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We aimed to evaluate the effect of transcatheter arterial embolization (TAE) with iodized oil (Lipiodol) on temperature change during cryoablation (CA) for renal cell carcinoma (RCC). We retrospectively reviewed patients receiving CA for RCC from February 2020 to July 2021, including those who received Lipiodol TAE prior to CA (TAE group) and those who underwent only CA with comparable clinical and tumor characteristics (non-TAE group). Clinical data and tumor characteristics of both groups were recorded. The temperature readings of each cryoprobe at every 15 s and 'time to −100 °C' were compared between the groups. A total of 17 patients with 18 RCCs were recruited (seven in the TAE group and 11 in the non-TAE group). The 'time to −100 °C' was significantly longer in the TAE group than in the non-TAE group (64.5 ± 24.3 s vs. 48.8 ± 9.7 s, p = 0.018). Positive correlation between 'time to −100 °C' and tumor maximal diameter, RENAL nephrometry and PADUA score were observed in the non-TAE group, while no corresponding correlation was found in the TAE group. Pre-embolization with iodized oil influences the temporal temperature changes during cryoablation by disrupting the positive correlation between the time to reach the target temperature and tumor characteristics. [ABSTRACT FROM AUTHOR]

Background: To compare the efficacy and safety of iodized oil versus polyvinyl alcohol (PVA) particles in portal vein embolization (PVE) before partial hepatectomy. Methods: From October 2016 to December 2021, 86 patients who planned to undergo hepatectomy after PVE were enrolled, including 61 patients post-PVE with PVA particles + coils and 25 patients post-PVE with iodized oil + coils. All patients underwent CT examination before and 2–3 weeks after PVE to evaluate the future liver remnant (FLR). The intercohort comparison included the degree of liver volume growth, changes in laboratory data, and adverse events. Results: There was no significant difference in the resection rate between the iodized oil group and the PVA particle group (68 % vs. 70 %, p = 0.822). In terms of the degree of hypertrophy (9.52 % ± 13.47 vs. 4.03 % ± 10.55, p = 0.047) and kinetic growth rate (4.07 % ± 5.4 vs. 1.55 % ± 4.63, p = 0.032), the iodized oil group was superior to the PVA group. The PVE operation time in the PVA particle group was shorter than that in the iodized oil group (121. 72 min ± 34.45 vs. 156. 2 min ± 71.58, p = 0.029). There was no significant difference in the degree of hypertrophy between the high bilirubin group and the control group (5.32 % ± 9.21 vs. 6.1 % ± 14.79, p = 0.764). Only 1 patient had a major complication. Conclusions: Compared with PVA particles, iodized oil PVE can significantly increase liver volume and the degree of hypertrophy without any significant difference in safety.

To compare the efficacy and safety of iodized oil versus polyvinyl alcohol (PVA) particles in portal vein embolization (PVE) before partial hepatectomy. From October 2016 to December 2021, 86 patients who planned to undergo hepatectomy after PVE were enrolled, including 61 patients post-PVE with PVA particles + coils and 25 patients post-PVE with iodized oil + coils. All patients underwent CT examination before and 2–3 weeks after PVE to evaluate the future liver remnant (FLR). The intercohort comparison included the degree of liver volume growth, changes in laboratory data, and adverse events. There was no significant difference in the resection rate between the iodized oil group and the PVA particle group (68 % vs. 70 %, p = 0.822). In terms of the degree of hypertrophy (9.52 % ± 13.47 vs. 4.03 % ± 10.55, p = 0.047) and kinetic growth rate (4.07 % ± 5.4 vs. 1.55 % ± 4.63, p = 0.032), the iodized oil group was superior to the PVA group. The PVE operation time in the PVA particle group was shorter than that in the iodized oil group (121. 72 min ± 34.45 vs. 156. 2 min ± 71.58, p = 0.029). There was no significant difference in the degree of hypertrophy between the high bilirubin group and the control group (5.32 % ± 9.21 vs. 6.1 % ± 14.79, p = 0.764). Only 1 patient had a major complication. Compared with PVA particles, iodized oil PVE can significantly increase liver volume and the degree of hypertrophy without any significant difference in safety. [ABSTRACT FROM AUTHOR]

Several publications show that superselective conventional TransArterial ChemoEmbolization (cTACE), meaning cTACE performed selectively with a microcatheter positioned as close as possible to the tumor, improves outcomes, maximizing the anti-tumoral effect and minimizing the collateral damages of the surrounding liver parenchyma. Recent recommendations coming from the European Association for the Study of the Liver (EASL) and European Society of Medical Oncology (ESMO) highlighted that TACE must be used in Hepatocellular Carcinoma (HCC) "selectively targetable" and "accessible to supraselective catheterization." The goal of the manuscript is to better define such population and to standardize superselective cTACE (ss-cTACE) technique. An expert panel with extensive clinical-procedural experience in TACE, have come together in a virtual meeting to generate recommendations and express their consensus. Experts recommend that anytime cTACE is proposed, it should be ss-cTACE, preferably with a 1.5-2.0 Fr microcatheter. Ideally, ss-cTACE should be proposed to patients with less than five lesions and a maximum number of two segments involved, with largest tumor smaller than 5 cm. Angio Cone-Beam Computed Tomography (CBCT) should be used to detect enhancing tumors, tumor feeders and guide tumor targeting. Whole tumor volume should be covered to obtain the best response. Adding peritumoral margins is encouraged but not mandatory. The treatment should involve a water-in-oil emulsion, whose quality is assessable with the "drop test." Additional particulate embolization should be systematically performed, as per definition of cTACE procedure. Non-contrast CBCT or Multi-Detector Computed Tomography (MDCT) combined with angiography has been considered the gold standard for imaging during TACE, and should be used to assess tumor coverage during the procedure. Experts convene that superselectivity decreases incidence of adverse effects and improves tolerance. Experts recommend contrast-enhanced Computed Tomography (CT) as initial imaging on first follow-up after ss-cTACE, and Magnetic Resonance Imaging (MRI) if remaining tumor viability cannot be confidently assessed on CT. If no response is obtained after two ss-cTACE sessions within six months, patient must be considered unsuitable for TACE and proposed for alternative therapy. Patients are best served by multidisciplinary decision-making, and Interventional Radiologists should take an active role in patient selection, treatment allocation, and post-procedural care. [ABSTRACT FROM AUTHOR]

