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BACKGROUND AND AIMS: Arterial chemoembolisation with lipiodol and a cytotoxic drug is reported to give equivocal results in irresectable primary hepatocellular cancer (HCC). In order to further elucidate the possible response to this treatment, we analysed the results of all patients with irresectable HCC treated with chemoembolisation at our hospital. MATERIAL AND METHODS: 58 consecutive patients with HCC were treated with lipiodolepirubicin chemoembolisation between February 1988 - October 1994 and followed until death or October 1998. RESULTS: The average survival was 11.7 months and median survival was 6 months. 17 patients had only one treatment mostly due to death within 6 weeks after the first treatment. Patients with an open portal system at inclusion (50% of all) were found to have significantly increased survival after 6 and 12 months compared to those with portal obstruction. The subgroup of patients displaying a decrease in tumour size as judged by repeated CT scan 6 months after inclusion had significantly increased survival; all survived more than 12 months (median survival 30 months). CONCLUSIONS: Chemoembolisation with lipiodol-epirubicin may have an impact on survival on selected patients with irresectable hepatocellular cancer. The treatment may justifiably be offered patients with an open portal venous system and without liver failure.

We report 36Cl determinations for groundwaters in the major confined aquifer, the Mereenie Sandstone, in the Amadeus Basin, in arid central Australia. Groundwaters at the synclinal margins of the Amadeus Basin have 36Cl ratios, 36Cl/Cl, averaging about 176 x 10-15. These groundwaters have radiocarbon contents ranging from 6 to 39% modern carbon, suggesting that they might 'average out' episodic recharge processes over the last 30,000 years. Deep within the Basin, groundwaters in the Mereenie Sandstone at Palm Valley sampled from petroleum exploration drilling, have 36Cl ratios ranging from 8 x 10-15 to 99 x 10-15. The average chlorinity of the deep groundwater samples is up to double that of the synclinal margin waters, indicating some addition of chloride in the aquifer. Even so, the groundwater residence times are implied to be about four hundred thousand years. These Mereenie Sandstone groundwaters are sourced several hundred metres below ground level, and their minimum flow path is 40-50 km from the recharge zone at the margin of the Basin. This gives an average flow rate of 0.1 m/a, in accord with previous hydraulic flow modelling which indicated that groundwater travel times in the Mereenie Sandstone are slow and uneven.

The sustainability of community water supplies drawn from shallow aquifers in the arid south-west of the Northern Territory has been evaluated using the radioactive isotope chlorine-36 (36Cl). These aquifers include fractured sandstones of the Ngalia Basin, fractured metamorphic rocks and Cainozoic sands and gravels. 36Cl/Cl ratios for these shallow, regional groundwaters exhibit a bimodal distribution with peaks at 205 (±7) and 170 (±7)×10-15. The higher ratio probably represents modern (Holocene) recharge, diluted with windblown salts from local playa lakes, and occurs mostly around the margin of the basin. The lower ratio corresponds to a 36Cl "age", or mean residence time, of 80-100 ka, implying that the last major recharge occurred during the last interglacial interval (Oxygen Isotope Stage 5). These values are mainly observed in the interior of the Ngalia Basin. Lower values of the 36Cl/Cl ratio measured near playa lakes are affected by addition of chloride from remobilised salts. Finite carbon-14 (14C) data for the groundwaters are at variance with the 36Cl results, but a depth profile suggests low recharge, allowing diffusion of recent atmospheric carbon to the water table. The 36Cl results have important implications for groundwater management in this region, with substantial recharge only occurring during favourable, wet, interglacial climatic regimes; most community water supplies are dependent on these "old" waters.

The aim of this prospective study was to evaluate MRI, including MR angiography (MRA), in the preoperative assessment of the resectability of suspected malignancy of the pancreas. A total of 17 patients with suspected pancreatic carcinoma and planned surgery were investigated with conventional angiography, ultrasonography with Doppler technique, MRI and MRA. The MRA protocol included both 2D inflow angiography and 3D phase-contrast angiography. Surgery was carried out in 13 patients. The image quality of MRA was judged satisfactory in all cases. The findings with respect to vascular involvement agreed between the radiological methods in all but 3 cases. When the findings were correlated with the final diagnosis, one false-negative case was found for each of the three methods. The results suggest that MRI with MRA, including both the phase-contrast and inflow techniques, has a similar diagnostic value to that of conventional angiography and ultrasonography in the preoperative assessment of the portal venous system in patients with pancreatic carcinoma. Further studies are needed to establish the optimal diagnostic procedure.

The study was designed to characterize L-[methyl-11 C]methionine accumulation in abnormal parathyroid tissues of hyperparathyroidism (HPT). METHODS: Thirty-four patients with primary (n = 32) or secondary HPT were investigated with PET before primary or reoperative (n = 25) parathyroid surgery. Parathyroid 11C-methionine accumulation was analyzed for integrated uptake values in defined tissue volumes standardized for the injected dose and body weight (SUV), four contiguous pixels of maximal accumulation (SUVhs), SUV multiplied by area of region of interest (SUVr) and by the excised tissue weight (SUVw). Transport rate constants (slope, slopehs) were calculated according to Patlak's formula using plasma 11C activity corrected for 11C-methionine metabolites. RESULTS: True-positive localization was achieved in 85% of patients in whom 81% of the excised parathyroid lesions were visualized; no false-positive results were obtained. Corresponding proportions were 59% and 57% for CT and 55% and 52% for ultrasound, respectively. In the true-positive cases, parathyroid SUV, SUVhs and transport rate constants were consistently higher (p < 0.01) than in the thyroid, pharynx-esophagus, neck muscle and apical lung. Parathyroid SUV, SUVhs and SUVr increased with intact serum parathyroid hormone and calcium values (p = 0.0001-0.031), and weight of the excised tissue correlated with SUV and SUVhs (p = 0.024, 0.044). Parathyroid SUVhs varied strongly with the transport rate constants (p = 0.0008), and SUVr as well as s-calcium values differed significantly between parathyroid adenomas (n = 11), chief cell hyperplasias (n = 13), inadvertent implants (n = 3) and parathyroid cancers (n = 3). CONCLUSION: Carbon-11-methionine PET has potential application in preoperative localization and metabolic characterization of abnormal parathyroid tissues in human HPT.