Contrast-enhanced magnetic resonance imaging (MRI) is a commonly used diagnostic tool. Compared to the standard gadolinium-based contrast agents, ferumoxytol (Feraheme, AMAG Pharmaceuticals, Waltham, MA), used as an alternative contrast medium, is feasible in patients with impaired renal function. Other attractive imaging features of intravenous (IV) ferumoxytol include a prolonged blood pool phase and delayed intracellular uptake. With its unique pharmacological, metabolic and imaging properties, ferumoxytol may play a crucial role in future MR imaging of the central nervous system (CNS), various organs outside the CNS, and the cardiovascular system. Preclinical and clinical studies have demonstrated the overall safety and effectiveness of this novel contrast agent with rarely occurring anaphylactoid reactions. The purpose of this review is to describe the general and organ specific properties of ferumoxytol, as well as the advantages and potential pitfalls associated with its use in MRI. In order to more fully demonstrate the applications of ferumoxytol throughout the body, an imaging atlas was created and is available as supplementary material online.

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Both flow and microstructure apparently contribute to the medullary diffusion anisotropy. The described novel method may be useful in separating decreased tubular flow from irreversible structural tubular damage, for example, in diabetic nephropathy or during allograft rejection.

Purpose: To develop and compare phase-contrast (PC) and spin-tag (ST) MR imaging techniques for accurate quantification of velocity and displacement distribution in the muscle tendon complex of the lower leg during isometric contractions under in vivo conditions, in healthy subjects and subjects with atrophy. Materials and Methods:Techniques were developed to acquire PC and ST dynamic images, gated to the force exerted by a subject during isometric contraction. Algorithms were optimized for correction of phase shading errors. Flow velocity quantification was validated in phantoms and ex vivo rabbit muscles. Trajectories of pixels calculated from PC images were compared with those in ST images. Velocity distributions were determined in healthy muscles, those atrophied by four weeks of suspension, and during physiotherapy-induced recovery. Results:The technique developed allowed acquisition of images retrospectively gated to the isometric contraction performed with the subject in the scanner. Significant phase shading errors in PC images (Ϸ3 cm/second over the field of view) were reduced to the background noise level by the correction algorithm. Tissue trajectories calculated from PC images agreed very well with those from ST images both in human and excised animal tissues. Peak velocities in atrophied muscles were significantly lower compared to the preatrophy state but recovered to baseline values after six weeks of therapy. Conclusion:We show the feasibility of monitoring muscle velocity and tissue displacement during voluntary contractions in humans under in vivo conditions using MR tissue motion mapping methods. The clinical feasibility of this technique in monitoring atrophied muscle is also demonstrated.

Three dimensional bilateral imaging is the standard for most clinical breast dynamic contrast-enhanced (DCE) MRI protocols. Because of high spatial resolution (sRes) requirement, the typical 1–2 min temporal resolution (tRes) afforded by a conventional full-k-space-sampling gradient echo (GRE) sequence precludes meaningful and accurate pharmacokinetic analysis of DCE time-course data. The commercially available, GRE-based, k-space undersampling and data sharing TWIST (time-resolved angiography with stochastic trajectories) sequence was used in this study to perform DCE-MRI exams on thirty one patients (with 36 suspicious breast lesions) before their biopsies. The TWIST DCE-MRI was immediately followed by a single-frame conventional GRE acquisition. Blinded from each other, three radiologist readers assessed agreements in multiple lesion morphology categories between the last set of TWIST DCE images and the conventional GRE images. Fleiss’ κ test was used to evaluate inter-reader agreement. The TWIST DCE time-course data were subjected to quantitative pharmacokinetic analyses. With a four-channel phased-array breast coil, the TWIST sequence produced DCE images with 20 s or less tRes and ~ 1.0×1.0×1.4 mm3 sRes. There were no significant differences in signal-to-noise (P = 0.45) and contrast-to-noise (P = 0.51) ratios between the TWIST and conventional GRE images. The agreements in morphology evaluations between the two image sets were excellent with the intra-reader agreement ranging from 79% for mass margin to 100% for mammographic density and the inter-reader κ value ranging from 0.54 (P < 0.0001) for lesion size to 1.00 (P < 0.0001) for background parenchymal enhancement. Quantitative analyses of the DCE time-course data provided higher breast cancer diagnostic accuracy (91% specificity at 100% sensitivity) than the current clinical practice of morphology and qualitative kinetics assessments. The TWIST sequence may be used in clinical settings to acquire high spatiotemporal resolution breast DCE-MRI images for both precise lesion morphology characterization and accurate pharmacokinetic analysis.