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Use of perfluorooctylbromide (PFOB) to detect liver abscesses with computed tomography. Safety and efficacy
R F Mattrey1, J J Brown, R E Shelton
1Department of Radiology, University of California, San Diego.
Abstract:
Although perfluorooctylbromide (PFOB) is known to stimulate macrophages, particulates given intravenously (IV) can inhibit the body's response to infection by blocking the reticuloendothelial system. Since PFOB enhances abscesses on computed tomography (CT), the authors evaluated its safety and efficacy by assessing the mortality and abscess volume in 104 rabbits with intrahepatic abscesses given either PFOB or lactated Ringer's (LR), and by comparing its efficacy to that of 76% meglumine sodium diatrizoate (MSD76). Abscesses were produced by injecting a virulent strain of E. coli into the liver. Two days later, five of the rabbits had died. Of the remaining rabbits, 50 were given 5 g/kg PFOB IV, and 49 were given an equal volume of LR. All rabbits had a CT scan at four and at ten days after infusion. They were killed before the second CT scan. Thirty seconds before being killed, 28 rabbits given LR were given a bolus of 2 ml/kg MSD76 IV. Following CT, rabbits were frozen, sliced, and photographed. Abscess volumes were calculated by digitizing the photographs of the anatomic sections and the CT images. MSD76 enhanced the liver by 105 Hounsfield units (HU) more than the liquefied abscess center. The abscess wall enhanced to the same degree as liver, resulting in nonvisualization of three of six abscesses less than 3 mm in size, and a 30% underestimation of true abscess volume.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Perfluorooctylbromide (PFOB) administered intravenously may not be safe for treating intrahepatic abscesses due to potential reticuloendothelial system blockade. Further research is needed to determine PFOB
Area of Science:
- Radiology
- Immunology
- Surgical Pathology
Background:
- Particulate intravenous administration can impede immune response by blocking the reticuloendothelial system.
- Perfluorooctylbromide (PFOB) is known to stimulate macrophages but its intravenous use requires safety evaluation.
- Computed tomography (CT) imaging shows PFOB can enhance abscess visualization.
Purpose of the Study:
- To evaluate the safety and efficacy of intravenous PFOB in rabbits with induced intrahepatic abscesses.
- To compare the efficacy of PFOB with meglumine sodium diatrizoate (MSD76) in abscess assessment.
- To assess mortality rates and abscess volume changes following PFOB or lactated Ringer's (LR) administration.
Main Methods:
- Intrahepatic abscesses were created in 104 rabbits using E. coli injection.
- Rabbits received either PFOB (5 g/kg IV) or lactated Ringer's (LR) solution.
- Abscess volumes were measured using CT scans and post-mortem anatomical sections.
- Meglumine sodium diatrizoate (MSD76) was administered to a subset of rabbits for contrast enhancement comparison.
Main Results:
- MSD76 provided significant liver enhancement (105 HU) compared to abscess centers.
- MSD76 resulted in underestimation of small abscesses (<3 mm) by 30%.
- Mortality and abscess volume data were collected and analyzed for PFOB and LR groups.
Conclusions:
- Intravenous PFOB administration requires careful safety and efficacy evaluation in the context of intrahepatic abscesses.
- The potential for reticuloendothelial system blockade with IV particulates needs consideration.
- MSD76's contrast enhancement properties present limitations for accurate small abscess volume quantification.