{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T07:36:52Z","timestamp":1775720212425,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Guerbert, France and USA","award":["Personal Grant"],"award-info":[{"award-number":["Personal Grant"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: There is a sparsity of data on the use of ethiodized poppy seed oil (EPO) contrast agent (Lipiodol) in patients. We investigated the safety of EPO in children, adolescents, and some adults for diagnostic and therapeutic interventions. Methods: All patients who underwent procedures with EPO between 1995 and 2014 were retrospectively included. Demographic characteristics, diagnosis, dose, route of administration, preparation of EPO in combination with other agents, and complications were recorded. Results: In 1422 procedures, EPO was used for diagnostic or treatment purposes performed in 683 patients. The mean patient age was 13.4 years (range: 2 months\u201350 years); 58% of patients were female. Venous malformations (n = 402, 58.9%) and arteriovenous malformations (n = 60, 8.8%) were the most common diagnosis. Combined vascular anomalies included capillary\u2013lymphatic\u2013venous malformations, fibroadipose vascular anomalies (n = 54, 7.9%), central conducting lymphatic anomalies (n = 31, 4.5%), lymphatic malformations (n = 24, 3.5%), aneurysmal bone cysts (n = 22, 3.2%), and vascularized tumors (n = 11, 1.6%). In 1384 procedures (96%), EPO was used in various combinations with sclerosing and embolization agents, including sodium tetradecyl sulfate, ethanol, and glue. The mean volume of EPO used in interventions was 3.85 mL (range: 0.1\u201325 mL) per procedure with a mean patient weight of 45.9 kg (range: 3.7\u2013122.6 kg) and a weight-adjusted dose of 0.12 mL\/kg (range: 0.001\u20131.73 mL\/kg). In 56 procedures (4%), EPO was used as a single agent for diagnostic lymphangiography. The mean volume was 4.8 mL (range: 0.3\u201313 mL) per procedure with a mean patient weight of 27.4 kg (range: 2.4\u201379.3 kg) and a weight-adjusted dose of 0.2 mL\/kg (range: 0.04\u20130.54 mL\/kg). Procedural-related complications occurred in 25 (1.8%) procedures. The 20 minor and 5 major complications were related to the primary treatment agents. None of them were directly related to EPO. No allergic reactions were noted. Conclusion: The use of an ethiodized poppy seed oil contrast agent in children, adolescents, and adults for diagnostic or therapeutic purposes is safe.<\/jats:p>","DOI":"10.3390\/diagnostics11101776","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T10:39:20Z","timestamp":1632739160000},"page":"1776","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors"],"prefix":"10.3390","volume":"11","author":[{"given":"Robert K.","family":"Clemens","sequence":"first","affiliation":[{"name":"Vascular Center, Cantonal Hospital Baden, CH-5404 Baden, Switzerland"},{"name":"Department of Radiology and Vascular Anomalies Center, Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0446-2862","authenticated-orcid":false,"given":"Tim","family":"Sebastian","sequence":"additional","affiliation":[{"name":"Clinic for Angiology, University Hospital Zurich and University Zurich, CH-8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Radiology and Vascular Anomalies Center, Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad I.","family":"Alomari","sequence":"additional","affiliation":[{"name":"Department of Radiology and Vascular Anomalies Center, Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,27]]},"reference":[{"key":"ref_1","first-page":"107","article-title":"Toxicologic Study Of An Iodinated Oil Following Intralymphatic And Intravenous Administration Into Dogs","volume":"121","author":"Thompson","year":"1965","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.jvir.2010.10.030","article-title":"Lipiodol = ethiodol","volume":"22","author":"Kolbeck","year":"2011","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_3","unstructured":"(2021, September 26). Lipiodol\u00ae (Ethiodized Oil) Injection\u2014Interventional Radiology. Available online: https:\/\/www.guerbet.com\/en-us\/products-solutions\/contrast-media\/lipiodol-ethiodized-oil-injection\/."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/00004728-198302000-00040","article-title":"Pulmonary oil embolism after lymphangiography","volume":"7","author":"Francis","year":"1983","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/archsurg.1973.01350180095027","article-title":"Neurologic complications following lymphangiography. Possible mechanisms and a case of blindness","volume":"106","author":"Jay","year":"1973","journal-title":"Arch. Surg."},{"key":"ref_6","first-page":"4355","article-title":"Cerebral lipiodol embolism following transcatheter arterial chemoembolization for hepatocellular carcinoma: A report of two cases and literature review","volume":"124","author":"Li","year":"2011","journal-title":"Chin. Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1148\/radiology.179.1.1848716","article-title":"Therapeutic effect of hysterosalpingography: Oil- versus water-soluble contrast media--a randomized prospective study","volume":"179","author":"Rasmussen","year":"1991","journal-title":"Radiology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/ajo.12124","article-title":"Establishment of lipiodol as a fertility treatment\u2014Prospective study of the complete innovative treatment data set","volume":"54","author":"Court","year":"2014","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1159\/000439381","article-title":"Thyroid Dysfunction in Neonates Born to Mothers Who Have Undergone Hysterosalpingography Involving an Oil-Soluble Iodinated Contrast Medium","volume":"84","author":"Satoh","year":"2015","journal-title":"Horm. Res. Paediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S0001-2998(81)80022-0","article-title":"The value, limitations, and applications of nuclear dacryocystography","volume":"11","author":"Brown","year":"1981","journal-title":"Semin. Nucl. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1136\/jech.40.1.86","article-title":"Prevalence of goitre and hypothyroidism in Southern Tanzania: Effect of iodised oil on thyroid hormone deficiency","volume":"40","author":"Mvungi","year":"1986","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S0022-3476(63)80069-4","article-title":"Laboratory aids in the diagnosis of malabsorption in pediatrics. I. Lipiodol absorption as a simple test for steatorrhea","volume":"62","author":"Jones","year":"1963","journal-title":"J. Pediatrics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1148\/95.2.273","article-title":"Emulsified ethiodol as a bronchographic contrast agent. Preliminary observations","volume":"95","author":"Baltaxe","year":"1970","journal-title":"Radiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1002\/1097-0142(197902)43:2<482::AID-CNCR2820430212>3.0.CO;2-S","article-title":"Severe pulmonary hemorrhage following lymphography","volume":"43","author":"Marglin","year":"1979","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1148\/92.5.1081","article-title":"Extralymphatic extravasation of ethiodol during lymphography","volume":"92","author":"Rogers","year":"1969","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"342","DOI":"10.2214\/ajr.131.2.342","article-title":"Extravasation of ethiodol into deep tissues of the foot: A complication of lymphangiography","volume":"131","author":"Rubin","year":"1978","journal-title":"Am. J. Roentgenol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1177\/0194599810390475","article-title":"Ethiodol extravasation during sialography","volume":"144","author":"Schilt","year":"2011","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3585","DOI":"10.1210\/jc.2018-00960","article-title":"Early Identification of Primary Hypothyroidism in Neonates Exposed to Intralymphatic Iodinated Contrast: A Case Series","volume":"103","author":"Cherella","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1055\/s-2006-941443","article-title":"Complications of Embolization","volume":"23","author":"Bilbao","year":"2006","journal-title":"Semin. Intervent. Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jpeds.2016.05.036","article-title":"Cerebral Lipiodol Embolism after Lymphatic Embolization for Plastic Bronchitis","volume":"176","author":"Kirschen","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s42155-019-0063-3","article-title":"Full recovery after non-target cerebral embolization of n-butyl-cyanoacrylate occurred during emergency treatment of a facial arteriovenous malformation","volume":"2","author":"Lanza","year":"2019","journal-title":"CVIR Endovasc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4103\/ijri.IJRI_424_18","article-title":"Pediatric chylous ascites treatment with combined ultrasound and fluoroscopy-guided intranodal lymphangiography","volume":"29","author":"Vora","year":"2019","journal-title":"Indian J. Radiol. Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Murakami, M., Fujiwara, G., Maruyama, D., Komaru, Y., and Murakami, N. (2019). Migration of lipiodol into lateral ventricles after embolization of cerebral arteriovenous malformation: A case report. Br. J. Neurosurg., 1\u20134.","DOI":"10.1080\/02688697.2019.1648755"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1136\/bmj.1.5382.529","article-title":"Chylous Reflux","volume":"1","author":"Kinmonth","year":"1964","journal-title":"Br. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1016\/j.jvir.2011.05.003","article-title":"Intranodal lymphangiography: Feasibility and preliminary experience in children","volume":"22","author":"Rajebi","year":"2011","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1053\/j.tvir.2016.10.010","article-title":"Lymphangiography for Thoracic Duct Interventions","volume":"19","author":"Stecker","year":"2016","journal-title":"Tech. Vasc. Interv. