8:09 AM; Abstract No. 90 - Pre-clinical study of intrabiliary radiofrequency hyperthermia -enhanced local chemotherapy of cholangiocarcinoma monitored by dual-modality molecular imaging

Abstract

M O N D A Y: S cintific S esions Materials and Methods: Consecutive patients that underwent TACE in 2000-2013 were included. NTE was defined as presence of ethiodized oil in organs other than liver seen on non-contrast CT performed day after TACE. CTs and angiography images were reviewed on PACS by abdominal imaging and interventional radiologist. Medical record were reviewed for clinical outcomes. Chi-square and Fischer exact tests were used for statistical analysis. Results: 583 TACE procedures for 360 patients were evaluated. HCC was treated in 394 cases (68%), 110 neuroendocrine tumors (19%) and 79 metastases (14%). Overall incidence of NTE was 33% (194), with 20% to lung, 13% gallbladder, 5% stomach, 1% pancreas, 1% spleen, 0.5% duodenum and 0.3% adrenal. S-TACE (164 cases) resulted in lower NTE rate (21% (34/164) vs. 38% (159/419), po0.001). Organ-specific incidence of NTE was reduced with S-TACE for stomach (1% (2/164) vs. 6% (25/419), p1⁄40.01) and gallbladder (4% (7/164) vs. 16% (67/ 419), po0.001), but not for lungs (16% (26/164) vs. 21% (88/ 419), p1⁄40.17). NTE to pancreas, duodenum and spleen occurred only with L-TACE. Two cases of NTE to adrenal occurred only with S-TACE. Pulmonary symptoms were present in 23/469 (5%) cases without lung oil deposition, but much more frequent in patients with lung oil deposition 24/114 (21%), (po0.001). 3/8 (38%) patients with pancreas oil deposition had clinical pancreatitis. Eight patients were admitted to intensive care unit, 7 (1.7%) after L-TACE and 1 (0.6%) after S-TACE. In 7 there was evidence of NTE, in 6 cases to lung and in 2 to gallbladder. Three patients (0.5%) expired during the post TACE admission; all of them had L-TACE and lung NTE. Patients with NTE had longer hospital stay 2.6 vs 1.9 days, p1⁄40.01. Conclusion: Transarterterial chemoembolization has a high rate of non-targeted embolization, which can be reduced significantly using a superselective approach. Non-targeted embolization was associated with longer hospital stay and complicated post procedure course.