Multicenter Safety and Practice for Off-Label Diagnostic Use of                    Ferumoxytol in MRI

Nguyen, Kim‐Lien; Yoshida, Takegawa; Kathuria‐Prakash, Nikhita; Zaki, Islam; Várallyay, Csanád; Semple, Scott; Saouaf, Rola; Rigsby, Cynthia K.; Stoumpos, Sokratis; Whitehead, Kevin K.; Griffin, Lindsay; Saloner, David; Hope, Michael D.; Prince, Martin R.; Fogel, Mark A.; Schiebler, Mark L.; Roditi, Giles; Radjenovic, Aleksandra; Newby, David E.; Neuwelt, Edward A.; Bashir, Mustafa R.; Hu, Peng; Finn, J. Paul

doi:10.1148/radiol.2019190477

Cited by 107 publications

(98 citation statements)

References 33 publications

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“…The rate of patient or healthcare staff reporting an allergic or anaphylactic reaction using the current protocol approximates 2%. 14 The minimum adequate dose for clinically acceptable imaging is unknown for each anatomical site of interest. The current dosing regimen (3 mg/kg) is unlikely necessary for imaging of non-cardiothoracic vasculature in the abdomen where motion artifact can be readily attenuated.…”

Section: Discussionmentioning

confidence: 99%

Alternative Diagnostic Strategy for the Assessment and Treatment of Pulmonary Embolus: A Case Series

Aghayev

Memon

Greenough

et al. 2020

Clinical Practice and Cases in Emergency Medicine

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Introduction: Ferumoxytol-enhanced magnetic resonance angiography (FeMRA) can be used as an alternate and safe method to diagnose patients with compromised renal function who present with acute pulmonary embolus in the emergency department (ED) setting. Case Report: A 62-year old man with a history of renal transplant and lymphoproliferative disease described new onset of breathlessness. His clinical symptoms were suggestive of pulmonary embolus. He underwent FeMRA in the ED to avoid exposure to intravenous iodinated contrast. FeMRA demonstrated a left main pulmonary artery embolus, which extended to the left interlobar pulmonary artery. Afterward, the patient initiated anticoagulation therapy. With preserved renal function he was able to continue his outpatient chemotherapy regimen. Conclusion: This case highlights a safe imaging technique for emergency physicians to diagnose pulmonary embolus and subsequently guide anticoagulation therapy for patients in whom use of conventional contrast is contraindicated.

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Section: Discussionmentioning

confidence: 99%

Alternative Diagnostic Strategy for the Assessment and Treatment of Pulmonary Embolus: A Case Series

Aghayev

Memon

Greenough

et al. 2020

Clinical Practice and Cases in Emergency Medicine

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“…FMX has increasingly been used off-label in MRI angiography due to its superparamagnetic properties [20][21][22]. Human clinical trials have demonstrated the safety and ability of FMX as MRI contrast agent [23]. Furthermore, studies in animal have shown that FMX can be used as a drug delivery nanovehicle allowing for MR-guided assessment of nanoparticle accumulation and drug release [24].…”

Section: Ivyspringmentioning

confidence: 99%

Intraoperative assessment and postsurgical treatment of prostate cancer tumors using tumor-targeted nanoprobes