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S199","DOI":"10.1097\/01.RVI.0000094584.83406.3e","article-title":"Society of Interventional Radiology clinical practice guidelines","volume":"14","author":"Sacks","year":"2003","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1177\/0268355515613740","article-title":"Sclerotherapy complications of peripheral venous malformations","volume":"31","author":"Aronniemi","year":"2015","journal-title":"Phlebology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1097\/RLI.0000000000000578","article-title":"Back to the Future: Lipiodol in Lymphography-From Diagnostics to Theranostics","volume":"54","author":"Pieper","year":"2019","journal-title":"Investig. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/s00270-015-1208-y","article-title":"Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion","volume":"39","author":"Arai","year":"2016","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_31","first-page":"96","article-title":"Transcatheter embolization therapy in liver cancer: An update of clinical evidences","volume":"27","author":"Wang","year":"2015","journal-title":"Chin. J. Cancer Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Chan, M., Chiang, C.L., Lee, V., Cheung, S., Leung, R., Wong, M., Lee, F., and Blanck, O. (2017). Target localization of 3D versus 4D cone beam computed tomography in lipiodol-guided stereotactic radiotherapy of hepatocellular carcinomas. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0174929"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1002\/hep.28453","article-title":"Lipiodol transarterial chemoembolization for hepatocellular carcinoma: A systematic review of efficacy and safety data","volume":"64","author":"Lencioni","year":"2016","journal-title":"Hepatology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s40644-019-0260-2","article-title":"Lipiodol retention pattern after TACE for HCC is a predictor for local progression in lesions with complete response","volume":"19","author":"Sartoris","year":"2019","journal-title":"Cancer Imaging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1177\/1538574418762192","article-title":"Preoperative Embolization of Venous Malformations Using n-Butyl Cyanoacrylate","volume":"52","author":"Uller","year":"2018","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1055\/s-0040-1713448","article-title":"Complications during Lymphangiography and Lymphatic Interventions","volume":"37","author":"Majdalany","year":"2020","journal-title":"Semin. Intervent. Radiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1055\/s-0040-1713442","article-title":"Nodal and Pedal MR Lymphangiography of the Central Lymphatic System: Techniques and Applications","volume":"37","author":"Pieper","year":"2020","journal-title":"Semin. Intervent. Radiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1055\/s-0040-1713441","article-title":"Lymphatic Imaging: Current Noninvasive and Invasive Techniques","volume":"37","author":"Schwartz","year":"2020","journal-title":"Semin. Intervent. Radiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1136\/adc.39.204.177","article-title":"Lymphangiography in Children","volume":"39","author":"Gough","year":"1964","journal-title":"Arch. Dis. Child."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1148\/radiology.187.3.8388567","article-title":"Pulmonary oil embolism after transcatheter oily chemoembolization of hepatocellular carcinoma","volume":"187","author":"Chung","year":"1993","journal-title":"Radiology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1097\/DSS.0000000000000469","article-title":"Treatment Algorithm and Clinical Outcome of Venous Malformations of the Limbs","volume":"41","author":"Manoli","year":"2015","journal-title":"Dermatol. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1024\/0301-1526\/a000650","article-title":"Percutaneous sclerotherapy for spongiform venous malformations\u2014Analysis of patient-evaluated outcome and satisfaction","volume":"46","author":"Clemens","year":"2017","journal-title":"Vasa"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jvsv.2020.03.011","article-title":"Clinicoradiologic predictors of sclerotherapy response in low-flow vascular malformations","volume":"9","author":"Bagga","year":"2020","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/10\/1776\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:05:39Z","timestamp":1760166339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/10\/1776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,27]]},"references-count":43,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["diagnostics11101776"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11101776","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,27]]}}}