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Feasibility of using hyperosmolar mannitol as a liquid tumor embolization agent
Lei Feng1, Beverly A Kienitz, Carolyn Matsumoto
1Department of Radiology, Columbia University, New York, NY 10032, USA.
AJNR. American Journal of Neuroradiology
|June 16, 2005
Summary
High concentrations of mannitol can damage endothelial and meningioma cells. However, mannitol is a feasible liquid embolic agent for treating meningioma, showing promising clinical results.
Area of Science:
- Neurosurgery
- Oncology
- Biomaterials
Background:
- Hyperosmolar mannitol's cytotoxicity on human cells was investigated.
- Clinical use of mannitol as a liquid tumor embolization agent was evaluated.
Purpose of the Study:
- To assess mannitol's cytotoxicity on endothelial and meningioma cells in vitro.
- To summarize clinical experience using mannitol for meningioma embolization.
Main Methods:
- In vitro: Human cells exposed to varying mannitol concentrations; cell death assessed via Live/Dead kit and thymidine incorporation.
- Clinical: Retrospective analysis of 23 patients treated with mannitol embolization vs. 31 treated with polyvinyl alcohol (PVA) particles.
Main Results:
- High mannitol concentrations (≥1200 mOsm) caused significant endothelial cell death (43%).
- Mannitol induced significant cell death in meningioma cell lines (22%).
- All patients treated with mannitol showed satisfactory angiographic results, with observed tumor necrosis and comparable blood loss to PVA embolization.
Conclusions:
- High-concentration mannitol can cause short-term injury to endothelial and meningioma cells.
- Mannitol is a feasible liquid embolic agent for meningioma treatment.