Teh¹,

Tripathi²,

Reichel³

et al. 2021

Nanotheranostics

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Successful visualization of prostate cancer (PCa) tumor margins during surgery remains a major challenge. The visualization of these tumors during surgery via near infrared fluorescence (NIRF) imaging would greatly enhance surgical resection, minimizing tumor recurrence and improving outcome. Furthermore, chemotherapy is typically administered to patients after surgery to treat any missed tumor tissue around the surgical area, minimizing metastasis and increasing patient survival. For these reasons, a theranostics fluorescent nanoparticle could be developed to assist in the visualization of PCa tumor margins, while also delivering chemotherapeutic drug after surgery. Methods: Ferumoxytol (FMX) conjugated to the fluorescent dye and PCa targeting agent, heptamethine carbocyanine (HMC), yielded the HMC-FMX nanoprobe that was tested in vitro with various PCa cell lines and in vivo with both subcutaneous and orthotopic PCa mouse models. Visualization of these tumors via NIRF imaging after administration of HMC-FMX was performed. In addition, delivery of chemotherapeutic drug and their effect on tumor growth was also assessed. Results: HMC-FMX internalized into PCa cells, labeling these cells and PCa tumors in mice with near infrared fluorescence, facilitating tumor margin visualization. HMC-FMX was also able to deliver drugs to these tumors, reducing cell migration and slowing down tumor growth. Conclusion: HMC-FMX specifically targeted PCa tumors in mice allowing for the visualization of tumor margins by NIRF imaging. Furthermore, delivery of anticancer drugs by HMC-FMX effectively reduced prostate tumor growth and reduced cell migration in vitro. Thus, HMC-FMX can potentially translate into the clinic as a nanotheranostics agent for the intraoperative visualization of PCa tumor margins, and post-operative treatment of tumors with HMC-FMX loaded with anticancer drugs.

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“…72 The authors reported a positive safety profile for ferumoxytol use in MRI and concluded that diagnostic ferumoxytol was well tolerated and associated with no serious adverse events. 72 Ferumoxytol-enhanced dynamic MRI was employed in healthy subjects to assess the blood volume in the renal cortex (mean rBV renal cortex = 41±8 ml/100 g). 61 When implementing ferumoxytol-based renal BVf assessment in clinical renal imaging protocols, caution should be taken to prevent interference of ferumoxytol with other MRI techniques and MR contrasts.…”

Section: Implementation Of Ferumoxytol -Enhanced Mri Assessment Of Rementioning

confidence: 99%

Probing renal blood volume with magnetic resonance imaging

et al. 2020

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Damage to the kidney substantially reduces life expectancy. Renal tissue hypoperfusion and hypoxia are key elements in the pathophysiology of acute kidney injury and its progression to chronic kidney disease. In vivo assessment of renal haemodynamics and tissue oxygenation remains a challenge. Blood oxygenation level–dependent (BOLD) magnetic resonance imaging (MRI) is sensitive to changes in the effective transversal relaxation time (T2*) in vivo, and is non‐invasive and indicative of renal tissue oxygenation. However, the renal T2* to tissue pO2 relationship is not governed exclusively by renal blood oxygenation, but is affected by physiological confounders with alterations in renal blood volume fraction (BVf) being of particular relevance. To decipher this interference probing renal BVf is essential for the pursuit of renal MR oximetry. Superparamagnetic iron oxide nanoparticle (USPIO) preparations can be used as MRI visible blood pool markers for detailing alterations in BVf. This review promotes the opportunities of MRI‐based assessment of renal BVf. Following an outline on the specifics of renal oxygenation and perfusion, changes in renal BVf upon interventions and their potential impact on renal T2* are discussed. We also describe the basic principles of renal BVf assessment using ferumoxytol‐enhanced MRI in the equilibrium concentration regimen. We demonstrate that ferumoxytol does not alter control of renal haemodynamics and oxygenation. Preclinical applications of ferumoxytol enhanced renal MRI as well as considerations for its clinical implementation for examining renal BVf changes are provided alongside practical considerations. Finally, we explore the future directions of MRI‐based assessment of renal BVf.

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Multicenter Safety and Practice for Off-Label Diagnostic Use of Ferumoxytol in MRI

Cited by 107 publications

References 33 publications

Alternative Diagnostic Strategy for the Assessment and Treatment of Pulmonary Embolus: A Case Series

Alternative Diagnostic Strategy for the Assessment and Treatment of Pulmonary Embolus: A Case Series

Intraoperative assessment and postsurgical treatment of prostate cancer tumors using tumor-targeted nanoprobes

Probing renal blood volume with magnetic resonance imaging

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