Ultraselective conventional transarterial chemoembolization (cTACE), defined as cTACE at the most distal portion of the subsubsegmental hepatic artery, is mainly performed for hepatocellular carcinoma (HCC) ≤5 cm. Distal advancement of a microcatheter enables injection of a larger volume of iodized oil into the portal vein in the limited area under non-physiological hemodynamics. As a result, the reversed portal flow into the tumor through the drainage route of the tumor that occurs when the hepatic artery is embolized is temporarily blocked. By adding gelatin sponge slurry embolization, both the hepatic artery and portal vein are embolized and not only complete necrosis of can be achieved. Ultraselective cTACE can cure small HCCs including less hypervascular tumor portions and replace surgical resection and radiofrequency ablation in selected patients.

Objective To investigate the cost - effect of transarterial chemoembolization (TACE) with CalliSpheres beads loaded with arsenic trioxide (ATO) (CBATO) versus ATO iodized oil emulsion (conventional TACE, cTACE) in the treatment of unresectable liver cancer. Methods A total of 100 patients with advanced liver cancer who attended The First Affiliated Hospital of Zhengzhou University from May 2017 to December 2018 were enrolled and divided into CBATO group (n = 45) and cTACE group(n = 55) according to the treatment regimen. Progression - free survival (PFS) was used to evaluate the efficacy of quality - adjusted life year (QALY), and European Quality of Life -5 Dimensions (EQ - 5D) index was used to evaluate quality of life. The t - test was used for comparison of continuous data between groups, and the chi - square test was used for comparison of categorical data between groups; the number of surgeries, length of hospital stay, treatment cost, and incremental cost - effectiveness ratio (ICER) were calculated for the two groups, and then a cost - effect analysis was performed. Results Within the PFS time, the per capita hospital cost was 96 446 yuan in the CBATO group and 91 230.43 yuan in the cTACE group. There were significant differences between the two groups in the mean number of surgeries (2.5 ± 0.7 vs 3.4 ± 0.8, t = 16. 911, P <0. 01) and mean hospital stay (5.8 ± 1.2 days vs 7.5 ± 1.8 days, t = 12. 459, P <0.01). The CBATO group had a significantly higher QALY than the cTACE group (0.804 vs 0.512). Compared with the cTACE group, the CBATO group had an ICER of 17861.53 yuan/QALY for unresectable liver cancer. Conclusion Although CBATO has a higher surgery cost than cTACE, CBATO has a better clinical effect than cTACE and can reduce the number of surgeries and length of hospital stay, with a better postoperative quality of life than cT ACE, suggesting that CBATO has marked cost - effect advantages. [ABSTRACT FROM AUTHOR]

Fe3O4 nanoparticles/iodized oil magnetic fluids (FIOMFs) have showed potential in targeted hyperthermia for liver tumors; in this paper, FIOMFs were simply and conveniently prepared by dispersing the synthesized hydrophobic Fe3O4 nanoparticles (FNPs) in iodized oil; the stability, magnetothermal effects, and the biotoxicity of FIOMFs were evaluated. The results showed that the stability of FIOMFs was mainly influenced by the morphology and the size of FNPs. FNPs prepared with FeCl3·6H2O, oleylamine (OAm), ethylene glycol (EG), and stearic acid exhibited the best suspension stability, which could suspend in iodized oil stably for a long time. Depending on the FNP content and the parameters of the alternating magnetic field (AMF), the temperature of FIOMF in AMF can reach up to more than 70 °C within 60 s, exhibited excellent magnetothermal effects. The in vitro cytotoxicity tests indicated the cytotoxicity of FNPs is mainly influenced by its concentration in cells. [ABSTRACT FROM AUTHOR]

Background: Although the policy of universal salt iodization and daily iodine-containing vitamin supplementations were implemented, the urinary iodine concentration (UIC) in pregnant women in the northeast of Thailand still showed mild iodine deficiency. Objective: To determine UIC in pregnant women receiving daily iodine-containing vitamin versus a single dose of two iodized oil capsules. Materials and Methods: The present study was conducted between March 2014 and October 2015, in 21 public hospitals in Khon Kaen Province. Healthy singleton pregnancy of a gestational age of less than 20 weeks that had not received iodine-containing vitamin were enrolled. The participants were asked to take either daily one tablet vitamin or a single dose of two iodized oil capsules. Random urine was collected before and after taking medication. Neonatal thyroid stimulating hormone (TSH) was retrieved from medical record. Results: Of the 2,079 participants, median UIC of pre- and post-daily vitamin supplementation in 1,061 pregnant women were 116.0 and 126.2 mcg/L. Median UIC of pre- and post-single dose iodized oil in 973 participants were 110.4 and 108.6 mcg/L. There was no statistically significant increase UIC post iodine supplementation in both groups (p=0.169). The median neonatal serum TSH were 4.34 and 3.79 mU/L in daily vitamin and single dose respectively, which is significantly lower in the iodized oil group (p=0.023). Conclusion: Post iodine supplementation either by daily vitamin or single dose did not significantly increase UIC. [ABSTRACT FROM AUTHOR]

