TY - JOUR
T1 - First Human Experience with Directly Image-able Iodinated Embolization Microbeads
AU - Levy, Elliot B.
AU - Krishnasamy, Venkatesh P.
AU - Lewis, Andrew L.
AU - Willis, Sean
AU - Macfarlane, Chelsea
AU - Anderson, Victoria
AU - van der Bom, Imramsjah M.J.
AU - Radaelli, Alessandro
AU - Dreher, Matthew R.
AU - Sharma, Karun V.
AU - Negussie, Ayele
AU - Mikhail, Andrew S.
AU - Geschwind, Jean Francois H.
AU - Wood, Bradford J.
N1 - Funding Information:
The NIH authors are supported by CRADA’s with Philips (B.W.) and with Biocompatibles/BTG (B.W). This work also supported by the Intramural Research Program of the NIH and the Center of Interventional Oncology, Grant/Z Number ZID BC011242-08. NIH may own intellectual property in the field.
Publisher Copyright:
© 2016, Springer Science+Business Media New York (outside the USA) and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
PY - 2016/8/1
Y1 - 2016/8/1
N2 - 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.
AB - 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.
KW - Embolization
KW - Hepatic
KW - Image-able
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U2 - 10.1007/s00270-016-1364-8
DO - 10.1007/s00270-016-1364-8
M3 - Article
C2 - 27206503
AN - SCOPUS:84969883802
SN - 0174-1551
VL - 39
SP - 1177
EP - 1186
JO - Cardiovascular and interventional radiology
JF - Cardiovascular and interventional radiology
IS - 8
ER -