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Cardiovasc Intervent Radiol. 2016 Aug;39(8):1177-86. doi: 10.1007/s00270-016-1364-8. Epub 2016 May 20.

First Human Experience with Directly Image-able Iodinated Embolization Microbeads.

Author information

1
Center for Interventional Oncology, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, USA. levyeb@cc.nih.gov.
2
Center for Interventional Oncology, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, USA.
3
Biocompatibles, UK Ltd, A BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, GU15 3YL, UK.
4
Philips, Image Guided Interventions, Clinical Science IGT Systems North & Latin America, Philips, 2 Canal Park, Cambridge, MA, 02141, USA.
5
Philips, Image Guided Interventions, Image-Guided Therapy Systems, Philips, Veenpluis 4-6, 5680 DA, Best, The Netherlands.
6
Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA.
7
Department of Radiology and Biomedical Imaging, 330 Cedar Street, PO Box 208042, New Haven, CT, 06520, USA.

Abstract

PURPOSE:

To describe first clinical experience with a directly image-able, inherently radio-opaque microspherical embolic agent for transarterial embolization of liver tumors.

METHODOLOGY:

LC Bead LUMI™ is a new product based upon sulfonate-modified polyvinyl alcohol hydrogel microbeads with covalently bound iodine (~260 mg I/ml). 70-150 μ LC Bead LUMI™ iodinated microbeads were injected selectively via a 2.8 Fr microcatheter to near complete flow stasis into hepatic arteries in three patients with hepatocellular carcinoma, carcinoid, or neuroendocrine tumor. A custom imaging platform tuned for LC LUMI™ microbead conspicuity using a cone beam CT (CBCT)/angiographic C-arm system (Allura Clarity FD20, Philips) was used along with CBCT embolization treatment planning software (EmboGuide, Philips).

RESULTS:

LC Bead LUMI™ image-able microbeads were easily delivered and monitored during the procedure using fluoroscopy, single-shot radiography (SSD), digital subtraction angiography (DSA), dual-phase enhanced and unenhanced CBCT, and unenhanced conventional CT obtained 48 h after the procedure. Intra-procedural imaging demonstrated tumor at risk for potential under-treatment, defined as paucity of image-able microbeads within a portion of the tumor which was confirmed at 48 h CT imaging. Fusion of pre- and post-embolization CBCT identified vessels without beads that corresponded to enhancing tumor tissue in the same location on follow-up imaging (48 h post).

CONCLUSION:

LC Bead LUMI™ image-able microbeads provide real-time feedback and geographic localization of treatment in real time during treatment. The distribution and density of image-able beads within a tumor need further evaluation as an additional endpoint for embolization.

KEYWORDS:

Embolization; Hepatic; Image-able

PMID:
27206503
DOI:
10.1007/s00270-016-1364-8
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