Selective portal vein embolization with ethanol in treatment of implanted liver tumor in rats / 中华放射学杂志

ABSTRACT

Objective To evaluate the feasibility, safety and efficacy of selective portal vein embolization (SPVE) in treatment of liver tumor in rats and to provide the groundwork for its future clinical applications. Methods 24 healthy rats underwent the embolization. Pre and post SPVE portogram and liver chemical profile were obtained. Four rats were sacrificed at 10 min, 7,14, 21 and 28 days respectively following follow up portography. The liver, heart, lungs and kidneys were examined macroscopically and microscopically. Fifteen rats implanted with Walker 256 tumor sized from 3 to 10 mm in liver were scanned with MRI and portography pre SPVE taken. Post SPVE 3 rats were examined with MRI for each group at the same interval as above and the lives were examined microscopically. Results (1) The blood flow to the target portal branches were immediately halted after SPVE. These vessels remained occluded without collateral formation up to 28 days. (2) The liver indexes and BUN level increased after embolization, but returned to normal within 21 d. Macroscopic and microscopic changes were not found in the heart, lungs or kidneys. (3) In the healthy rats, the affected segment was atrophic and the remaining liver underwent compensatory hypertrophy. Histologic examination revealed that the targeted portal veins were coagulated, the endothelium were degenerated and the local hepatocytes were necrotic after embolization. (4) In the rats with implanted liver tumor, the affected segment including the tumor was necrotic and atrophic. The tumors were completely necrotic, and no viable tumor cell was seen under microscope in 12 among the 15 rats. Three tumors 10 mm in diameter were not completely necrotic. Part of tumor cells were still alive and infiltrated into the surrounding liver. Conclusion SPVE with ethanol is effective in the treatment of small liver tumor in rats. However,in case of bigger tumors involving several segments, SPVE should be combined with other treatment.