Intra-arterial radionuclide therapy for liver tumours: effect of selectivity of catheterization and 131I-Lipiodol delivery on tumour uptake and response

Nucl Med Commun. 2003 Apr;24(4):391-6. doi: 10.1097/00006231-200304000-00008.


Several authors have demonstrated the good tolerance of hepatic intra-arterial 131I-Lipiodol therapy and report survival rates of 21-25% after 1 year in inoperable patients. This study explored the possibility that more selective hepatic arterial instillation could be a strategy for increasing tumoural uptake and response of 131I-Lipiodol. Between June 1999 and September 2001 we selected 24 patients: 14 received a selective instillation of 131I-Lipiodol to the proper hepatic artery (SEL group); and 10 received a hyperselective instillation in the right or left hepatic artery (HYP-SEL group). The individual 131I-Lipiodol activity as a per cent of the injected activity per millilitre of tumour (%IA/ml tumour) was correlated with the selectivity of instillation in 28 tumours and with tumour response in 24 tumours. Differences in tumour response or tumour uptake between the SEL and HYP-SEL groups were not significant. In general, we observed a %IA/ml tumour of 0.05-2.6% for the uptake of 131I-Lipiodol. The uptake was significantly higher in responsive disease than in stable or progressive disease (P=0.002). A large tumour volume was invariably related to low uptake of 131I-Lipiodol and progressive disease (P=0.008). In conclusion, our study does not support the general use of hyper-selective or super-selective intra-arterial administration of 131I-Lipiodol. This result may be extrapolated to similar types of intra-arterial, loco-regional hepatic radionuclide therapy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / blood supply
  • Carcinoma, Hepatocellular / metabolism*
  • Carcinoma, Hepatocellular / radiotherapy*
  • Carcinoma, Hepatocellular / surgery
  • Catheterization, Peripheral / methods*
  • Female
  • Humans
  • Injections, Intra-Arterial / methods*
  • Iodine Radioisotopes
  • Iodized Oil / administration & dosage*
  • Iodized Oil / pharmacokinetics*
  • Liver Neoplasms / blood supply
  • Liver Neoplasms / metabolism*
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Radiometry
  • Radiopharmaceuticals / pharmacokinetics
  • Radiopharmaceuticals / therapeutic use
  • Radiotherapy Dosage*
  • Tissue Distribution
  • Treatment Outcome


  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Iodized Oil