Lipiodol

Last revised by Dr Daniel J Bell on 18 Apr 2022

Lipiodol (also known as ethiodized oil) is an oil-based iodinated contrast medium that was historically used for myelography and hysterosalpingography 1. It was later superseded by newer, less hazardous, agents, and now is used primarily as a therapeutic agent. Guerbet is now the sole manufacturer of this agent.

Lipiodol comprises a combination of iodine and ethyl esters of poppy seed oil 2. The iodine is intercalated into the constituent fatty acids to produce a mixture of iodostearic and stearic-acid derived esters. The precise structure of Lipiodol has never been characterized 2.

  • Lipiodol radiolabeled with Re-188
    • rhenium-188 Lipiodol is a radiopharmaceutical that can be used to treat patients with unresectable hepatocellular carcinoma. The final lipophilic complex, bis-(diethyldithiocarbamato) nitrido rhenium-188, to be administered through the hepatic artery, is as follows: Re-188 N (DEDC) 2-Lipiodol 3-6.
  • conventional transcatheter hepatic arterial chemoembolisation (cTACE) 7
    • transcatheter radioembolization was initially developed using Lipiodol, but now non-Lipiodol drug-eluted glass or resin microspheres are preferred 8,9

Lipiodol was discovered by the co-founders of the healthcare company Guerbet, Marcel Guerbet and Laurent Lafay in 1901 10. Indeed originally it was marketed as Lipiodol Lafay. Initially it was developed as a therapeutic agent - a way to deliver iodine to tissues.

It was first employed in radiology in 1921 by Jean-Athanase Sicard and Jacques Forestier, French radiologists, who developed positive contrast myelography. This supplanted air myelography which had been used until then. Due to complications (e.g. chemical arachnoiditis) Lipiodol was itself superseded by iophendylate.

It was previously marketed as Ethiodol in the US but is now globally sold as Lipiodol. 

An article was published in 2021 to celebrate one hundred years of continuous use of Lipiodol in radiology 11.

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Cases and figures

  • Case 1: Lipiodol lymphography (historical)
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