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Title: Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion

Transarterial chemoembolization with Lipiodol (Lipiodol TACE), also called conventional TACE, was developed in the early 1980s and widely adopted worldwide after randomized control trials and meta-analysis demonstrated superiority of Lipiodol TACE to best supportive care. Presently, there is no level one evidence that other TACE techniques are superior to Lipiodol TACE for intermediate stage hepatocellular carcinoma (HCC), which includes patients with preserved liver function and nonsurgical large or multinodular HCC without distant metastases. In addition, TACE is part of the treatment for progressive or symptomatic liver metastases from gastroenteropancreatic neuroendocrine tumors. When injected into the hepatic artery, Lipiodol has the unique property of selective uptake and retention in hyperarterialyzed liver tumors. Lipiodol/drug emulsion followed by particle embolization has been demonstrated to improve the pharmacokinetic of the drug and tumor response. Radio opacity of Lipiodol helps to monitor treatment delivery, with retention of Lipiodol serving as an imaging biomarker for tumor response. For 30¬†years, Lipiodol TACE has been inconsistently referenced in many publications with various levels of details for the method of preparation and administration, with reported progressive outcomes following improvements in the technique and the devices used to deliver the treatment and better patient selection. Consequently, there is no consensusmore » on the standard method of TACE regarding the use of anticancer agents, embolic material, technical details, and the treatment schedule. In order to develop an internationally validated technical recommendation to standardize the Lipiodol TACE procedure, a worldwide panel of experts participated in a consensus meeting held on May 10, 2014.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ;  [7] ;  [8]
  1. Gustave Roussy, Department of Interventional Radiology (France)
  2. National Cancer Center, Department of Diagnostic Radiology (Japan)
  3. Pisa University School of Medicine, Division of Diagnostic Imaging and Intervention (R.L.) (Italy)
  4. The Johns Hopkins Hospital, Vascular and Interventional Radiology (United States)
  5. Medical College of Wisconsin, Division of Vascular and Interventional Radiology Rm2803 (United States)
  6. Northwestern University, Department of Radiology (United States)
  7. Kanazawa University Graduate School of Medical Sciences, Department of Advanced Medical Imaging (Japan)
  8. University of Pennsylvania, Division of Interventional Radiology (MCS) (United States)
Publication Date:
OSTI Identifier:
22469572
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 3; Other Information: Copyright (c) 2016 Springer Science+Business Media New York 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; BIOLOGICAL MARKERS; BIOMEDICAL RADIOGRAPHY; DRUGS; EMULSIONS; HEPATOMAS; LIPIODOL; LIVER; METASTASES; PATIENTS; RECOMMENDATIONS; VASCULAR DISEASES