Ferumoxytol vs. Gadolinium agents for contrast‐enhanced MRI: Thoughts on evolving indications, risks, and benefits

Finn, J. Paul; Nguyen, Kim‐Lien; Hu, Peng

doi:10.1002/jmri.25580

Cited by 37 publications

(30 citation statements)

References 44 publications

(66 reference statements)

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“…As the only approved iron based agent to treat anemia, ferumoxytol has to be administered slowly “as an IV infusion over a minimum of 15 minutes”, instead of “as an undiluted IV injection”, according to the warning statement issued by the FDA . In the past year, several review articles have been published discussing the off‐label use of ferumoxytol as contrast agent, finding very little evidence of an adverse effect at this low dose …”

Section: Discussionmentioning

confidence: 99%

Susceptibility weighted imaging and quantitative susceptibility mapping of the cerebral vasculature using ferumoxytol

Liu

Brisset

et al. 2017

Magnetic Resonance Imaging

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Purpose To demonstrate the potential of imaging cerebral arteries and veins with ferumoxytol using susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM). Materials and Methods The relationships between ferumoxytol concentration and the apparent susceptibility at 1.5T, 3T, and 7T were determined using phantom data; the ability of visualizing subvoxel vessels was evaluated using simulations; and the feasibility of using ferumoxytol to enhance the visibility of small vessels was confirmed in three healthy volunteers at 7T(with doses 1 mg/kg to 4 mg/kg). The visualization of the lenticulostriate arteries and the medullary veins was assessed by two raters and the contrast-to-noise ratios (CNRs) of these vessels were measured. Results The relationship between ferumoxytol concentration and susceptibility was linear with a slope 13.3 ± 0.2 ppm·mg−1·mL at 7T. Simulations showed that SWI data with an increased dose of ferumoxytol, higher echo time (TE), and higher imaging resolution improved the detection of smaller vessels. With 4 mg/kg ferumoxytol, voxel aspect ratio = 1:8, TE = 10 ms, the diameter of the smallest detectable artery was approximately 50µm. The rating score for arteries was improved from 1.5 ± 0.5 (precontrast) to 3.0 ± 0.0 (post-4 mg/kg) in the in vivo data and the apparent susceptibilities of the arteries (0.65 ± 0.02 ppm at 4 mg/kg) agreed well with the expected susceptibility (0.71 ± 0.05 ppm). Conclusion The CNR for cerebral vessels with ferumoxytol can be enhanced using SWI, and the apparent susceptibilities of the arteries can be reliably quantified using QSM. This approach improves the imaging of the entire vascular system outside the capillaries and may be valuable for a variety of neurodegenerative diseases which involve the microvasculature.

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Section: Discussionmentioning

confidence: 99%

Susceptibility weighted imaging and quantitative susceptibility mapping of the cerebral vasculature using ferumoxytol

Liu

Brisset

et al. 2017

Magnetic Resonance Imaging

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“…36 In some rare cases, however, severe adverse effects such as anaphylactoid reactions have been reported, which occurred when injecting ferumoxytol as a bolus in therapeutic doses (U.S. Food and Drug Administration [FDA]). In particular, the USPIO ferumoxytol has been used in many diagnostic imaging studies.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric characterization of response to anti‐angiogenic therapy using USPIO contrast‐enhanced MRI in combination with dynamic contrast‐enhanced MRI

Kim

Euceda

et al. 2017

Magnetic Resonance Imaging

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“…Ferumoxytol is Food and Drug Administration‐approved for the treatment of anemia. It is not contraindicated in patients with renal failure, and although bolus injection of ferumoxytol is currently not recommended, it has a growing safety record with slow infusion . Ferumoxytol offers the advantage of strong T 1 and

T_{2}^{*}

shortening effects and at typical doses and clinical field strengths, ferumoxytol

T_{2}^{*}

effects are substantially higher than available gadolinium‐based contrast agents (GBCA) .…”

Section: Introductionmentioning

confidence: 99%

Measurement of microvascular cerebral blood volume changes over the cardiac cycle with ferumoxytol‐enhanced T₂^* MRI

Rivera‐Rivera

Johnson

Turski

et al. 2019

Magnetic Resonance in Med

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Purpose This feasibility study investigates the non‐invasive measurement of microvascular cerebral blood volume (BV) changes over the cardiac cycle using cardiac‐gated, ferumoxytol‐enhanced T2∗ MRI. Methods Institutional review board approval was obtained and all subjects provided written informed consent. Cardiac gated MR scans were prospectively acquired on a 3.0T scanner in 22 healthy subjects using T2∗‐weighted sequences with 2D‐EPI and 3D spiral trajectories. Images were collected before and after the intravenous administration of 2 doses of ferumoxytol (1 mg FE/kg and 4 mg FE/kg). Cardiac cycle‐induced R2∗ (1/T2∗) changes (ΔR2∗) and BV changes (ΔBV) throughout the cardiac cycle in gray matter (GM) and white matter (WM) were quantified and differences assessed using ANOVA followed by post hoc analysis. Results ΔR2∗ was found to increase in a dose‐dependent fashion. A significantly larger increase was observed in GM compared to WM in both 2D and 3D acquisitions (P < 0.050). In addition, ΔR2∗ increased significantly (P < 0.001) post versus pre‐contrast injection in GM in both T2∗ MRI acquisitions. Mean GM ΔR2∗ derived from 2D‐EPI images was 0.14 ± 0.06 s−1 pre‐contrast and 0.33 ± 0.13 s−1 after 5 mg FE/kg. In WM, ΔR2∗ was 0.19 ± 0.06 s−1 pre‐contrast, and 0.23 ± 0.06 s−1 after 5 mg FE/kg. The fractional changes in BV throughout the cardiac cycle were 0.031 ± 0.019% in GM and 0.011 ± 0.008% in WM (P < 0.001) after 5 mg FE/kg. Conclusion Cardiac‐gated, ferumoxytol‐enhanced T2∗ MRI enables characterization of microvascular BV changes throughout the cardiac cycle in GM and WM tissue of healthy subjects.

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Ferumoxytol vs. Gadolinium agents for contrast‐enhanced MRI: Thoughts on evolving indications, risks, and benefits

Cited by 37 publications

References 44 publications

Susceptibility weighted imaging and quantitative susceptibility mapping of the cerebral vasculature using ferumoxytol

Susceptibility weighted imaging and quantitative susceptibility mapping of the cerebral vasculature using ferumoxytol

Multiparametric characterization of response to anti‐angiogenic therapy using USPIO contrast‐enhanced MRI in combination with dynamic contrast‐enhanced MRI

Measurement of microvascular cerebral blood volume changes over the cardiac cycle with ferumoxytol‐enhanced T₂^* MRI

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Ferumoxytol vs. Gadolinium agents for contrast‐enhanced MRI: Thoughts on evolving indications, risks, and benefits

Cited by 37 publications

References 44 publications

Susceptibility weighted imaging and quantitative susceptibility mapping of the cerebral vasculature using ferumoxytol

Susceptibility weighted imaging and quantitative susceptibility mapping of the cerebral vasculature using ferumoxytol

Multiparametric characterization of response to anti‐angiogenic therapy using USPIO contrast‐enhanced MRI in combination with dynamic contrast‐enhanced MRI

Measurement of microvascular cerebral blood volume changes over the cardiac cycle with ferumoxytol‐enhanced T2* MRI

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Measurement of microvascular cerebral blood volume changes over the cardiac cycle with ferumoxytol‐enhanced T₂^* MRI