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Transcatheter arterial embolization of renal VX-2 carcinoma: ethiodol-ethanol capillary embolization combined with carboplatin.

Kónya A, Choi BG, Van Pelt CS, Wright KC - Korean J Radiol (2007 Mar-Apr)

Bottom Line: Histologically, the kidneys were evaluated on the basis of the residual tumor found in the serial sections.The results obtained with carboplatin infusion alone (Groups 2A and 2B) and CE without RAO (Group 3) were similar to those of the control animals (Group 1).None of the Ethiodol-based modalities combined with locoregional carboplatin were more efficacious for tumor ablation than EEM alone.

View Article: PubMed Central - PubMed

Affiliation: Vascular and Interventional Radiology, Division of Diagnostic Imaging, Unit 057, The University of Texas MD Anderson Cancer Center, TX 77030, USA. akonya@mdanderson.org

ABSTRACT

Objective: We wanted to determine whether transcatheter Ethiodol-based capillary embolization in combination with carboplatin could improve the efficiency of a 1:1 Ethiodol-ethanol mixture (EEM) to ablate kidneys that been inoculated with VX-2 carcinoma.

Materials and methods: The right kidney in 34 New Zealand white rabbits were inoculated with fresh VX-2 tumor fragments. One week later, the kidneys were subjected to transarterial treatment (4-5 rabbits/group): Saline infusion (Group 1); carboplatin infusion (5 or 10 mg, Groups 2A and 2B); carboplatin-Ethiodol (CE) alone (Group 3) and followed by main renal artery occlusion with ethanol (RAO) (Group 4); carboplatin-EEM (C-EEM) followed by RAO (Group 5); carboplatin infusion followed by EEM plus RAO (Group 6); and EEM followed by RAO (Group 7). The animals were followed for up to 3-weeks. The treated kidneys were evaluated angiographically and macroscopically. The kidneys that showed successful embolization macroscopically were entirely cut into serial sections, and these were examined microscopically. Histologically, the kidneys were evaluated on the basis of the residual tumor found in the serial sections.

Results: The results obtained with carboplatin infusion alone (Groups 2A and 2B) and CE without RAO (Group 3) were similar to those of the control animals (Group 1). Kidneys from Groups 4-7 demonstrated macroscopically successful embolization with histologically proven complete renal parenchyma infarction; however, some residual tumor was evident in all but one animal.

Conclusion: None of the Ethiodol-based modalities combined with locoregional carboplatin were more efficacious for tumor ablation than EEM alone.

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Related in: MedlinePlus

The amount of residual tumor remaining in the kidney at post treatment was assessed from H & E stained sections of paraffin-embedded, formalin-fixed tissues (see text). The figure contains all the slides (2/kidney) analyzed for the non-responder kidneys from Group 1 ("sham" treatment).
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Figure 1: The amount of residual tumor remaining in the kidney at post treatment was assessed from H & E stained sections of paraffin-embedded, formalin-fixed tissues (see text). The figure contains all the slides (2/kidney) analyzed for the non-responder kidneys from Group 1 ("sham" treatment).

Mentions: The animals were sacrificed with using Beuthanasia-D (1 mL; Schering-Plough Animal Health Corp., Kenilworth, NJ), and complete necropsy was then performed. The two largest perpendicular diameters of the kidneys, which were macroscopically much larger than normal, were measured at an accuracy of 5 mm. The measurements involved the perirenal tissues (largely adipose tissues). Because of the presence of significant amounts of perirenal adipose tissue, in the case where the kidney showed a definite reduction in size macroscopically, we did not measure the kidney's diameters. The treated kidneys were fixed in 10% buffered formalin. Those kidneys showing a reduction in size were cut transversally into a series of 2-3-mm thick histological blocks, whereas only a limited number of sections (2-4) were obtained from those kidneys that showed significant enlargement due to uncontrolled tumor growth. Histologic slides were prepared from each section and these were stained with hematoxylin and eosin (H & E) for light microscopic examination. All the histological slides were evaluated by the same board certified veterinary pathologist for the remaining viable kidney parenchyma and tumor. For a semiquantitative analysis, all the slides were scanned (HP scanjet 7400c) into a jpg file with using an overlay grid. For each animal, the total number of squares stained blue/purple per section was counted, as was the total number of squares. The slides were then microscopically assessed to confirm whether the blue/purple squares contained tumor, inflammation or mineral. The number of squares containing tumor was divided by the total number of squares to give a percent of tumor-squares. The amount of remaining viable tumor in each kidney was then established on the basis of the % of the squares that contained viable tumor (Fig. 1).


