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This study aimed to propose a novel approach of lipiodol combined with drug-eluting beads transarterial chemoembolization (Lipiodol-DEB TACE) and to compare the safety and efficacy with DEB-TACE alone for patients with unresectable hepatocellular carcinoma (HCC). From the database of four centers, the records of patients with HCC who received DEB-TACE or Lipiodol-DEB TACE as initial treatment were retrospectively evaluated. The tumor response was measured based on the Modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS), progression-free survival (PFS) and adverse events (AEs) were compared between two groups. A total of 244 patients were included with 160 patients receiving DEB-TACE and 84 patients receiving Lipiodol-DEB TACE. Lipiodol-DEB TACE group had higher objective response rate (86.9 % vs. 76.3 %), higher disease control rate (97.6 % vs. 88.8 %), longer median OS (42.6 vs. 25.8 months) and longer median PFS (34.0 vs. 17.0 months) than DEB-TACE group (P < 0.05). There was no significant difference observed in the incidence of AEs between two groups. Cox analysis identified total bilirubin level, maximum tumor diameter, TACE method and portal vein invasion as independent prognostic factors. Lipiodol-DEB TACE was a safe option and associated with improved tumor response and survival outcome compared to DEB-TACE alone for selected patients with HCC. [ABSTRACT FROM AUTHOR]

Hysterosalpingography is widely used as a first-line investigation for infertility, and may also be therapeutic, increasing pregnancy rates. Aqueous and oil-based contrast agents can be used. Some studies suggest Lipiodol hysterosalpingography has a greater therapeutic effect on fertility than aqueous contrast, though this is contentious. There are additionally safety concerns surrounding Lipiodol hysterosalpingography. This review summarises the adverse effects associated with Lipiodol hysterosalpingography, particularly on thyroid function. 331 articles were identified. Of these, 46 met inclusion criteria. 3 further articles were identified from reference lists. Complications typically cited in the literature include pain, intravasation, life-threatening oil embolism, and lipogranuloma formation. Emerging evidence suggests that Lipiodol hysterosalpingography may also impact maternal and neonatal thyroid function. Women may develop hypo- or hyperthyroidism. Thyroid dysfunction is clinically significant as even subclinical hypothyroidism reduces fertility, increases the risk of pregnancy complications including miscarriage, pre-eclampsia and perinatal mortality, and adversely impacts foetal neurodevelopment. One study suggested a possible link with neonatal congenital hypothyroidism. There is emerging evidence to suggest that Lipiodol hysterosalpingography can cause hypo- or hyperthyroidism, in addition to known adverse effects of pain, intravasation, oil embolism, and lipogranuloma formation. Given the significance of these risks, and contention surrounding whether Lipiodol truly increases pregnancy rates compared to aqueous mediums, careful consideration is required in the selection of contrast agent. In particular, Lipiodol hysterosalpingography may not be suitable for women with pre-existing thyroid dysfunction. [ABSTRACT FROM AUTHOR]

Chylothorax is the accumulation of lymphatic fluid in pleural space following traumatic injury to lymphatic vessels, systemic venous obstruction, dysfunction of the right ventricle, thrombosis of the duct, superior vena cava or subclavian vein, or postoperatively. A 2 ½-year-old male child operated for transposition of great arteries (TGA), tricuspid atresia (TA), and hypoplastic right ventricle 15 days ago developed chylothorax and left internal jugular vein thrombus. The child was initially managed conservatively with nutritional management, anticoagulation, and octreotide followed by interventional radiological management with lipoidol injection. Early suspicion and diagnosis are crucial. The management was difficult owing to a lack of proper guidelines. Further research is warranted. [ABSTRACT FROM AUTHOR]

