Evaluation of Ultrasmall Superparamagnetic Iron Oxide-Enhanced MRI of Carotid Atherosclerosis to Assess Risk of Cerebrovascular and Cardiovascular Events: Follow-Up of the ATHEROMA Trial

Non-immunogenic dextran-coated superparamagnetic iron oxide nanoparticles: a biocompatible, size-tunable contrast agent for magnetic resonance imaging

“…Multiple studies confirmed the ability of USPIO-enhanced MRI to identify plaque inflammation and vulnerability, 11,12 also within otherwise morphologically "stable" plaques, 13 and in asymptomatic patients. 14 Furthermore, ferumoxtran-enhanced MRI has been shown to predict the expansion and rupture of aortic aneurysms 15 and detect inflammation following ischemic stroke. 16 Importantly, sequential USPIO-enhanced MRI in patients suffering from stenosis of carotid arteries 17 provided evidence that, within 6 months, ferumoxtran particles administered at 2.6 mg Fe/kg were cleared out of the plaque, with no major adverse effects observed following multiple infusions.…”

A comprehensive literatures update of clinical researches of superparamagnetic resonance iron oxide nanoparticles for magnetic resonance imaging

“…In a recent study, Degnan et al (104) reported an association between SPIO-defined plaque inflammation and developing subsequent vascular events (P=0.07). The nonsignificant (P value =0.07) was considered to be due to the study was inadequately powered (104). Interesting, in hyperlipidemic rabbits, the in vivo MRI enhancement was found to be higher with the long half-life agent ferumoxtran-10 as compared to that obtained with ferumoxytol which has shorter half-life, whereas in vitro macrophage phagocytosis was greater with ferumoxytol (105).…”

“…USPIO hypointensity changes can differentiate symptomatic carotid arteries from the contra-lateral asymptomatic side with greater relative signal loss seen in symptomatic patients (99,103). In a recent study, Degnan et al (104) reported an association between SPIO-defined plaque inflammation and developing subsequent vascular events (P=0.07). The nonsignificant (P value =0.07) was considered to be due to the study was inadequately powered (104).…”

Cardiovascular therapy through nanotechnology – how far are we still from bedside?

“…In those analyses, 62 patients initially screened for enrollment to ATHEROMA trial were examined for the occurrence of adverse cerebrovascular or cardiovascular events following the initial USPIO-imaging. Despite the small size of the study group and only 17 cardiovascular/cerebrovascular events reported in total, an association was observed (p = 0.07) between the magnitude of maximal USPIO-induced signal intensity loss within carotid plaques and the risk of developing subsequent vascular events (131). As the study lacked adequate statistical power, future prospective studies with new generation of USPIO-based contrast agents are urgently needed.…”

“…This technique was thus suitable to assess therapeutic response in an interventional drug trial in humans, additionally facilitating enrollment of the specific patient cohort in the trial. The results of the long-term follow-up of the ATHEROMA trial were published in 2012 (131), evaluating the ability of USPIOenhanced MRI to predict subsequent cerebrovascular and cardiovascular events. In those analyses, 62 patients initially screened for enrollment to ATHEROMA trial were examined for the occurrence of adverse cerebrovascular or cardiovascular events following the initial USPIO-imaging.…”