Objectives: To verify the feasibility of walking to shorten the time before obtaining delayed radiographs after iodized oil hysterosalpingography (HSG). Material and methods: One hundred women with infertility were selected for HSG from June 2018 to December 2018 at the Women's Hospital of Nanjing Medical University; the subjects were randomly divided into walking and control groups. The walking group was required to walk more than 12,000 steps within 6 hours after HSG, while the control group was prohibited from performing high-intensity exercise. The degree of pelvic adhesion was diagnosed with delayed radiographs acquired at 6 and 24 hours, and the diagnostic consistency of the radiographs at the two time points was evaluated. Results: No significant difference was observed in the baseline data between groups (p > 0.05). The delayed radiograph results in the walking group showed good agreement (p = 0.255 > 0.05, Kappa value 0.781 > 0.75), while those in the control group showed general agreement (p = 0.002 < 0.05, Kappa value 0.493 > 0.40 < 0.75). Conclusions: The time for acquiring delayed radiographs can be shortened by instructing patients to walk after HSG. This method improves the diagnostic efficiency of Iodized oil, saves time and costs, and may contribute to the popularization of HSG for female infertility screening, while offering good clinical application prospects. [ABSTRACT FROM AUTHOR]

Transarterial chemoembolization (TACE) is a first-line treatment for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer stage B (BCLC-B). There are two major techniques of TACE: conventional TACE (cTACE) using iodized oil and gelatin sponge particles, and TACE using drug-eluting beads (DEB-TACE). The latest randomized controlled trial proved the superiority of cTACE regarding local effects over DEB-TACE; however, cTACE also damages the liver more severely. Therefore, cTACE should be performed for localized HCCs as selectively as possible. On the other hand, DEB-TACE has less liver toxicity and is favorable for patients with an advanced age, large and/or bilobar tumors, or a poor liver function. However, some BCLC-B HCCs are TACE-resistant and the concept of TACE unsuitability (mainly up-to-7 criteria out) has been proposed by Asia-Pacific Primary Liver Cancer Expert Meeting. Systemic therapy is recommended for patients with TACE-unsuitable HCC; however, the condition of TACE-unsuitable HCC does not always rule out TACE monotherapy and some up-to-7 criteria out tumors may also be good candidates for superselective cTACE when localized in limited liver segments. The sequential therapy of an antiangiogenic and TACE is also a novel option for patients with TACE-unsuitable HCC, antiangiogenic-refractory HCC, or even down-staged HCC. [ABSTRACT FROM AUTHOR]