Background: The current study aims to investigate the DNA strand breaks based on the Monte Carlo simulation within and around the Lipiodol with flattening filter (FF) and flattening filter-free (FFF) photon beams. Materials and methods: The dose-mean lineal energy (yD) and DNA single- and double strand breaks (DSB/SSB) based on spatial patterns of inelastic interactions were calculated using the Monte Carlo code: particle and heavy ion transport system (PHITS). The ratios of dose using standard radiation (200 kVX) to the dose of test radiation (FF and FFF of 6 MV X-ray (6MVX) and 10 MVX beams) to produce the same biological effects was defined as RBEDSB. The RBEDSB within the Lipiodol and in the build-up and build-down regions was evaluated. Results: The RBEDSB values with the Lipiodol was larger than that without the Lipiodol at the depth of 4.9 cm by 4.2% and 2.5% for 6 MVX FFF and FF beams, and 3.3% and 2.5% for 10 MVX FFF and FF beams. The RBEDSB values with the Lipiodol was larger than that without the Lipiodol at the depth of 6.5 cm by 2.9% and 2.4% for 6 MVX FFF and FF beams, and 1.9% and 1.4% for 10 MVX FFF and FF beams. In the build-down region at the depth of 8.1 cm, the RBEDSB values with the Lipiodol was smaller than that without the Lipiodol by 4.2% and 2.9% for 6 MVX FFF and FF beams, and 1.4% and 0.1% for 10 MVX FFF and FF beams. Conclusions: The current study simulated the DNA strand break except for the physical dose difference. The lower and FFF beam occurred the higher biological effect. [ABSTRACT FROM AUTHOR]

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High atomic number (Z) element-based radiosensitizers have been widely reported for enhancing radiotherapeutic effect, while its limited tumor distribution and long-term safety are major limitations in clinics. In this study, we propose the clinically used lipiodol, a liquid radiological imaging agent with high iodine concentration, as a potential radiosensitizer. Compared to clinically approved high Z nanoradiosensitizer HfO 2 , lipiodol emulsion shows much better tumor spatial distribution and tumor inhibiting ability at in vivo level upon radiation treatment. In addition to primary tumor, lipiodol emulsion also exhibited efficient targetability and inhibition of lymph node metastasis with radiation treatment. Furthermore, the in vitro mechanism study indicates that lipiodol enhances radiotherapeutic effect by generating extra reactive oxygen species to cause DNA damage and cell death, irrespective of cancer type. Lastly, toxicity assessments demonstrate the safety of lipiodol for practical medical applications. This report provides scientific evidence supporting the century-old lipiodol as an effective liquid radiosensitizer ready for clinical implementation. [Display omitted] • This is the first liquid-based high atomic element radiosensitizer. • Clinically used lipiodol formulation in TACE holds promise as a readily available radiosensitizer. • Lipiodol-based radiosensitizer shows homogenous spatial distribution and long retention in tumors. • Radiosensitization of both primary and lymph node metastatic tumor can be achieved. • It is suitable for a variety of solid tumors where radiotherapy is indicated. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to develop a fluorescent iodized emulsion comprising indocyanine green (ICG) solution and lipiodol (ethiodized oil) and evaluate its feasibility for use in a clinical setting. Background: ICG use for the preoperative localization of pulmonary nodules is limited in terms of penetration depth and diffusion. Methods: First, fluorescent microscopy was used to investigate the distribution of ICG-lipiodol emulsions prepared using different methods. The emulsions were injected in 15 lung lobes of 3 rabbits under computed tomography fluoroscopy guidance; evaluation with imaging and radiography was conducted after thoracotomy. Subsequently, the emulsions were used to preoperatively localize 29 pulmonary nodules in 24 human subjects, and wedge resections were performed using fluorescent imaging and C-arm fluoroscopy. Results: The optimal emulsion of 10% ICG and 90% lipiodol mixed through 90 passages had even distribution and the highest signal intensity under fluorescent microscopy; it also had the best consistency in the rabbit lungs, which persisted for 24 hours at the injection site. In human subjects, the mean diameter of pulmonary nodules was 0.9 ± 0.4 cm, and depth from the pleura was 1.2 ± 0.8 cm. All emulsion types injected were well localized around the target nodules without any side effects or procedure-related complications. Wedge resection with minimally invasive approach was successful in all pulmonary nodules with a free resection margin. Conclusions: A fluorescent iodized emulsion prepared by mixing ICG with lipiodol enabled accurate localization and resection of pulmonary nodules. [ABSTRACT FROM AUTHOR]

