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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

EEM embolization (03L-326).A. Normal selective right renal arteriogram (magnification 1X).B. Selective right renal angiogram 1-week post VX-2 tumor inoculation: Several peripheral branches are occluded at the interlobar-interlobular-arcuate level throughout the kidney, the intensity of the parenchymal staining is slightly uneven (magnification 1X).C. Selective right renal arteriogram obtained 3-weeks post EEM embolization: The right renal artery is occluded, except for a 1-cm long stump that carries the patent capsular artery. The capsular artery increased in caliber, (its branches supply the perirenal soft tissue), but there is no parenchymal staining. Note that the right kidney is slightly reduced in size with moderately increased radiopacity, indicating residual Ethiodol and mineralization (normal view).
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Figure 4: EEM embolization (03L-326).A. Normal selective right renal arteriogram (magnification 1X).B. Selective right renal angiogram 1-week post VX-2 tumor inoculation: Several peripheral branches are occluded at the interlobar-interlobular-arcuate level throughout the kidney, the intensity of the parenchymal staining is slightly uneven (magnification 1X).C. Selective right renal arteriogram obtained 3-weeks post EEM embolization: The right renal artery is occluded, except for a 1-cm long stump that carries the patent capsular artery. The capsular artery increased in caliber, (its branches supply the perirenal soft tissue), but there is no parenchymal staining. Note that the right kidney is slightly reduced in size with moderately increased radiopacity, indicating residual Ethiodol and mineralization (normal view).

Mentions: A mean of 0.38±0.07 mL of 1:1 EEM that was injected during 32.8±5.5 minutes led to capillary stasis. Complete arterial stasis was achieved in all kidneys ; in four kidneys, this required injection of pure ethanol (0.15 mL for each of 4 kidneys). Angiographically, all the renal arteries remained completely occluded at 3-weeks (Fig. 4). Necropsy revealed that all the kidneys were significantly reduced in size. Histologically, complete parenchymal infarction was found with some tumor growth in all kidneys.


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)

EEM embolization (03L-326).A. Normal selective right renal arteriogram (magnification 1X).B. Selective right renal angiogram 1-week post VX-2 tumor inoculation: Several peripheral branches are occluded at the interlobar-interlobular-arcuate level throughout the kidney, the intensity of the parenchymal staining is slightly uneven (magnification 1X).C. Selective right renal arteriogram obtained 3-weeks post EEM embolization: The right renal artery is occluded, except for a 1-cm long stump that carries the patent capsular artery. The capsular artery increased in caliber, (its branches supply the perirenal soft tissue), but there is no parenchymal staining. Note that the right kidney is slightly reduced in size with moderately increased radiopacity, indicating residual Ethiodol and mineralization (normal view).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: EEM embolization (03L-326).A. Normal selective right renal arteriogram (magnification 1X).B. Selective right renal angiogram 1-week post VX-2 tumor inoculation: Several peripheral branches are occluded at the interlobar-interlobular-arcuate level throughout the kidney, the intensity of the parenchymal staining is slightly uneven (magnification 1X).C. Selective right renal arteriogram obtained 3-weeks post EEM embolization: The right renal artery is occluded, except for a 1-cm long stump that carries the patent capsular artery. The capsular artery increased in caliber, (its branches supply the perirenal soft tissue), but there is no parenchymal staining. Note that the right kidney is slightly reduced in size with moderately increased radiopacity, indicating residual Ethiodol and mineralization (normal view).
Mentions: A mean of 0.38±0.07 mL of 1:1 EEM that was injected during 32.8±5.5 minutes led to capillary stasis. Complete arterial stasis was achieved in all kidneys ; in four kidneys, this required injection of pure ethanol (0.15 mL for each of 4 kidneys). Angiographically, all the renal arteries remained completely occluded at 3-weeks (Fig. 4). Necropsy revealed that all the kidneys were significantly reduced in size. Histologically, complete parenchymal infarction was found with some tumor growth in all kidneys.

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