MR Imaging of Iron Phagocytosis in Intraluminal Thrombi of Abdominal Aortic Aneurysms in Humans

Nchimi, Alain; Defawe, Olivier; Brisbois, Denis; Broussaud, Thomas; Defraigne, Jean; Magotteaux, P; Massart, B.; Serfaty, Jean Michel; Houard, Xavier; Michel, Jean Baptiste; Sakalihasan, Natzi

doi:10.1148/radiol.09090657

Cited by 59 publications

(47 citation statements)

References 31 publications

(33 reference statements)

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“…A previous study using the larger SPIO particles (80 to 150 nm) demonstrated their accumulation in the luminal layer of aortic thrombus, resulting in an MRI signal that correlated with histological evidence of leukocyte infiltration (CD68 and CD66b) and levels of matrix metalloproteinases. 31 As acknowledged by the authors, these large SPIO particles are not well suited to vascular tissue imaging because of their short plasma half-life that limits their sensitivity for detecting vessel wall inflammation.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Aortic Aneurysm Growth Predicted by Uptake of Ultrasmall Superparamagnetic Particles of Iron Oxide

Richards

Semple²,

MacGillivray³

et al. 2011

Circ: Cardiovascular Imaging

160

164

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Background-Abdominal aortic aneurysms are a major cause of death. Prediction of aneurysm expansion and rupture is challenging and currently relies on the simple measure of aneurysm diameter. Using MRI, we aimed to assess whether areas of cellular inflammation correlated with the rate of abdominal aortic aneurysm expansion. Methods and Results-Stable patients (nϭ29; 27 male; age, 70Ϯ5 years) with asymptomatic abdominal aortic aneurysms (4.0 to 6.6 cm) were recruited from a surveillance program and imaged using a 3-T MRI scanner before and 24 to 36 hours after administration of ultrasmall superparamagnetic particles of iron oxide (USPIO). The change in T2* value on T2*-weighted imaging was used to detect accumulation of USPIO within the abdominal aortic aneurysm. Histological examination of aneurysm tissue confirmed colocalization and uptake of USPIO in areas with macrophage infiltration. Patients with distinct mural uptake of USPIO had a 3-fold higher growth rate (nϭ11, 0.66 cm/y; Pϭ0.020) than those with no (nϭ6, 0.22 cm/y) or nonspecific USPIO uptake (nϭ8, 0.24 cm/y) despite having similar aneurysm diameters (5.4Ϯ0.6, 5.1Ϯ0.5, and 5.0Ϯ0.5 cm, respectively; PϾ0.05). In 1 patient with an inflammatory aneurysm, there was a strong and widespread uptake of USPIO extending beyond the aortic wall. Conclusions-Uptake of USPIO in abdominal aortic aneurysms identifies cellular inflammation and appears to distinguish those patients with more rapidly progressive abdominal aortic aneurysm expansion.

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Section: Discussionmentioning

confidence: 99%

Abdominal Aortic Aneurysm Growth Predicted by Uptake of Ultrasmall Superparamagnetic Particles of Iron Oxide

Richards

Semple²,

MacGillivray³

et al. 2011

Circ: Cardiovascular Imaging

160

164

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“…Imaging of inflammation associated with AAA disease is equally promising. Uptake is associated with an abundance of leukocytes in the intraluminal thrombus of AAA, and when uptake is detected, focal inflammation is linked to AAA growth rates that are threefold higher [16,41]. We present a case of rapid AAA growth associated with focal signal dropout within the intraluminal thrombus on delayed ferumoxytol imaging (Fig.…”

Section: Delayed Imagingmentioning

confidence: 92%

“…

Subjects and Imaging Techniques

This study was approved by the institutional review board at our facility and is compliant with HIPAA.

…”

mentioning

confidence: 99%

Vascular Inflammation in a Growing Iliac Artery Aneurysm

Hope

Gasper²,

Rapp³

et al. 2015

Clinical Nuclear Medicine

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can be applied to vessel wall imaging [16]. The goal of this article is to summarize more than 3 years of clinical experience with ferumoxytol-enhanced MR angiography (MRA) at our institution for a range of applications including standard clinical indications (i.e., pulmonary embolism, aorta, coronary and peripheral vascular imaging) and advanced research topics (i.e., 4D flow imaging and imaging to detect vascular inflammation). Subjects and Imaging TechniquesThis study was approved by the institutional review board at our facility and is compliant with HIPAA. A total of 102 patients underwent MRA with ferumoxytol (Feraheme, AMAG Pharmaceuticals) between December 2010 and January 2015. Informed consent for the use of ferumoxytol was acquired for all examinations, and medical records were reviewed to rule out iron overload and other potential contraindications for MRI or for USPIO administration.The clinical indications for the examinations were evaluation of abdominal aortic aneurysms (AAAs) (30 patients, 29.4%), thoracoabdominal aortic aneurysms (three patients, 2.9%), pulmonary embolism (eight patients, 7.8%), aortic dissection (two patients, 2.0%), intracranial aneurysms (two patients, 2.0%), arteriovenous fistulas (15 patients, 14.7%), coronary arteries (four patients, 3.9%), carotid arteries (11 patients, 10.8%), and lower extremity vasculature (27 patients, 26.5%). The mean age of the study group was 70.7 ± 10.5 (SD) years (range, 47-95 years); there were

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“…Thus, targeting vascular inflammation through molecular imaging techniques might provide valuable functional information about aneurysms. Recent work has also shown that uptake of magnetic nanoparticles at the luminal surface of patients with highrisk aortic aneurysms correlated with thrombus leukocyte infiltration levels and proteolytic enzyme activity [5]. In the abdominal aorta, the destruction of elastic laminae is characteristic of aneurysm formation.…”

Section: Aortic Aneurysms and Inflammationmentioning

confidence: 99%

Molecular Imaging of Inflammation in Aortic Aneurysmal Disease

Chan

Kaijzel

Löwik

et al. 2011

Curr Cardiovasc Imaging Rep

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The high mortality rate of diseases of the aorta has its foundation in imaging methods that define anatomy and disease burden but less so upon the diagnosis of asymptomatic conditions, rate of aneurysm expansion, or prediction of rupture. However, anatomical features can now be co-localized with molecular and physiological activity. The advancement of nanoparticles based upon iron oxide will also serve to bring a trio of magnetic, radionuclide, and optical imaging modalities together. The combinations of these technologies are still at the preclinical refinement stage but already enzyme-activatable probes have been used to interrogate different stages of aneurysmal disease. Like many disease areas where in vivo optical imaging may play a major role in the future, unravelling and management of aortic aneurysmal disease will progress through better understanding of its pathophysiology. This will translate into new clinical applications led by targetspecific probes and the use of nanoparticle technology.

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MR Imaging of Iron Phagocytosis in Intraluminal Thrombi of Abdominal Aortic Aneurysms in Humans

Abstract: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090657/-/DC1.

Cited by 59 publications

References 31 publications

Abdominal Aortic Aneurysm Growth Predicted by Uptake of Ultrasmall Superparamagnetic Particles of Iron Oxide

Abdominal Aortic Aneurysm Growth Predicted by Uptake of Ultrasmall Superparamagnetic Particles of Iron Oxide

Vascular Inflammation in a Growing Iliac Artery Aneurysm

Molecular Imaging of Inflammation in Aortic Aneurysmal Disease

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