Ｏｂｊｅｃｔｉｖｅ Ｔｏ ｉｎｖｅｓｔｉｇａｔｅ ｔｈｅ ｃｌｉｎｉｃａｌ ｅｆｆｅｃｔ ａｎｄ ｓａｆｅｔｙ ｏｆ ｔｒａｎｓａｒｔｅｒｉａｌ ｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ （ＴＡＣＥ）ｗｉｔｈ ｕｌｔｒａ － ｌｉｑｕｉｄ ｉｏｄｉｚｅｄ ｏｉｌ ｃｏｍｂｉｎｅｄ ｗｉｔｈ ｄｒｕｇ － ｅｌｕｔｉｎｇ ｂｅａｄｓ ｉｎ ｔｈｅ ｔｒｅａｔｍｅｎｔ ｏｆ Ｂａｒｃｅｌｏｎａ Ｃｌｉｎｉｃ Ｌｉｖｅｒ Ｃａｎｃｅｒ （ＢＣＬＣ）ｓｔａｇｅ Ｂ／ Ｃ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａ （ＨＣＣ）． Ｍｅｔｈｏｄｓ Ａ ｒｅｔｒｏｓｐｅｃｔｉｖｅ ａｎａｌｙｓｉｓ ｗａｓ ｐｅｒｆｏｒｍｅｄ ｆｏｒ ｔｈｅ ｃｌｉｎｉｃａｌ ｄａｔａ ｏｆ ５１ ｐａｔｉｅｎｔｓ ｗｉｔｈ ＢＣＬＣ ｓｔａｇｅ Ｂ／ Ｃ ＨＣＣ ｗｈｏ ｕｎｄｅｒｗｅｎｔ ＴＡＣＥ ｗｉｔｈ ｕｌｔｒａ － ｌｉｑｕｉｄ ｉｏｄｉｚｅｄ ｏｉｌ ｃｏｍｂｉｎｅｄ ｗｉｔｈ ｄｒｕｇ － ｅｌｕｔｉｎｇ ｂｅａｄｓ ｉｎ Ｔｈｅ Ｆｉｒｓｔ Ａｆｆｉｌｉａｔｅｄ Ｈｏｓｐｉｔａｌ ｏｆ Ｓｏｏｃｈｏｗ Ｕｎｉｖｅｒｓｉｔｙ ｆｒｏｍ Ｍａｙ ２０１６ ｔｏ Ｓｅｐｔｅｍ ｂｅｒ ２０１８． Ｌｉｖｅｒ ｆｕｎｃｔｉｏｎ ｗａｓ ｏｂｓｅｒｖｅｄ ｂｅｆｏｒｅ ｔｒｅａｔｍｅｎｔ ａｎｄ ａｔ ３ ｄａｙｓ，７ ｄａｙｓ，ａｎｄ １ ｍｏｎｔｈ ａｆｔｅｒ ｔｒｅａｔｍｅｎｔ，ａｎｄ ａｄｖｅｒｓｅ ｅｖｅｎｔｓ ａｎｄ ｃｏｍｐｌｉ ｃａｔｉｏｎｓ ｗｅｒｅ ｒｅｃｏｒｄｅｄ ｉｎ ｄｅｔａｉｌ． Ｍｏｄｉｆｉｅｄ Ｒｅｓｐｏｎｓｅ Ｅｖａｌｕａｔｉｏｎ Ｃｒｉｔｅｒｉａ ｉｎ Ｓｏｌｉｄ Ｔｕｍｏｒｓ ｗａｓ ｕｓｅｄ ｔｏ ｅｖａｌｕａｔｅ ｃｌｉｎｉｃａｌ ｏｕｔｃｏｍｅ ａｔ １ ａｎｄ ３ ｍｏｎｔｈｓ ａｆｔｅｒ ｓｕｒｇｅｒｙ． Ｔｈｅ ｔ － ｔｅｓｔ ｗａｓ ｕｓｅｄ ｆｏｒ ｃｏｍｐａｒｉｓｏｎ ｏｆ ｃｏｎｔｉｎｕｏｕｓ ｄａｔａ ｂｅｔｗｅｅｎ ｔｗｏ ｇｒｏｕｐｓ． Ｒｅｓｕｌｔｓ Ｓｕｐｅｒｓｅｌｅｃｔｉｖｅ ＴＡＣＥ ｐｒｏｃｅｄｕｒｅ ｗａｓ ｃｏｍｐｌｅｔｅｄ ｉｎ ａｌｌ ５１ ｐａｔｉｅｎｔｓ． Ａｔ １ ｍｏｎｔｈ ａｆｔｅｒ ｓｕｒｇｅｒｙ，ｔｈｅ ｔａｒｇｅｔ ｌｅｓｉｏｎｓ ｈａｄ ａ ｄｉｓｅａｓｅ ｒｅｍｉｓｓｉｏｎ ｒａｔｅ ｏｆ ７０． ６％ ａｎｄ ａ ｄｉｓｅａｓｅ ｃｏｎｔｒｏｌ ｒａｔｅ ｏｆ ９６． １％ ，ｗｈｉｌｅ ａｔ ３ ｍｏｎｔｈｓ ａｆｔｅｒ ｓｕｒｇｅｒｙ，ｔｈｅ ｔａｒｇｅｔ ｌｅｓｉｏｎｓ ｈａｄ ａ ｄｉｓｅａｓｅ ｒｅｍｉｓｓｉｏｎ ｒａｔｅ ｏｆ ６４． ０％ ａｎｄ ａ ｄｉｓｅａｓｅ ｃｏｎｔｒｏｌ ｒａｔｅ ｏｆ ８８ ０％ ． Ｏｆ ａｌｌ ５１ ｐａｔｉｅｎｔｓ，５ （９． ８％ ）ｅｘｐｅｒｉｅｎｃｅｄ ａｃｕｔｅ ｌｉｖｅｒ ｉｎｊｕｒｙ ａｔ ３ ｄａｙｓ ａｆｔｅｒ ｓｕｒｇｅｒｙ，ａｎｄ ｔｈｅｒｅ ｗｅｒｅ ｓｉｇｎｉｆｉｃａｎｔ ｃｈａｎｇｅｓ ｉｎ ａｌａｎｉｎｅ ａｍｉｎｏｔｒａｎｓｆｅｒａｓｅ （ＡＬＴ），ａｓｐａｒｔａｔｅ ａｍｉｎｏｔｒａｎｓｆｅｒａｓｅ，ｔｏｔａｌ ｂｉｌｉｒｕｂｉｎ （ＴＢｉｌ），ａｎｄ ａｌｂｕｍｉｎ （Ａｌｂ）（ｔ ＝ － ５． ４５４，－ ３． ９９７，－ ５． ３４６，ａｎｄ ７ ２１２，ａｌｌ Ｐ ＜０． ００１）． Ｔｈｅｒｅ ｗｅｒｅ ａｌｓｏ ｓｉｇｎｉｆｉｃａｎｔ ｃｈａｎｇｅｓ ｉｎ ＡＬＴ，ＴＢｉｌ，ａｎｄ Ａｌｂ ａｔ ７ ｄａｙｓ ａｆｔｅｒ ｓｕｒｇｅｒｙ （ｔ ＝ － ３． １７７，－ ３． ６６５，ａｎｄ ３ １９４，ａｌｌ Ｐ ＜０． ０５）． Ｏｆ ａｌｌ ５１ ｐａｔｉｅｎｔｓ，３５ （６８． ６％ ）ｅｘｐｅｒｉｅｎｃｅｄ ｇｒａｄｅ １ ｏｒ ２ ａｄｖｅｒｓｅ ｅｖｅｎｔｓ ａｔ １ ｍｏｎｔｈ ａｆｔｅｒ ｓｕｒｇｅｒｙ，ａｎｄ ｎｏ ｃｏｍｐｌｉｃａ ｔｉｏｎｓ ｏｆ ｌｉｖｅｒ ｆａｉｌｕｒｅ，ｌｉｖｅｒ ａｂｓｃｅｓｓ，ｂｉｌｅ ｔｕｍｏｒ，ａｎｄ ｇａｓｔｒｏｉｎｔｅｓｔｉｎａｌ ｂｌｅｅｄｉｎｇ ｗｅｒｅ ｏｂｓｅｒｖｅｄ． Ｏｎｅ ｐａｔｉｅｎｔ ｄｉｅｄ ｏｆ ｍｕｌｔｉｐｌｅ ｏｒｇａｎ ｆａｉｌｕｒｅ ｄｕｅ ｔｏ ｔｕｍｏｒ ｐｒｏｇｒｅｓｓｉｏｎ ｏｎ ｄａｙ ６１ ａｆｔｅｒ ｓｕｒｇｅｒｙ． Ｃｏｎｃｌｕｓｉｏｎ ＴＡＣＥ ｗｉｔｈ ｕｌｔｒａ － ｌｉｑｕｉｄ ｉｏｄｉｚｅｄ ｏｉｌ ｃｏｍｂｉｎｅｄ ｗｉｔｈ ｄｒｕｇ － ｅｌｕｔｉｎｇ ｂｅａｄｓ ｉｓ ｓａｆｅ ａｎｄ ｅｆｆｅｃｔｉｖｅ ｉｎ ｔｈｅ ｔｒｅａｔｍｅｎｔ ｏｆ ＢＣＬＣ ｓｔａｇｅ Ｂ／ Ｃ ＨＣＣ，ａｎｄ ｆｕｒｔｈｅｒ ｓｔｕｄｉｅｓ ａｒｅ ｎｅｅｄｅｄ ｔｏ ｏｂｓｅｒｖｅ ｌｏｎｇ － ｔｅｒｍ ｅｆｆｉｃａｃｙ ａｎｄ ｓｕｒｖｉｖａｌ ｂｅｎｅｆｉｔ． [ABSTRACT FROM AUTHOR]

