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; COMPUTER CODES; COMPUTERIZED TOMOGRAPHY; EVALUATION; FLUOROSCOPY; HAZARDS; HEPATOMAS; HUMAN POPULATIONS; HYDROGELS; IMAGES; IODINE; LIVER; PATIENTS; PLANNING; POTENTIALS; PVA; VASCULAR DISEASES

Citation Formats

Levy, Elliot B., E-mail: levyeb@cc.nih.gov, Krishnasamy, Venkatesh P., Lewis, Andrew L., Willis, Sean, Macfarlane, Chelsea, Anderson, Victoria, Bom, Imramsjah MJ van der, Radaelli, Alessandro, Dreher, Matthew R., Sharma, Karun V., Negussie, Ayele, Mikhail, Andrew S., Geschwind, Jean-Francois H., and Wood, Bradford J. First Human Experience with Directly Image-able Iodinated Embolization Microbeads. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1364-8.
Levy, Elliot B., E-mail: levyeb@cc.nih.gov, Krishnasamy, Venkatesh P., Lewis, Andrew L., Willis, Sean, Macfarlane, Chelsea, Anderson, Victoria, Bom, Imramsjah MJ van der, Radaelli, Alessandro, Dreher, Matthew R., Sharma, Karun V., Negussie, Ayele, Mikhail, Andrew S., Geschwind, Jean-Francois H., & Wood, Bradford J. First Human Experience with Directly Image-able Iodinated Embolization Microbeads. United States. doi:10.1007/S00270-016-1364-8.
Levy, Elliot B., E-mail: levyeb@cc.nih.gov, Krishnasamy, Venkatesh P., Lewis, Andrew L., Willis, Sean, Macfarlane, Chelsea, Anderson, Victoria, Bom, Imramsjah MJ van der, Radaelli, Alessandro, Dreher, Matthew R., Sharma, Karun V., Negussie, Ayele, Mikhail, Andrew S., Geschwind, Jean-Francois H., and Wood, Bradford J. Mon . "First Human Experience with Directly Image-able Iodinated Embolization Microbeads". United States. doi:10.1007/S00270-016-1364-8.
@article{osti_22645474,
title = {First Human Experience with Directly Image-able Iodinated Embolization Microbeads},
author = {Levy, Elliot B., E-mail: levyeb@cc.nih.gov and Krishnasamy, Venkatesh P. and Lewis, Andrew L. and Willis, Sean and Macfarlane, Chelsea and Anderson, Victoria and Bom, Imramsjah MJ van der and Radaelli, Alessandro and Dreher, Matthew R. and Sharma, Karun V. and Negussie, Ayele and Mikhail, Andrew S. and Geschwind, Jean-Francois H. and Wood, Bradford J.},
abstractNote = {PurposeTo describe first clinical experience with a directly image-able, inherently radio-opaque microspherical embolic agent for transarterial embolization of liver tumors.MethodologyLC Bead LUMI™ is a new product based upon sulfonate-modified polyvinyl alcohol hydrogel microbeads with covalently bound iodine (~260 mg I/ml). 70–150 μ LC Bead LUMI™ iodinated microbeads were injected selectively via a 2.8 Fr microcatheter to near complete flow stasis into hepatic arteries in three patients with hepatocellular carcinoma, carcinoid, or neuroendocrine tumor. A custom imaging platform tuned for LC LUMI™ microbead conspicuity using a cone beam CT (CBCT)/angiographic C-arm system (Allura Clarity FD20, Philips) was used along with CBCT embolization treatment planning software (EmboGuide, Philips).ResultsLC Bead LUMI™ image-able microbeads were easily delivered and monitored during the procedure using fluoroscopy, single-shot radiography (SSD), digital subtraction angiography (DSA), dual-phase enhanced and unenhanced CBCT, and unenhanced conventional CT obtained 48 h after the procedure. Intra-procedural imaging demonstrated tumor at risk for potential under-treatment, defined as paucity of image-able microbeads within a portion of the tumor which was confirmed at 48 h CT imaging. Fusion of pre- and post-embolization CBCT identified vessels without beads that corresponded to enhancing tumor tissue in the same location on follow-up imaging (48 h post).ConclusionLC Bead LUMI™ image-able microbeads provide real-time feedback and geographic localization of treatment in real time during treatment. The distribution and density of image-able beads within a tumor need further evaluation as an additional endpoint for embolization.},
doi = {10.1007/S00270-016-1364-8},
journal = {Cardiovascular and Interventional Radiology},
number = 8,
volume = 39,
place = {United States},
year = {Mon Aug 15 00:00:00 EDT 2016},
month = {Mon Aug 15 00:00:00 EDT 2016}
}