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Iodized oil
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Iodized oil
Iodized oil, also known as ethiodized oil, brand name Lipiodol, is a medication derived from poppyseed oil and iodine. When given by injection, it is a radio-opaque contrast agent that is used to outline structures in radiological investigations. When given orally or by intramuscular injection once or twice a year, it prevents endemic goitre in remote communities. It has an additional use in gastric variceal obliteration as a dilutant that does not affect polymerization of cyanoacrylate.
When used as tissue contrast, iodized oil has a risk of entering the vein and causing embolism in the brain and lungs. There is a boxed warning referring to the risk of embolism. Use as iodine supplementation is recommended in regions where deficiency is common, otherwise it is not recommended. It should not be used for hysterosalpingography in pregnancy.
Iodized oil was first made in 1901 by Marcel Guerbet and Laurent Lafay. Originally used to treat iodine deficiency, it was identified as an effective radiocontrast in 1921 by Sicard and Forestier, before returning as a tool to treat iodine deficiency in goiter eradication campaigns of the 1980s. Under the name "iodine", iodized oil is on the World Health Organization's List of Essential Medicines, in liquid and capsule form.
Iodized oil is a radio-opaque contrast agent. It is used in chemoembolization applications as a contrast agent in follow-up imaging. Lipiodol is also used in lymphangiography, the imaging of the lymphatic system.
Historically Lipiodol was often used as a contrast medium at hysterosalpingography (HSG: a procedure to determine tubal patency [i.e. whether the fallopian tubes are open], used in the investigation of subfertility). It became less commonly utilized in the 1960s to 1980s because the more modern water-soluble media give images that are easier to interpret. There is also an important safety issue with Lipiodol in that intravasation (leakage) of the fluid into the venous system has caused complications in the past.
Lipiodol is used in conventional transcatheter arterial chemoembolization (TACE), a procedure for treating liver tumors. An anticancer drug is first emulsified into lipiodol to form a suspension. Guided by an imaging system, a catheter is moved into an artery that feeds the tumor and injects the suspension. Lipiodol helps retain the drug around the cancer cells. An embolic material is then injected to restrict blood supply to the tumor.
"Transarterial radioembolization" (TARE) is a similar procedure where the anticancer drug is radioactive. An experimental version of TARE uses iodine-131-labeled lipiodol. The radioactive lipiodol is attracted to the tumor, much like regular lipiodol. Its radioactivity destroys tumor tissue. However, I131-lipiodol has been withdrawn from the market by its European manufacturer due to risk of embolism, especially in patients with hepatic arterio-venous shunting. I131-lipidol is also less tumor-targeted than the microbeads used in conventional TARE procedures, requiring much higher radiation doses. It remains available in India, where its cost-effectiveness over conventional Y90 TARE is valued.
It has an additional use in gastric variceal obliteration as a dilutant that does not affect polymerization of cyanoacrylate.
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Iodized oil
Iodized oil, also known as ethiodized oil, brand name Lipiodol, is a medication derived from poppyseed oil and iodine. When given by injection, it is a radio-opaque contrast agent that is used to outline structures in radiological investigations. When given orally or by intramuscular injection once or twice a year, it prevents endemic goitre in remote communities. It has an additional use in gastric variceal obliteration as a dilutant that does not affect polymerization of cyanoacrylate.
When used as tissue contrast, iodized oil has a risk of entering the vein and causing embolism in the brain and lungs. There is a boxed warning referring to the risk of embolism. Use as iodine supplementation is recommended in regions where deficiency is common, otherwise it is not recommended. It should not be used for hysterosalpingography in pregnancy.
Iodized oil was first made in 1901 by Marcel Guerbet and Laurent Lafay. Originally used to treat iodine deficiency, it was identified as an effective radiocontrast in 1921 by Sicard and Forestier, before returning as a tool to treat iodine deficiency in goiter eradication campaigns of the 1980s. Under the name "iodine", iodized oil is on the World Health Organization's List of Essential Medicines, in liquid and capsule form.
Iodized oil is a radio-opaque contrast agent. It is used in chemoembolization applications as a contrast agent in follow-up imaging. Lipiodol is also used in lymphangiography, the imaging of the lymphatic system.
Historically Lipiodol was often used as a contrast medium at hysterosalpingography (HSG: a procedure to determine tubal patency [i.e. whether the fallopian tubes are open], used in the investigation of subfertility). It became less commonly utilized in the 1960s to 1980s because the more modern water-soluble media give images that are easier to interpret. There is also an important safety issue with Lipiodol in that intravasation (leakage) of the fluid into the venous system has caused complications in the past.
Lipiodol is used in conventional transcatheter arterial chemoembolization (TACE), a procedure for treating liver tumors. An anticancer drug is first emulsified into lipiodol to form a suspension. Guided by an imaging system, a catheter is moved into an artery that feeds the tumor and injects the suspension. Lipiodol helps retain the drug around the cancer cells. An embolic material is then injected to restrict blood supply to the tumor.
"Transarterial radioembolization" (TARE) is a similar procedure where the anticancer drug is radioactive. An experimental version of TARE uses iodine-131-labeled lipiodol. The radioactive lipiodol is attracted to the tumor, much like regular lipiodol. Its radioactivity destroys tumor tissue. However, I131-lipiodol has been withdrawn from the market by its European manufacturer due to risk of embolism, especially in patients with hepatic arterio-venous shunting. I131-lipidol is also less tumor-targeted than the microbeads used in conventional TARE procedures, requiring much higher radiation doses. It remains available in India, where its cost-effectiveness over conventional Y90 TARE is valued.
It has an additional use in gastric variceal obliteration as a dilutant that does not affect polymerization of cyanoacrylate.