Feasibility of Helical I-125 Seed Implant in the Portal Vein
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To evaluate the feasibility of helical iodine-125 (I-125) seed portal vein implantation.
Materials and Methods
Helical I-125 seed implants were placed into the portal vein of healthy pigs through the transjugular (n = 3) or percutaneous transhepatic (n = 3) route. Six pigs received follow-up at 9 weeks after implantation. Blood tests were performed preimplantation, and at 1 and 9 weeks after implantation. Contrast-enhanced computed tomography (CT) and single-photon emission computed tomography combined with CT (SPECT-CT) were acquired after implantation. Post-implantation CT was imported to the treatment planning system (TPS) for dose verification. At 9 weeks after implantation, another CT was performed before histopathological examination.
All implantations were successful, and the helical implants were fixed to the portal vein. CT showed no implant migration or portal vein thrombosis. The average dose to 90% of the target volume calculated from TPS was 68.4 Gy. SPECT-CT revealed an irregular isodose around the implant, in which the hottest spot was near the central portal vein lumen. All pigs were in good condition at the 9-week follow-up. Histopathology studies confirmed no portal vein thrombosis. Pigs showed no signs of bleeding, necrosis, or perforation of the peripheral tissue or organs. Intimal hyperplasia was observed at the two ends of the implant. A mild inflammatory response was detected in the bile duct and adjacent liver tissues, yet there was no apparent inflammation of the hepatic arteries.
The helical I-125 seed implants can be inserted into the portal veins of healthy pigs.
KeywordsPortal vein Tumor thrombus Endovascular brachytherapy Helical I-125 seed implants
Contrast-enhanced computed tomography
Single-photon emission computed tomography
Treatment planning system
Dose to 90% of the target volume
Portal vein tumor thrombus
Main portal vein tumor thrombus
External beam radiotherapy
Dose volume histogram
Analysis of variance
Planning target volume
This study was supported by Jiangsu Provincial Medical Talent funding (Grant Number ZDRCA2016038).
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the Animal Ethics Committee of Suzhou University in China. The Experimental Animal Center of Suzhou University provided six pigs that were single-housed. Food intake was monitored, and the animals were housed according to the standard procedures. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.
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