Previously, the physical dose-enhancement factor (D phys EF) enhancement was introduced. However, the dose enhancement considering the biological effectiveness was not shown. The aim of the current study was to evaluate the biological dose-enhancement factor (D bio EF) by the dose rate and to compare the D phys EF and the D bio EF in Lipiodol for liver Stereotactic Body Radiation Therapy (SBRT). Flattening-filter-free (FFF) 6-MV (6MVX) and 10MVX beams were delivered by TrueBeam. A virtual inhomogeneity phantom and a liver SBRT patient-treatment plan were used. The D phys EF and lineal energy distribution (y) distribution was calculated from Monte Carlo simulations. Using a microdosimetric-kinetic (MK) model that is estimated based on the linear-quadratic formula for Lipiodol using human liver hepatocellular cells (HepG2), the biological dose and biological dose enhancement factor (D bio EF) were calculated. The dose rate in the simulation was changed from 0.1 to 24 Gy/min. The D bio EF (DR:2Gy/min) and D phys EF with 10MVX FFF beam were 23.2% and 19.1% at maximum and 12.8% and 11.1% on average in the Lipiodol. In the comparison of the D bio EF between 0.1–24 Gy/min, the D bio EF was 21.2% and 11.1% with 0.1 Gy/min for 6MVX and 10 MVX, respectively. The D bio EF was larger than DEF for the 6MVX and 10MVX FFF beams. In clinical cases with the 10MVX FFF beam, the D bio EF and D phys EF in the Lipiodol region can increase the in-tumor dose by approximately 11% and 10%, respectively, without increasing the dose to normal tissue. The lower-energy and higher-dose-rate beams were contributed to the biological dose. The Lipiodol caused the enhancement of the physical dose and biological effectiveness. The biological dose enhancement (D bio EF) should be considered in the high-density material such as the Lipiodol. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Water-in-oil (W/O) Lipiodol emulsions remain the preferable choice for local delivery of chemotherapy in the treatment of hepatocellular carcinoma. However, their low stability severely hampers their efficiency. Here, remarkably stable W/O Lipiodol emulsion stabilized by biodegradable particles was developed thanks to Pickering technology. The addition of poly(lactide-co-glycolide) nanoparticles (NPs) into the aqueous-phase of the formulation led to W/O Pickering emulsion by a simple emulsification process through two connected syringes. Influence of nanoparticles concentration and water/oil ratio on emulsion stability and droplet size were studied. All formulated Pickering emulsions were W/O type, stable for at least one month and water droplets size could be tuned by controlling nanoparticle concentration from 24 µm at 25 mg/mL to 69 µm at 5 mg/mL. The potential of these emulsions to efficiently encapsulate chemotherapy was studied through the internalization of doxorubicin (DOX) into the aqueous phase with a water/oil ratio of 1/3 as recommended by the medical community. Loaded-doxorubicin was released from conventional emulsion within a few hours whereas doxorubicin from stable Pickering emulsion took up to 10 days to be completely released. In addition, in vitro cell viability evaluations performed on the components of the emulsion and the Pickering emulsion have shown no significant toxicity up to relatively high concentrations of NPs (3 mg/mL) on two different cell lines: HUVEC and HepG2. Statement of Significance We present an original experimental research in the field of nanotechnology for biomedical applications. In particular, we have formulated, thanks to Pickering technology, a new therapeutic emulsion stabilized with biodegradable PLGA nanoparticles. As far as we know, this is the first therapeutic Pickering emulsion reported in the literature for hepatocellular carcinoma. Such a new emulsion allows to easily prepare a predictable and stable lipiodolized emulsion having all the required characteristics for optimum tumor uptake. As demonstrated throughout our manuscript, emulsions stabilized with these nanoparticles have the advantage of being biodegradable, biocompatible and less toxic compared to usual emulsions stabilized with synthetic surfactants. These findings demonstrate the plausibility of the use of Pickering emulsions for chemoembolization as a therapeutic agent in extended release formulations. [ABSTRACT FROM AUTHOR]