Introduction: Radiotherapy to the bladder has a risk of toxicity to pelvic structures, which can be reduced by using fiducial markers for targeting. Injectable contrast offers an alternative marker to gold seeds, which may fall out or exacerbate scarring. Combining contrast agents with tissue glue can minimize dispersion through tissue, enhancing its utility. We evaluated combinations of contrast agents and tissue glue using porcine bladder, for feasibility and utility as fiducial markers to aid image-guided radiotherapy. Methods: Different contrast agents (Lipiodol ultra or Urografin) were combined with different tissue glues (Histoacryl, Tisseal or Glubran2). The mixtures were endoscopically injected into porcine bladder submucosa to identify the area of interest with multiple fiducial markers. The porcine bladders were imaged within a phantom porcine pelvis using standard radiation therapy imaging modalities. The feasibility as an injectable fiducial marker and visibility of each fiducial marker on imaging were scored as binary outcomes by two proceduralists and two radiation therapists, respectively. Results: Lipiodol–glue combinations were successfully administered as multiple fiducials that were evident on CT and CBCT. Lipiodol with Histoacryl or Glubran2 was visible on kV imaging. The Lipiodol Glubran2 combination was deemed subjectively easiest to use at delivery, and a better fiducial on KV imaging. Conclusion: This study demonstrates the feasibility of mixing contrast medium Lipiodol with Histoacryl or Glubran2 tissue glue, which, injected endoscopically, provides discrete and visible fiducial markers to aid image-guided radiotherapy. Although promising, further study is required to assess the durability of these markers through a course of radiotherapy. [ABSTRACT FROM AUTHOR]

Transarterial chemoembolization (TACE) is a first-line treatment for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer stage B (BCLC-B). There are two major techniques of TACE: conventional TACE (cTACE) using iodized oil and gelatin sponge particles, and TACE using drug-eluting beads (DEB-TACE). The latest randomized controlled trial proved the superiority of cTACE regarding local effects over DEB-TACE; however, cTACE also damages the liver more severely. Therefore, cTACE should be performed for localized HCCs as selectively as possible. On the other hand, DEB-TACE has less liver toxicity and is favorable for patients with an advanced age, large and/or bilobar tumors, or a poor liver function. However, some BCLC-B HCCs are TACE-resistant and the concept of TACE unsuitability (mainly up-to-7 criteria out) has been proposed by Asia-Pacific Primary Liver Cancer Expert Meeting. Systemic therapy is recommended for patients with TACE-unsuitable HCC; however, the condition of TACE-unsuitable HCC does not always rule out TACE monotherapy and some up-to-7 criteria out tumors may also be good candidates for superselective cTACE when localized in limited liver segments. The sequential therapy of an antiangiogenic and TACE is also a novel option for patients with TACE-unsuitable HCC, antiangiogenic-refractory HCC, or even down-staged HCC.

Objective: The aim of this study was to evaluate the potential implications of fusion imaging with C-arm computed tomography (CACT) scans for repetitive conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma., Materials and Methods: Fifty-six cTACE sessions were performed using fusion CACT images from September 2020 to June 2021 in a tertiary referral center, and the data were retrospectively analyzed. Fusion of unenhanced and enhanced CACT images was considered when previously accumulated iodized oil hampered the identification of local tumor progression or intrahepatic distant metastasis (indication A), when a tumor was supplied by multiple arteries with different origins from the aorta and missing tumor enhancement was suspected (indication B), or when iodized oil distribution on immediate post-cTACE CACT images needed to be precisely compared with the pre-cTACE images (indication C). Fusion image quality, initial tumor response, time to local progression (TTLP) of index tumors, and time to progression (TTP) were evaluated., Results: The fusion quality was satisfactory with a mean misregistration distance of 1.4 mm. For the 40 patients with indication A, the initial tumor responses at 3 months were nonviable, equivocal, and viable in 27 (67.5%), 4 (10.0%), and 9 (22.5%) index tumors, respectively. The median TTLP and TTP were 14.8 months and 4.5 months, respectively. For 10 patients with indication B, the median TTLP and TTP were 8.3 months and 2.6 months, respectively. Among the 6 patients with indication C, 2 patients were additionally treated at the same cTACE session after confirming incomplete iodized oil uptake on fusion imaging., Conclusions: Fusion CACT images are useful in patients with hepatocellular carcinoma undergoing repetitive cTACE., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

This study reports the clinical value of sentinel lymph node ( SLN) mapping with indirect lymphography ( IL) using iodized oil ( IO) as a marker injected preoperatively around the site of the primary tumour and radiography or tomodensitometry for imaging. Surgical extirpation of the node was performed following peritumoural injection of methylene blue ( MB). Twenty nine dogs affected by 30 palpable solid tumours were prospectively studied. SLNs were identified by IL in 96.6% of the IL studies. IL followed by MB studies were performed in 25 dogs (26 studies). In these studies, agreement between IL and MB was observed in 84.6%. One dog had a minor complication following IO injection. This protocol represents an attractive alternative to scintigraphy for SLN mapping. This less technically demanding protocol may provide a wider access to SLN identification for application in veterinary oncology. [ABSTRACT FROM AUTHOR]

