Clinical evaluation of percutaneous ethanol injection therapy (PEIT) to large hepatocellular carcinomas. The experimental and clinical studies of contrast medium-PEIT (CM-PEIT)

To evaluate the therapeutic effect of percutaneous ethanol injection therapy (PEIT) to large hepatocellular carcinomas (HCC) (over 30 mm in diameter), we have demonstrated contrast-medium PEIT (CM-PEIT). CM-PEIT is a newly developed methods that HCC nodules are punctured by a needle under ultrasound imaging and injected with ethanol mixed with water-soluble contrast medium (iopamidol containing 370 mg/ml iodine) (vol/vol:7/3) (CME). In this study, CM-PEIT was evaluated on experimental and clinical studies. In elemental study, ethanol at various concentrations (30%, 50%, 70% and 100%) was injected to DAB-induced rat hepatomas. Histological findings of rat hepatomas following the injection of 70% ethanol were similar to those of rat hepatomas injected 100% ethanol. Completely enhanced rat hepatoma nodules on soft X-p tumorgraphy after 70% CME injection was revealed histologically complete necrosis. In clinical study, CM-PEIT was performed to large HCCs and the therapeutic effect was evaluated by CT tumorgraphy and X-p tumorgraphy. The area spreaded into HCC nodules by 70% CME on CT tumorgraphy was the same as that of histologically complete necrosis on surgical resection or autopsy. Completely enhanced large HCC nodules on X-p tumorgraphy after 70% CME injection showed almost histologically complete necrosis. These results suggest that CM-PEIT is a new useful method to evaluate the therapeutic effect of PEIT on large HCCs. (author)