Lipiodol-Mediated Dose Enhancement in Radiation Therapy: A Phantom and In Vitro Study in Hepatocellular Carcinoma
Abstract
PURPOSE: To assess Lipiodol-mediated photon dose perturbation and biological effects using complementary kilovoltage and megavoltage irradiation geometries relevant to hepatocellular carcinoma.
MATERIALS AND METHODS: Phantom dosimetry used containers filled with lipiodol-oil mixtures (0-100%) embedded in a water phantom with radiochromic film to quantify concentration-dependent enhancement under 6-MV beam. HepG2 human hepatoma cells were irradiated at 0-6 Gy using 160-kVp (photoelectric effect dominant) with lipiodol or water placed beneath the cell monolayer to isolate backscatter; γH2AX foci indicating DNA damage were quantified shortly after irradiation. For megavoltage testing, a 6-MV (Compton scattering dominant) Lipiodol-rich "sandwich" geometry (Lipiodol above and below the cell monolayer) was used; apoptosis was quantified at 96 h using NucView/NucSpot (apoptotic fraction), and results are reported descriptively.
RESULTS: Film dosimetry demonstrated increasing enhancement with Lipiodol concentration, spatially localized to the Lipiodol region, with a maximum localized increase of 57.1% at 100% Lipiodol versus water. In the 160-kVp backscatter model, higher γH2AX foci were observed at 4 and 6 Gy in Lipiodol versus control. In the 6-MV sandwich model, cell-plane film confirmed an 11.5% higher delivered dose at 2 Gy with Lipiodol and apoptotic fraction was 1.36-5.79-fold higher across 2-6 Gy compared to the control.
CONCLUSION: Lipiodol measurably intensified local…
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