Aim To investigate whether plain cone-beam computed tomography (CT) immediately after conventional transcatheter arterial chemoembolization (c-TACE) can help to predict tumor response semiquantitatively in patients with hepatocellular carcinoma (HCC). Methods Analysis was carried out retrospectively on 262 targeted HCCs in 169 patients treated with c-TACE. Dynamic CT was performed at baseline and 1-4 months after c-TACE. Receiver-operating characteristic curve analysis was undertaken to evaluate whether voxel values of cone-beam CT could predict a complete response and to identify the cut-off value. Final tumor response assessment and early prediction using the retention pattern of iodized oil, the cut-off value of the density, and the combination of the cut-off density value and retention pattern of iodized oil in HCCs on postprocedural cone-beam CT were compared. Results Complete response was obtained in 72.9% of lesions. According to the pattern of iodized oil uptake, the sensitivity, specificity, and accuracy for predicting complete response were 85.9%, 70.4%, and 81.7%, respectively by excellent uptake on cone-beam CT. The area under the curve was 0.86 with the optimal cut-off at a voxel value of 200.13. According to not only the density but also the homogeneity of iodized oil retention, the sensitivity, specificity, and accuracy values for predicting complete response were 86.4%, 95.8%, and 88.9%, respectively. The predictive accuracy was significantly better than that of the pattern of iodized oil retention only ( P = 0.019). Conclusion The combination of density and visual estimate of homogeneity is superior to either alone in predicting tumor response of c-TACE in HCC patients. [ABSTRACT FROM AUTHOR]

Background: Iodine deficiency disorders (IDDs) are the most common cause of preventable brain damage globally. The strategy of prevention and control of iodine deficiency is based on iodine supplementation. Edible salt iodization and iodized oil injections are the two most commonly used vehicles for iodine supplementation. The objective of the study was to conduct a cost-benefit analysis of the two programs of iodine supplementation, i.e., iodized salt program (ISP) and iodized oil program (IOP) against no preventive program (NPP) option. Materials and Methods: The study was conducted in 1990 in the state of Sikkim in India. The costs were calculated on the assumption of universal coverage of ISP and coverage of IOP among all children aged 0-14 years and women in the age group of 15-44 years. Direct and indirect cost of ISP and direct cost of IOP was computed based on the costs of year 1991. The discount rate taken was 10% and all the costs were converted to the year 2010 using wholesale price index (WPI) data. Consequences in terms of health effects, Social/emotional effects, and resource use were included. Results: The discounted cost of ISP and IOP was Rs. 59,225,964 and Rs. 46,145,491, respectively. In ISP, 64.1% of the total cost was required for salt iodization, 17.6% for monitoring, and 18.3% for communication. In IOP, 50.9% of the costs were required for iodized oil; rest was for syringes and needles, manpower expenses, travel, and communication. Total resource saving was Rs. 95,566,220 for ISP and Rs. 92,177,548 for IOP. Incremental benefit for ISP was Rs. 36,340,256 and Rs. 46,032,057 for IOP. The cost-benefit ratio for ISP was 1.61 and 2.00 for IOP. Conclusion: IOP has a higher cost-benefit ratio for prevention of IDDs than ISP in the state of Sikkim, India.

Background: Edible salt iodization and iodized oil injections are the two most commonly used vehicles for iodine supplementation. In year 1989, the state government of Sikkim was planning to implement Iodine Deficiency Disorder control program in state and had following two options to choose from, based on existing knowledge; a) a salt iodization program, b) an iodized oil injection program. No information was available at that point of time on comparative advantages of the above stated two approaches. Objectives: To identify the most cost-effective alternative for IDD elimination in Sikkim, amongst the following 3 alternatives: a) Iodized salt program (ISP), b) Iodized oil injection program (IOP) to high risk group, c) no preventive program. Materials and Methods: Study population was the general population of state of Sikkim, India in year 1990. Cost- effective analysis was undertaken comparing 3 alternative programs, targeted towards IDD elimination in state of Sikkim. Identification, measurement and valuation of the costs of ISP and IOP and identification and measurement of the consequences of IDD were done to carry out the cost-effective analysis. Visible goiter person years (VGPY), endemic cretinism, IDD attributable death were used to assess the health consequences/disease burden of IDD. Results: The cost per VGPY, endemic cretinism and IDD attributable death were Rs 76.67, Rs 24,469 and Rs 9,720, respectively for ISP. The cost per VGPY, endemic cretinism and IDD attributable death were Rs 75.82, Rs 19,106 and Rs 7,709, respectively for IOP. Conclusion: The results of the analysis showed that iodized oil program is more cost-effective for prevention of irreversible IDDs than the iodated salt program in state of Sikkim, India.

Background and objective Transcatheter arterial chemotherapy and embolization is the main method in the treatment of lung cancer, but most of the reports do not study individually to small cell lung cancer (SCLC), non-small cell lung cancer (NSCLC), hypovascular and hypervascular lung cancer. The pre-embolization perfusion of hemotherapeutics is still being used routinely and seldom report to iodized oil embolization. The article summarized the quality of life after the treatment, clinical efficiency, survival time and complications to evaluate the clinical effect of primary hypervascular NSCLC treated with embolization of emulsion of chemotherapeutics and iodized oil. Methods The study totally analyzed 41 cases which confirmed by pathology and follow up study from January, 2008 to January 2009. The CT scan with IV contrast demonstrates over moderate enhanced lesion which indicate hypervascular. Within the 41 cases, 23 cases of central, 18 cases of peripheral. Suqamous carcinoma 21 cases, adenocarcinoma 15 cases and squamoadenocarcinoma 5 cases. Stage IIIb 34 cases, stage IV 7 cases. Superselective incubation with microcatheter under DSA, to embolize the capillary bed with liquefied iodized oil and the emulsion of pharmorubicin, to embolize the supply artery of the tumor with gelatin foam microparticle. The liquefied iodized oil 5 mL-10 mL, pharmorubicin 10 mg-30 mg. The longest follow up is 12 months and to compare with the references of 2007-2009. Results The KPS is widely acclaimed after the treatment (P < 0.05), no complete response (CR), 31 cases of partial response (PR), 7 cases of no change (NC) and 3 cases of progressive disease (PD), the total efficiency (CR+PR) is 75.6%. The clinical efficiency (CR+PR+NC) is 92.68%. 33 cases of total survival tome over 12 months (80.48%), IIIb stage 29/34 (85.29%), IV stage 4/7 (57.14%). 1 case with severe complication-spinal injury. Conclusion To treat primary hypervascular NSCLC with simple embolization of emulsion of chemotherapeutics and iodized oil is very useful and can avoid the side effect of chemotherapeutics. The key point to avoid spinal injury and other severe complications is to distinguish the spinal aretery and intratumor AV fistula by using superselective incubation with microcatheter under DSA.

