J Korean Radiol Soc.  1989 Aug;25(4):548-563. 10.3348/jkrs.1989.25.4.548.

The biodistribution and effect on hepatic parenchyme with intraarterial injected I-131 Lipiodol into hepatic artery

• Kim DI
• Suh JH
• Yoo HS
• Lee JT
• Kim KW
• Park CI
• Kim BR

• KMID: 2359076
• DOI: http://doi.org/10.3348/jkrs.1989.25.4.548

Abstract

Iodized oil has been used as a contrast agent in lymphangiography. One of the commercially available compoundsis Lipiodol Ultra-fluid (LUF) which contains 38% iodine by weight. Nakakuma et al (1979) reported that LUF wasselectively retained in the hypervascular hepatocellular carcinoma when injected directly into the ligated hepaticartery. Since that time, it has been widely utilized in the detection as well as the therapeutic attempts ofhepatocellular carcinoma, where it has been mixed with chemotherapeutic agents or labeled with radioactive I-131. Like all significant advances, the mechanism of lipid retention within the hepatocellullar carcinoma is notclearly understood, and also there is a lack of information about the biodistribution and kinetics of I-131 Lipiodol. The apparent safety of this technique require confirmation. The present study was aimed to assess the biodistribution and kinetics of intra-arterially injected I-131 Lipiodol and the histologic changes in caninelivers. It was also to verify the safety of this technique in clinical applications. Radioactive iodized oil wasobtained by simple exchange method. 518±19MBq(14 mCi, about 1 mCi/kg body weight) of I-131-Lipiodol was injectedintra-arterially in 12 dogs as a experimental group. Serial count rates over the livers under gamma camera weremeasured, and then it was compared with quantitative analysis of radioactivities distributed in liver, lung,spleen, kidney, thyroid, bile and circulating blood using dose calibrator after sacrifice at various timeintervals. Cumulative radiation doses were calculated by Quimby method. The effect of I-131-Lipiodol on hepaticfunction were analysed by serial liver function tests after intrahepatic injection of I-131-Lipiodol and comparedwith preinjection values. Liver tissue obtained after sacrifice were stained with hematoxylin-eosin. Oil red-O, and also electron microscopic examinations were performed. The results were summerized as follows; 1. Intra-arterially injected I-131-Lipiodol was trapped first in the liver, and gradually cleared from the liver upto50% in the initial 1 week. It was excreted through urine(36.4%) and stool (6.5%) in the same period. 2. I-131-Lipiodol were consistently identified within the hepatocysts and sinusoids as well as bile duct epitheliumwithin the initial 1 weeks. and minor foreign body reaction and lipid granuloma were appeared at the time of 1-4weeks. 3. Transient and slight elevation of hepatic enzymes were developed in 7/12 dogs after postinjecttion of 1-4 weeks,. and returened to normal level of preinjection state. 4. The radiation dosimetry measured by means ofthe biodistribution and clearance data disclosed that the radiation dose to liver was 13.7Gy; thyroid gland, 3.7Gy; lung, 2Gy; remained body organs, 0.1-0.3 Gy, respectively. It could be predicted that the equivalent dose inclinical application distributes in the critical organs below the tolerance dose levels. It was concluded that theintra-arterially injected I-131 Lipiodol was mainly distributed in liver and supposed to be methabolized withinthe hepatocytes; the main excretion route is urine; and the diagnostic and therapeutic purpose of I-131 Lipiodolinjection for hepatocellular carcinoma could be safely performed.

MeSH Terms

Animals
Bile
Bile Ducts
Carcinoma, Hepatocellular
Dogs
Ethiodized Oil*
Foreign-Body Reaction
Gamma Cameras
Granuloma
Hepatic Artery*
Hepatocytes
Iodine
Iodized Oil
Kidney
Kinetics
Liver
Liver Function Tests
Lung
Lymphography
Methods
Radioactivity
Radiometry
Thyroid Gland
Ethiodized Oil
Iodine
Iodized Oil