Objectives We examine the contrast agent Lipiodol effect on the relative biological effectiveness (RBE) values for flattening filter free (FFF) and flattening filter (FF) beams of 6 MV-Xray (6 MVX) and 10 MVX. Methods Lipiodol was placed at 5 cm depth in water. According to the microdosimetric kinetic model, the RBE values for killing the human liver hepatocellular cells were calculated from dose and lineal energy ( yd ( y )) from Monte Carlo simulations. RBE 200kVX and RBE Co were defined as the ratios of dose using reference radiation (200 kVX, Co-ɤ) to the dose of test radiation (FFF and FF beams for 6 MV and 10 MV) to produce the same biological effects. The dose enhancement RBE (RBE DE ) was defined as the ratios of a dose without Lipiodol to with Lipiodol using to produce the same biological effects. The dose needed to achieve 10% (D 10% ) and 1% cell survival (D 1% ) was evaluated by cell surviving fraction (SF) formula. Results The deviation of mean y ‾ D values with and without Lipiodol were 3.9–4.8% for 6 MVX and 3.5–3.6% for 10 MVX. The RBE 200kVX and RBE Co with Lipiodol were larger than that without Lipiodol. The RBE DE was larger for FFF beam than for FF beam. The deviation of RBE DE for FFF and FF beams of 6 MVX was larger than that of 10 MVX. Conclusion The presence of Lipiodol seemed to locally increase the absorbed dose and to also cause an enhancement of the relative biological effectiveness. [ABSTRACT FROM AUTHOR]

Transarterial therapies in the setting of primary and secondary liver malignancies are becoming an essential part of the oncology landscape. The mechanism of action of c-TACE is the induction of tumor necrosis due to the high concentration of the chemotherapeutic that is delivered only locally and to the embolic effect that causes ischemia and increased dwell time of the chemotherapeutic in the tumor. Recently, DEB-TACE has emerged as a variation of c-TACE with the potential for the selective delivery of large amounts of drugs to the tumor for a prolonged period, thereby decreasing plasma levels of the chemotherapeutic agent and related systemic effects. There is an increasing consensus that compared with conventional lipiodol-based regimen, DEB-TACE offers standardized methodology, is more reproducible and is associated with improved response and significantly better safety profile. Using an easy to access point by point format, this manuscript summarizes the expert discussion from the Mediterranean Interventional Oncology Live Congress (MIOLive 2017) about the role of TACE in the treatment of liver tumors. [ABSTRACT FROM AUTHOR]

Aim Lipiodol was used for stereotactic body radiotherapy combining trans arterial chemoembolization. Lipiodol used for tumour seeking in trans arterial chemoembolization remains in stereotactic body radiation therapy. In our previous study, we reported the dose enhancement effect in Lipiodol with 10× flattening-filter-free (FFF). The objective of our study was to evaluate the dose enhancement and energy spectrum of photons and electrons due to the Lipiodol depth with flattened (FF) and FFF beams. Methods FF and FFF for 6 MV beams from TrueBeam were used in this study. The Lipiodol (3 × 3 × 3 cm 3 ) was located at depths of 1, 3, 5, 10, 20, and 30 cm in water. The dose enhancement factor (DEF) and the energy fluence were obtained by Monte Carlo calculations of the particle and heavy ion transport code system (PHITS). Results The DEFs at the centre of Lipiodol with the FF beam were 6.8, 7.3, 7.6, 7.2, 6.1, and 5.7% and those with the FFF beam were 20.6, 22.0, 21.9, 20.0, 12.3, and 12.1% at depths of 1, 3, 5, 10, 20, and 30 cm, respectively, where Lipiodol was located in water. Moreover, spectrum results showed that more low-energy photons and electrons were present at shallow depth where Lipiodol was located in water. The variation in the low-energy spectrum due to the depth of the Lipiodol position was more explicit with the FFF beam than that with the FF beam. Conclusions The current study revealed variations in the DEF and energy spectrum due to the depth of the Lipiodol position with the FF and FFF beams. Although the FF beam could reduce the effect of energy dependence due to the depth of the Lipiodol position, the dose enhancement was overall small. To cause a large dose enhancement, the FFF beam with the distance of the patient surface to Lipiodol within 10 cm should be used. [ABSTRACT FROM AUTHOR]

Postoperative chylothorax in infants prolongs hospital stay and possibly causes developmental delay because of its conservative treatment including inanition. Several medical and surgical treatments may be applied, but none constitute the absolute solution. Treatment with lipiodol during lymphangiography for postoperative chylothorax has been reported to be highly effective and less invasive in adults. On the other hand, few cases have been reported in infants. We demonstrate successful blockage of chyle leakage with lipiodol injection through the inguinal lymph node in a 2-year-old infant. The patient had undergone on-pump coarctectomy and chylothorax developed soon after surgery. Several medical treatments were partially effective, but the chest tube could not be removed because sequential aspiration was required to maintain a normal respiratory status. With the patient under general anesthesia, lipiodol injection combined with indocyanine green (ICG) lymphography was performed. Lymphography combined with ICG significantly contributed not only to intraoperative detection of the inguinal lymph nodes but also to postoperative early detection of lymphedema caused by this procedure. This procedure required a simple maneuver and is probably applicable to other cases of traumatic chylothorax, such as after surgeries on the esophagus, trachea, or other components of the posterior mediastinum. [ABSTRACT FROM AUTHOR]