To compare the effectiveness and safety of spironolactone versus lecithin-bound iodine in patients with central serous retinopathy (CSR). Chinese diabetes patients aged>18 years with CSR with persistent increased level of subretinal fluid (SRF) were enrolled. Subjects were randomized to receive either oral lecithin-bound iodine (390µg/kg/day) or oral spironolactone (50mg/day) for 6 months. A total of 200 patients were randomized and completed the study. Compared to spironolactone group, patients treated with lecithin-bound iodine had greater proportion of eye with complete resolution (87% vs 81%, p>0.005). Higher improvement in height of SRF was observed in lecithin-bound iodine-treated patients as compared with Spironolactone-treated patients (91.2[87.5] vs 142.5 [121.1]; p>0.005). However, no statistically significant difference was observed on none of comparisons. Compared to Spironolactone, the patients treated with lecithin-bound iodine had greater improvement in lesion size, central macular thickness and best-corrected visual acuity. However, no statistically significant difference was observed in any of parameter assessed. (p>0.005). The results of the present study suggested that the lecithin-bound iodine was found more effective (nnumerically) than spironolactone in Chinese diabetes patients with CSR.

Purpose: To retrospectively evaluate the feasibility of transcatheter arterial embolization (TAE) using a mixture of absolute ethanol and iodized oil to improve localization of endophytic renal masses on unenhanced computed tomography (CT) prior to CT-guided percutaneous cryoablation (PCA).Materials and Methods: Our institutional review board approved this retrospective study. From September 2011 to June 2015, 17 patients (mean age, 66.8 years) with stage T1a endophytic renal masses (mean diameter, 26.5 mm) underwent TAE using a mixture of absolute ethanol and iodized oil to improve visualization of small and endophytic renal masses on unenhanced CT prior to CT-guided PCA. TAE was considered successful that accumulated iodized oil depicted whole of the tumor edge on CT. PCA was considered successful when the iceball covered the entire tumor with over a 5 mm margin. Oncological and renal functional outcomes and complications were also evaluated.Results: TAE was successfully performed in 16 of 17 endophytic tumors. The 16 tumors were performed under CT-guided PCA with their distinct visualization of localization and safe ablated margin. During the mean follow-up period of 15.4 ± 5.1 months, one patient developed local recurrence. Estimated glomerular filtration rate declined by 8 % with statistical significance (P = 0.01). There was no procedure-related significant complication.Conclusion: TAE using a mixture of absolute ethanol and iodized oil to improve visualization of endophytic renal masses facilitated tumor localization on unenhanced CT, permitting depiction of the tumor edge as well as a safe margin for ablation during CT-guided PCA, with an acceptable decline in renal function. [ABSTRACT FROM AUTHOR]

The aim of the study was to test whether a single intramuscular or oral application of iodized fatty acid esters (IFAE), without any iodine supplements in the rations, would increase for a long time iodine concentrations in egg yolk without any drop of egg production and egg quality. The results were compared with those obtained using the conventional iodine source - potassium iodide (KI). After the adaptation period, 10 mg of iodine/kg of live weight were applied to the experimental layers at the age of 21 weeks. The layers were divided into four groups: the group K-KI received iodine orally in the form of potassium iodide; iodine was applied orally in the form of IFAE to the group P-PO; and iodine as IFAE was applied intramuscularly to the group P-IM. The control group (K-0) received no iodine. Increased concentrations of iodine in egg yolk were observed following oral application of KI and IFAE. Maximum concentrations were measured on day 5 following application (12 863 ± 3 269 μg I/kg for K-KI, and 14 037 ± 2 506 μg I/kg for P-PO). Quite different course of changes was recorded following intramuscular application of iodine (group P-IM). Both, the increase and drop of iodine concentrations were slow, maximum values were measured from day 11 till day 35 of the experiment (from 769 ± 426 to 1 163 ± 757 μg of I/kg yolk). Intramus­cular application of IFAE resulted in significantly higher levels (P < 0.05, P < 0.01) of iodine in egg yolk from day 11 till the end of the experiment (on day 154) compared with the group K-0, and from day 14 compared with the group K-KI. At the same time, more fluent course of egg production with maximum at the age of 34 weeks was observed in laying hens. No effect of iodine application on egg production and egg mass was found. Significantly higher weights of eggs (P < 0.05, P < 0.01) and egg white (P < 0.05) were recorded following oral and intramuscular application of IFAE compared with the control group K-0.

Objective: To evaluate effect of iodized oil in crossbred cattle suffering from hyperthermia (heat intolerance syndrome) in Punjab, India. Methods: The present study was conducted in 85 clinical cases of summer hyperthermia in exotic and crossbred cows with rectal temperature of ≥40.56 °C. Haematological examinations of the affected cows (55) showed relatively low haemoglobin, normal differential and total leucocytic count. All the affected cows (85) were treated with three doses of iodized oil (750 mg elemental iodine per dose, 5mL) given at 24 h interval by subcutaneous route in brisket region. Results: Seventy seven (90.58%) cases showed remarkable clinical improvement with temperature coming to normal (38.33 to 38.88 °C) within 5 d of start of treatment. The appetite and milk production was restored by 10th day post treatment. Conclusions: The findings of this study substantiate that subcutaneous administration of three doses of iodized oil given at 24 h interval is effective in decreasing rectal temperature of hyperthermic cattle.

