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European Radiology

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01-10-2012 | Interventional

Nitroglycerine use in transcatheter arterial (chemo)embolization in patients with hepatocellular carcinoma and dual-energy CT assessment of Lipiodol retention

Authors: Yi-Sheng Liu, Ming-Tsung Chuang, Yi-Shan Tsai, Hong-Ming Tsai, Xi-Zhang Lin

Published in: European Radiology | Issue 10/2012

Abstract

Objectives

To investigate whether the addition of nitroglycerine to transcatheter arterial (chemo)embolization (TAE/TACE) can increase the delivery and effectiveness of TAE/TACE in patients with hepatocellular carcinoma (HCC) by dual-energy CT.

Methods

HCC patients (BCLC stage A or B) were randomized to (n = 51) or not to (n = 50) receive nitroglycerine and an emulsion of Lipiodol with or without doxorubicin, followed by embolization with Gelfoam pledgets. Dual-energy CT was performed pre- and 1 to 3 months post-embolization to assess changes in tumour diameter and Lipiodol levels in tumours.

Results

Median tumour diameter decreased from baseline in both groups with and without nitroglycerine (7.11 % vs. 12.5 %, respectively), and was statistically significant in the group receiving nitroglycerine (P = 0.023). There was no difference between the two groups in disease response (P = 0.237). The concentration and percentage of Lipiodol retained in tumours were significantly greater in patients treated with nitroglycerine compared to those without (median concentration 15.05 mg/mL vs. 4.40 mg/mL, respectively, P < 0.001; median percentage 82.01 % vs. 36.75 %, respectively, P < 0.001).

Conclusions

Nitroglycerine increased delivery of the Lipiodol emulsion via TAE/TACE to HCC tumours with significant tumour reduction. Dual-energy CT can accurately quantify the amount of Lipiodol deposited in tumours.

Key Points

• Nitroglycerine improves delivery of tumour-targeted therapy via enhanced permeability and retention.

• In hepatocellular carcinoma, nitroglycerine added to TAE/TACE showed greater tumour reduction.

• Dual-energy CT can reliably quantify the amount of Lipiodol in TAE/TACE.

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Title: Nitroglycerine use in transcatheter arterial (chemo)embolization in patients with hepatocellular carcinoma and dual-energy CT assessment of Lipiodol retention
Authors: Yi-Sheng Liu
Ming-Tsung Chuang
Yi-Shan Tsai
Hong-Ming Tsai
Xi-Zhang Lin
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2484-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nitroglycerine use in transcatheter arterial (chemo)embolization in patients with hepatocellular carcinoma and dual-energy CT assessment of Lipiodol retention

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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