Introduction Ultrasound-guided intranodal lipiodol lymphangiography (LAG) from the groin is a recently introduced technique for diagnosing and treating postoperative chylothorax. The benefits of this technique include reduced technical difficulty and shorter procedure duration, as compared to traditional pedal LAG. Although these benefits may eventually increase utilization of intranodal LAG, reports are still few. Presentation of cases Herein, we report three cases of post-esophagectomy chylothorax in whom ultrasound-guided intranodal lipiodol LAG from the groin were successfully performed with no complications. Leak points were clearly identified in the three cases. Cure was obtained in one case by the LAG only. Surgical ligations were performed after LAG in two cases and cures were achieved. Discussion If LAG successfully cured chylothorax, chest drain output would decrease dramatically and the leaked lipiodol could be confirmed near the leak point in plain computerized tomography (CT) in the following 1-2 days. But if LAG failed to cure, chest drain output would be unchanged and the leaked lipiodol would be found diffusing in the surrounding. Conclusion Ultrasound-guided intranodal lipiodol LAG from the groin is a minimally invasive and easily performed procedure with high diagnostic and therapeutic value for postoperative chylothorax. If LAG failed to cure, conservative management is often insufficient and surgical ligation should be performed as soon as possible. [ABSTRACT FROM AUTHOR]

An adolescent with plastic bronchitis due to congenital heart disease had altered mental status after an interventional lymphatic procedure in which lipiodol contrast was used. Neuroimaging revealed cerebral lipiodol embolization due to direct shunting between lymphatic channels and pulmonary veins. Cerebral lipiodol embolization is a potential neurologic morbidity associated with interventional lymphatic procedures. [ABSTRACT FROM AUTHOR]

• We propose a novel light delivery technique to use lipiodol as the light diffusing agent to enhance the range of photodynamic therapy in peripheral lung cancer. • This study proved the feasibility and safety of this novel method • The method is worth additional research as it causes no serious adverse effects • Multiple illuminations with tolerable light doses from different angles could be planned to fully encase the tumor Photodynamic therapy involves using a photosensitizer with l illumination and is recommended for treating early, centrally located lung cancers, but it is not a standard treatment for peripheral lung tumor.. We previously proposed a novel light delivery method, in which lipiodol is perfused into the bronchial tree to increase the scope of illumination via the fiber effect. Herein, we attempted this novel technique under electromagnetic bronchoscope guidance in a hybrid operation room where lipiodol facilitated light diffusion, and evaluated the effectiveness and feasibility of this technique for peripheral lung cancers. This phase 0 pilot study included three patients with peripheral lung cancers (primary tumors ≤20-mm diameter). The photodynamic therapy was administered using Porfimer sodium as the photosensitizer, and an electromagnetic navigation bronchoscope in a hybrid operating room to guide the catheter to the tumor. This facilitated lipiodol infusion to encase the tumor and permit the transbronchial photodynamic therapy ablation. Administering 630 nm 200 J/cm (400mW/500sec) energy through a 3-cm cylindrical diffusing laser fiber was safe; no significant acute complications were observed. Although the treatment outcome was unsatisfactory due to the low light dose, tumor pathology in one case revealed tumor necrosis, with no significant damage to the surrounding lung tissue. Novel light delivery transbronchial photodynamic therapy ablation for peripheral lung tumors is feasible and safe. Additional clinical trials may help determine the best illumination plan and light dose through multiple deliveries from multiple angles. [ABSTRACT FROM AUTHOR]