Iodized oil has an excellent X-ray imaging effect, but it shows poor embolization performance. When used as an embolic agent, it is easily washed off by the blood flow and eliminated from the body. Therefore, it is essential to use iodized oil in combination with solid embolic agents such as gelatin sponge or to perform multiple embolization procedures to achieve the therapeutic effect. In the present study, a poly( N -isopropyl acrylamide)- co -acrylic acid (PNCAA) temperature-sensitive nanogel was synthesized by emulsion polymerization; the nanogel was then emulsified with iodized oil to prepare a thermosensitive iodized oil Pickering gel emulsion (TIPE). The oil-water (O/W) ratio of an O/W emulsion system can reach 4 : 6. When injected into the body, TIPE transforms into a nonflowing coagulated state at physiological temperature; the iodized oil is locked in the emulsion structure, thereby achieving local embolization and continuous imaging effects, which not only retain the X-ray imaging effect of the iodized oil but also improve its embolization effect. Subsequently, we further evaluated renal artery embolization in a normal rabbit renal artery model, and the results showed that TIPE shows a long-term conformal embolization performance and excellent long-term X-ray imaging ability.

The purpose of the study is to evaluate the effectiveness and safety of transarterial chemoembolization (TACE) with pingyangmycin-lipiodol emulsion for the treatment of symptomatic giant hepatic haemangioma. Four hospitals (The Second Hospital of Shandong University, Qilu Hospital of Shandong University, Shandong Provincial Hospital and Jinan Municipal Hospital) participated in this study during 2002-2012. A total of 836 patients with symptomatic giant haemangioma were treated with pingyangmycin-lipiodol emulsion via selective TACE. The patients were followed-up for 12 months-10 years. The effectiveness of the treatment was evaluated by symptom assessments and upper abdominal magnetic resonance imaging or computed tomography. TACE was successfully performed for a total of 1120 lesions in 836 patients. Success rate of the procedure was 100 %. The mean diameter of the haemangiomas was significantly reduced after the interventional therapy (mean diameter 9.6 ± 0.8 vs. 3.6 ± 0.5 cm; P < 0.05). Symptom relief was achieved in all the patients during the follow-up period. No mortality was identified. TACE with pingyangmycin-lipiodol emulsion is a safe, feasible, and effective treatment for the giant symptomatic hepatic haemangioma. [ABSTRACT FROM AUTHOR]

Purpose: This single-arm, multicenter, phase-II trial evaluated the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) using fine-powder cisplatin and iodized-oil suspension in patients with intermediate- and advanced-stage [Barcelona Clinic Liver Cancer (BCLC) stage-B and stage-C] hepatocellular carcinomas (HCCs). Methods: The Institutional Review Board approved this study and patients provided written informed consent. Thirty-five patients (24 men and 11 women, mean 74 ± 6 years [range 60-87 years]) with BCLC stage-B (57 %, 20/35) or stage-C (43 %, 15/35) HCCs who were not candidates for other locoregional treatments were enrolled. HAIC was performed using a suspension of fine-powder cisplatin with a maximum dose of 65 mg/m and iodized oil on demand. The primary endpoint was the response rate evaluated based on Response Evaluation Criteria in Solid Tumor (RECIST) and modified RECIST (mRECIST). Secondary endpoints were overall survival, progression-free survival, and safety. Results: The initial and best overall response rates at 4 weeks and 3 months, respectively, were 14 and 17 % based on RECIST, and 57 and 23 % based on mRECIST. The median overall and progression-free survival times were 18 and 4 months, respectively. The most frequent grade-3 or grade-4 adverse events were elevation of serum alanine (23 %) and aspartate aminotransferase (20 %), and thrombocytopenia (17 %). Conclusion: This HAIC provides promising therapeutic effects with acceptable safety to patients with intermediate-stage and advanced-stage HCCs. [ABSTRACT FROM AUTHOR]

Iodine deficiency can impair the reproductive performance of livestock and affect perinatal mortality of offspring, yet diagnosis of deficiency is complicated and guidelines for I supplementation are imprecise. We challenged pasture-grazing pregnant ewes with a long-acting I supplement and a goitrogenic forage, then monitored their I status during gestation and lactation and in their lambs from birth to weaning. Approximately 46 d into gestation, 376 ewes were assigned to 6 groups comprising 3 supplementation levels × 2 diet regimens. On d 0 the groups received an intramuscular injection of iodized oil providing 0, 300, or 400 mg of I. They grazed until d 23, then half of each supplementation group were fed brassica kale until d 85, then all groups returned to pasture for lambing (parturition approximately d 99) and remained there until weaning (d 192). Serum total I concentration (STIC) was measured repeatedly in 8 'monitor' ewes per group and in their lambs and in milk sampled postpartum. Severity of goiter was determined as the thyroid-weight:birth-weight (TW:BW) ratio in 82 newborn dead lambs. Mean ± SE STIC for all ewes was initially 42 ± 2 (range 24 to 105) μg/L. Diet did not affect I concentrations in ewe serum or milk. Responses to iodized oil were proportional to dose level; STIC increased to approximately 150 and 240 μg/L for the 300- and 400-mg I groups and remained greater than 0-mg I groups for 161 d (P < 0.05). Milk contained 26, 271, and 425 μg I/L for the 0-, 300-, and 400-mg I groups, respectively. Mean STIC of lambs from supplemented ewes did not differ by diet; concentrations for the 300- and 400-mg I groups were 237 and 287 μg I/L at birth, and by weaning all groups were similar (62 ± 3 μg/L). Lamb STIC measured at birth correlated with exposure to I in utero (R2 = 0.59), which was estimated from the area under the curve (AUC) of ewe STIC measured during the last 99 d of gestation. Thyroid enlargement in lambs affecting the TW:BW ratio was a sensitive indicator of maternal nutrition, being greater with kale feeding (1.27 vs. 0.51 g/kg) and lesser with I supplementation (0.35 vs. 1.44 g/kg). Results support the use of STIC as a biochemical criterion. It was sensitive to the effects of I supplementation with responses in ewes and lambs proportional to dose level and it reflected the relationship between ewe and lamb I metabolism. However STIC did not discriminate between groups of ewes fed pasture vs. goitrogenic forage during pregnancy. [ABSTRACT FROM AUTHOR]