Transarterial Radionuclide Therapy with ¹⁸⁸Re-Labelled Lipiodol

Abstract

Hepatocellular carcinoma (HCC) is usually detected late, in patients with advanced disease, who are thus not eligible for radical therapy. Despite this grim scenario, new treatment options for intermediate to advanced stages hold great promise, such as internal radionuclide therapy. Several techniques have been developed for radionuclide therapy of HCC. Among these, use of transarterial injection of a radiolabelled embolizing agent, such as microspheres or Lipiodol, has led to very encouraging results. Over the last few years, efforts to label Lipiodol with rhenium-188, an attractive beta-emitter, have led to a very active area of research. Lipiodol has been labelled either directly or by solubilisation of a lipophilic ¹⁸⁸Re-labelled complex. Preliminary clinical findings indicate the feasibility of using ¹⁸⁸Re-labelled Lipiodol, which has shown good tolerance and good response rates in the treatment of unresectable HCC as well as in adjuvant or neo-adjuvant settings.