A 60-year-old male patient who previously underwent transarterial chemoembolization for recurrent hepatocellular carcinoma three months ago presented to the emergency department with pleural effusion and hemoptysis. On serial review of plain radiographs and chest CT, transdiaphragmatic migration of Lipiodol from the treated area of the liver into the ipsilateral pleural cavity was demonstrated. The patient consequently developed empyema in the right thorax. Therefore, percutaneous drainage was performed. Empyema and pleural effusion regressed after 10 days of medical treatment and drainage. After that, the patient was transferred back to the local clinic upon full symptomatic recovery. Herein, we describe a rare complication of transarterial chemoembolization for hepatocellular carcinoma manifesting as an empyema secondary to the migration of the ethiodized oil content from the liver into the ipsilateral pleural cavity. [ABSTRACT FROM AUTHOR]

Introduction: Transcatheter arterial chemoembolization (TACE) is a widely used form of therapy in advanced hepatocellular carcinoma. We report the first pathological data from an autopsy case of multiple cerebral emboli occurring during TACE. Methods: A Medline search for previous cases of cerebral embolism and TACE revealed 11 other cases. Findings: Multiple microscopic subacute infarcts were found in the cerebrum, midbrain, and cerebellum of our patient on autopsy, but no embolic material was seen. Embolic material was noted in dilated vessels throughout the fibrotic right diaphragm and in the upper lobe of the right lung. Combining the literature search with our patient, the mortality of cerebral embolism after TACE is 25% (n = 12). Intracardiac shunts were seen in 20% of the cases (n = 10). Hyperdense lesions were seen on head CT in 80% of the patients evaluated (n = 10). Chest imaging revealed infiltrate or consolidation in 60% of the cases (n = 5). Pulmonary emboli were reported in 100% of the cases (n = 8). Conclusions: Cerebral embolism after TACE is devastating. Brain pathology supports embolization of ethiodized oil rather than DC beads as the mechanism of cerebral injury. Further pathological studies are needed to better understand the pathophysiology of this condition. Lung pathology confirmed the presence of embolic material in the distal lung, suggestive of a hepatopulmonary shunt undetectable by current modalities. Evaluation for such shunts with emerging modalities such as TCD with emboli detection may be an area of future research. [ABSTRACT FROM AUTHOR]

Abstract: There is limited information about the retention of lipiodol in the parotid gland after parotid gland sialography. This study assesses the prevalence of lipiodol retention after parotid sialography and determines if retention of lipiodol is related to the sialography technique or the underlying salivary gland pathology. Using the electronic hospital database (1996–2006), 66 out of 565 patients were identified who had additional maxillofacial radiographic examinations after the initial sialography. Additional radiographs up to October 2007 were included; these were orthopantomographic radiographs in all cases. In 28 patients (42%) signs of lipiodol retention were observed (mean radiographic follow-up: 15±13 months). Retention was characterized by small radiopaque spots in the periphery of the gland. Lipiodol retention was predominantly associated with a fausse route (n =8) or the presence of salivary gland disease (sialectasia; n =17). In 9 patients with signs of lipiodol retention, a series of radiographs was available. Lipiodol radiodensities decreased in size during 28 months, and could disappear gradually (follow-up 14–57 months). Despite the high frequency of retention of small depots of lipiodol for years after sialography in patients subjected to additional radiographic examinations, no clinically adverse effects were observed. [Copyright &y& Elsevier]

Abstract: Background: The majority of patients with hepatocellular carcinoma are not eligible for surgical radical treatment (resection or liver transplantation) and lipiodol chemoembolisation is an efficient alternative procedure in this indication. Aims: To identify prognostic factors in patients treated with lipiodol chemoembolisation. Patients and methods: During 10 years, 89 consecutive patients with unresectable hepatocellular carcinoma underwent lipiodol chemoembolisation as a single treatment. There were 80 males and 9 females, with a median age of 65 years. Treatment consisted of one to six courses of hepatic intra-arterial lipiodol with doxorubicine and gelatin sponge. Results: The median survival was 13 months with a 13.6% survival rate at 4 years. Univariate analysis showed that serum levels of albumin, bilirubin, alkaline phosphatase and alpha-fetoprotein, Child''s class, tumour type, tumour size and intensity of lipiodol capture after the first course of lipiodol chemoembolisation were significant prognostic factors of survival. In the multivariate analysis, four parameters remained associated with a significantly better outcome: Child''s class A, largest lesion<5cm, uninodular tumour and intense lipiodol capture. Conclusions: While lipiodol chemoembolisation is associated with good results only in some patients, in the absence of lipiodol capture, it should be ruled out. [Copyright &y& Elsevier]

