Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion

Thierry de Baere, Yasuaki Arai, Riccardo Lencioni, Jean Francois Geschwind, William Rilling, Riad Salem, Osamu Matsui, Michael C. Soulen

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Transarterial chemoembolization with Lipiodol (Lipiodol TACE), also called conventional TACE, was developed in the early 1980s and widely adopted worldwide after randomized control trials and meta-analysis demonstrated superiority of Lipiodol TACE to best supportive care. Presently, there is no level one evidence that other TACE techniques are superior to Lipiodol TACE for intermediate stage hepatocellular carcinoma (HCC), which includes patients with preserved liver function and nonsurgical large or multinodular HCC without distant metastases. In addition, TACE is part of the treatment for progressive or symptomatic liver metastases from gastroenteropancreatic neuroendocrine tumors. When injected into the hepatic artery, Lipiodol has the unique property of selective uptake and retention in hyperarterialyzed liver tumors. Lipiodol/drug emulsion followed by particle embolization has been demonstrated to improve the pharmacokinetic of the drug and tumor response. Radio opacity of Lipiodol helps to monitor treatment delivery, with retention of Lipiodol serving as an imaging biomarker for tumor response. For 30 years, Lipiodol TACE has been inconsistently referenced in many publications with various levels of details for the method of preparation and administration, with reported progressive outcomes following improvements in the technique and the devices used to deliver the treatment and better patient selection. Consequently, there is no consensus on the standard method of TACE regarding the use of anticancer agents, embolic material, technical details, and the treatment schedule. In order to develop an internationally validated technical recommendation to standardize the Lipiodol TACE procedure, a worldwide panel of experts participated in a consensus meeting held on May 10, 2014.

Original languageEnglish (US)
Pages (from-to)334-343
Number of pages10
JournalCardioVascular and Interventional Radiology
Volume39
Issue number3
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

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Ethiodized Oil
Expert Testimony
Liver
Neoplasms
Therapeutics
Hepatocellular Carcinoma
Neoplasm Metastasis
Hepatic Artery
Tumor Biomarkers
Emulsions
Radio
Pharmaceutical Preparations
Antineoplastic Agents
Patient Selection
Publications
Meta-Analysis
Appointments and Schedules
Pharmacokinetics

Keywords

  • Chemoembolization/chemoembolisation
  • Clinical practice
  • Hepatocellular carcinoma (HCC)
  • Interventional oncology
  • Intra-arterial
  • Liver/hepatic
  • Transarterial chemoembolization/embolisation (TACE)
  • Transcatheter therapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

de Baere, T., Arai, Y., Lencioni, R., Geschwind, J. F., Rilling, W., Salem, R., ... Soulen, M. C. (2016). Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion. CardioVascular and Interventional Radiology, 39(3), 334-343. https://doi.org/10.1007/s00270-015-1208-y

Treatment of Liver Tumors with Lipiodol TACE : Technical Recommendations from Experts Opinion. / de Baere, Thierry; Arai, Yasuaki; Lencioni, Riccardo; Geschwind, Jean Francois; Rilling, William; Salem, Riad; Matsui, Osamu; Soulen, Michael C.

In: CardioVascular and Interventional Radiology, Vol. 39, No. 3, 01.03.2016, p. 334-343.

Research output: Contribution to journalArticle

de Baere, T, Arai, Y, Lencioni, R, Geschwind, JF, Rilling, W, Salem, R, Matsui, O & Soulen, MC 2016, 'Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion', CardioVascular and Interventional Radiology, vol. 39, no. 3, pp. 334-343. https://doi.org/10.1007/s00270-015-1208-y
de Baere, Thierry ; Arai, Yasuaki ; Lencioni, Riccardo ; Geschwind, Jean Francois ; Rilling, William ; Salem, Riad ; Matsui, Osamu ; Soulen, Michael C. / Treatment of Liver Tumors with Lipiodol TACE : Technical Recommendations from Experts Opinion. In: CardioVascular and Interventional Radiology. 2016 ; Vol. 39, No. 3. pp. 334-343.
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