Transcatheter arterial embolization of renal VX-2 carcinoma: ethiodol-ethanol capillary embolization combined with carboplatin.

Kónya A, Choi BG, Van Pelt CS, Wright KC - Korean J Radiol (2007 Mar-Apr)

The amount of residual tumor remaining in the kidney at post treatment was assessed from H & E stained sections of paraffin-embedded, formalin-fixed tissues (see text). The figure contains all the slides (2/kidney) analyzed for the non-responder kidneys from Group 1 ("sham" treatment).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2626785&req=5

Figure 1: The amount of residual tumor remaining in the kidney at post treatment was assessed from H & E stained sections of paraffin-embedded, formalin-fixed tissues (see text). The figure contains all the slides (2/kidney) analyzed for the non-responder kidneys from Group 1 ("sham" treatment).
Mentions: The animals were sacrificed with using Beuthanasia-D (1 mL; Schering-Plough Animal Health Corp., Kenilworth, NJ), and complete necropsy was then performed. The two largest perpendicular diameters of the kidneys, which were macroscopically much larger than normal, were measured at an accuracy of 5 mm. The measurements involved the perirenal tissues (largely adipose tissues). Because of the presence of significant amounts of perirenal adipose tissue, in the case where the kidney showed a definite reduction in size macroscopically, we did not measure the kidney's diameters. The treated kidneys were fixed in 10% buffered formalin. Those kidneys showing a reduction in size were cut transversally into a series of 2-3-mm thick histological blocks, whereas only a limited number of sections (2-4) were obtained from those kidneys that showed significant enlargement due to uncontrolled tumor growth. Histologic slides were prepared from each section and these were stained with hematoxylin and eosin (H & E) for light microscopic examination. All the histological slides were evaluated by the same board certified veterinary pathologist for the remaining viable kidney parenchyma and tumor. For a semiquantitative analysis, all the slides were scanned (HP scanjet 7400c) into a jpg file with using an overlay grid. For each animal, the total number of squares stained blue/purple per section was counted, as was the total number of squares. The slides were then microscopically assessed to confirm whether the blue/purple squares contained tumor, inflammation or mineral. The number of squares containing tumor was divided by the total number of squares to give a percent of tumor-squares. The amount of remaining viable tumor in each kidney was then established on the basis of the % of the squares that contained viable tumor (Fig. 1).

Bottom Line: Histologically, the kidneys were evaluated on the basis of the residual tumor found in the serial sections.The results obtained with carboplatin infusion alone (Groups 2A and 2B) and CE without RAO (Group 3) were similar to those of the control animals (Group 1).None of the Ethiodol-based modalities combined with locoregional carboplatin were more efficacious for tumor ablation than EEM alone.

View Article: PubMed Central - PubMed

Affiliation: Vascular and Interventional Radiology, Division of Diagnostic Imaging, Unit 057, The University of Texas MD Anderson Cancer Center, TX 77030, USA. akonya@mdanderson.org

ABSTRACT

Objective: We wanted to determine whether transcatheter Ethiodol-based capillary embolization in combination with carboplatin could improve the efficiency of a 1:1 Ethiodol-ethanol mixture (EEM) to ablate kidneys that been inoculated with VX-2 carcinoma.

Materials and methods: The right kidney in 34 New Zealand white rabbits were inoculated with fresh VX-2 tumor fragments. One week later, the kidneys were subjected to transarterial treatment (4-5 rabbits/group): Saline infusion (Group 1); carboplatin infusion (5 or 10 mg, Groups 2A and 2B); carboplatin-Ethiodol (CE) alone (Group 3) and followed by main renal artery occlusion with ethanol (RAO) (Group 4); carboplatin-EEM (C-EEM) followed by RAO (Group 5); carboplatin infusion followed by EEM plus RAO (Group 6); and EEM followed by RAO (Group 7). The animals were followed for up to 3-weeks. The treated kidneys were evaluated angiographically and macroscopically. The kidneys that showed successful embolization macroscopically were entirely cut into serial sections, and these were examined microscopically. Histologically, the kidneys were evaluated on the basis of the residual tumor found in the serial sections.

Results: The results obtained with carboplatin infusion alone (Groups 2A and 2B) and CE without RAO (Group 3) were similar to those of the control animals (Group 1). Kidneys from Groups 4-7 demonstrated macroscopically successful embolization with histologically proven complete renal parenchyma infarction; however, some residual tumor was evident in all but one animal.

Conclusion: None of the Ethiodol-based modalities combined with locoregional carboplatin were more efficacious for tumor ablation than EEM alone.

Show MeSH
Related in: MedlinePlus