Venogenic erectile dysfunction is an important problem. Embolization of draining veins through penile deep dorsal vein is an effective alternative endovascular treatment procedure. We report a 27-year-old male with venogenic erectile dysfunction who developed pulmonary embolism after penile deep dorsal vein embolization with n-butyl-2-cyanoacrylate (NBCA) and lipiodol mixture. Although it is uncommon, due to inherent possible complications of liquid embolic material n-butyl-2-cyanoacrylate and lipid soluble contrast material lipiodol, symptomatic pulmonary embolism could be seen after deep dorsal vein embolization if the amount of lipiodol is increased and repeat injection is performed without performing a control venogram. [Copyright &y& Elsevier]

Chylous ascites (CA) is an infrequent, intractable complication that may arise after abdominal surgery. Although various attempts at treatment have been adopted, to date, none of them have been consistently effective. We describe the successful treatment of CA using lymphangiography and embolization with lipiodol. A 79-year-old woman underwent laparoscopic surgery for rectum cancer at another hospital. She was discharged on postoperative day (POD) 9; however, she had to be treated and hospitalized for CA three times until POD 76. She visited our hospital to undergo treatment for CA on POD 90 because the previous conservative treatment had not improved her condition. The computed tomography (CT) scans revealed ascites effusion. We performed lymphangiography and embolization with lipiodol two times. Repeated CT on POD 134 showed that the ascites had not increased. Lymphangiography and embolization with lipiodol effectively resolved chylous leakage that occurred after abdominal surgery. Additionally, we compare the features of two groups of cases of CA: one group in which patients were treated by lymphatic intervention and the second in which patients were treated through surgical procedures. We were thus able to demonstrate the clinical effectiveness of lipiodol lymphangiography in treating CA. [ABSTRACT FROM AUTHOR]

Abstract: Drug-induced interstitial pneumonia is a severe disease that has been reportedly caused by more than 100 compounds, the most common being amiodarone, methotrexate and bleomycin. We report a case of fatal acute interstitial pneumonia occurring after a second injection of 131I-labeled lipiodol for hepatocellular carcinoma treatment. Infectious pneumonia was ruled out and lung biopsy revealed a pattern of usual interstitial pneumonia. Despite early initiation of systemic corticosteroids and additionally, antioxidant medications, the patient’s condition gradually worsened and he died 24 days after admission. 131I-labeled lipiodol-induced interstitial pneumonia is probably frequently undiagnosed. A better knowledge of this disease would help to estimate its true incidence and may impact on the perceived risk/benefit ratio for its treatment. Moreover, this may have consequences on the prescription of 131I-labeled lipiodol. [Copyright &y& Elsevier]

Accurate and safe preoperative localization is useful for video-assisted thoracic surgery of small pulmonary lesions with ground-glass opacity (GGO). However, the optimal localization method is unclear. The aim of this study was to compare the usefulness and safety of the lipiodol and hook-wire localization techniques for video-assisted thoracic surgery of GGO lesions. This prospective, non-randomized comparative study was conducted between April 2014 and December 2016 at 8 qualifying university teaching hospitals. Two-hundred-fifty patients with pulmonary lesions having GGO were included. Patients were assigned in a 1:1 ratio to either the lipiodol (n = 125, 4 hospitals) or hook-wire group (n = 125, 4 hospitals) for preoperative localization procedures. Participants underwent preoperative localization via the lipiodol or hook-wire technique followed by thoracoscopic surgery. The primary endpoint was the procedure success rate. The procedure success rates (hook-wire vs lipiodol group) were 94.40% versus 99.16% (P =.08). Localization-related complications occurred in 53.60% versus 48.33% of patients (P =.49). Hemorrhage rates were significantly greater in the hook-wire group than in the lipiodol group (21.6% vs 5.83%, P <.001). The lipiodol procedure time was significantly longer than that of the hook-wire technique (20.69 ± 9.34 vs 17.15 ± 7.91 minutes, P =.001). The initially positive surgical resection margin was significantly greater in the hook-wire group than in the lipiodol group (10.89% vs 2.38%, P =.02). There was no significant difference in success rate between the hook-wire and lipiodol methods. However, the hemorrhage rate was significantly greater in the hook-wire group, whereas the hook-wire group showed greater initially positive surgical resection margins. [ABSTRACT FROM AUTHOR]