利用碘化油作为化疗载体的传统经动脉化疗栓塞术（cTACE）已成为中期肝细胞癌（HCC）的标准治疗方法，并已被采用作为肝移植的桥接和降期治疗。由碘化油和化疗溶液组成的油包水乳剂保留在肿瘤脉管系统中，从而导致高组织药物浓度和低全身化疗剂量。治疗后成像中肿瘤内碘化油的密度和分布模式可预测肿瘤坏死的程度和治疗反应的持续时间。本综述描述了碘化油的多种作用，特别是其作为肿瘤对 cTACE 反应的生物标志物的作用。临床相关性：随着局部治疗方案（包括联合疗法的使用）日益复杂，治疗反应评估变得具有挑战性；碘化油沉积模式可以作为预测治疗反应的成像生物标志物，并可能预测治疗后的预后。要点： • 由于治疗后影像学表现各异，肝细胞癌局部治疗后的治疗反应评估充满了多重挑战。 • 乙碘化油的独特之处在于其射线不透性可以作为成像生物标志物来帮助预测治疗反应。 • 乙硫碘油的沉积模式已成为一种检测未充分治疗的肿瘤部分的机制，并且可以作为增强的辅助手段，以改善接受乙硫碘油动脉内栓塞治疗的患者的治疗。© 2023。作者（ s）。

Conventional transarterial chemoembolization (cTACE) utilizing ethiodized oil as a chemotherapy carrier has become a standard treatment for intermediate-stage hepatocellular carcinoma (HCC) and has been adopted as a bridging and downstaging therapy for liver transplantation. Water-in-oil emulsion made up of ethiodized oil and chemotherapy solution is retained in tumor vasculature resulting in high tissue drug concentration and low systemic chemotherapy doses. The density and distribution pattern of ethiodized oil within the tumor on post-treatment imaging are predictive of the extent of tumor necrosis and duration of response to treatment. This review describes the multiple roles of ethiodized oil, particularly in its role as a biomarker of tumor response to cTACE. CLINICAL RELEVANCE: With the increasing complexity of locoregional therapy options, including the use of combination therapies, treatment response assessment has become challenging; Ethiodized oil deposition patterns can serve as an imaging biomarker for the prediction of treatment response, and perhaps predict post-treatment prognosis. KEY POINTS: • Treatment response assessment after locoregional therapy to hepatocellular carcinoma is fraught with multiple challenges given the varied post-treatment imaging appearance. • Ethiodized oil is unique in that its' radiopacity can serve as an imaging biomarker to help predict treatment response. • The pattern of deposition of ethiodozed oil has served as a mechanism to detect portions of tumor that are undertreated and can serve as an adjunct to enhancement in order to improve management in patients treated with intraarterial embolization with ethiodized oil.© 2023. The Author(s).