The Potential of Ferumoxytol Nanoparticle Magnetic Resonance Imaging, Perfusion, and Angiography in Central Nervous System Malignancy

Neuwelt, Edward A.; Várallyay, Csanád; Manninger, Sándor; Solymosi, Diána; Haluska, Marianne; Hunt, Matthew A.; Nesbit, Gary M.; Stevens, Alexander A.; Jerosch‐Herold, Michael; Jacobs, Paula; Hoffman, John M.

doi:10.1227/01.neu.0000255350.71700.37

Cited by 171 publications

(166 citation statements)

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“…28 Nevertheless, the US federal government continues to fund multiple clinical studies investigating the MRI-based applications of ferumoxytol. 29 This labeling unfortunately creates a perception that ferumoxytol administration is contraindicated when, in fact, an MRI may be desirable. Clinicians and radiologists should be made aware of any prior USPIO administration, however, in order to allow proper interpretation of MRI studies.…”

Section: Resultsmentioning

confidence: 99%

Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL

et al. 2013

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Objective: The study goal was to assess the benefits and potential limitations in the use of ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles in the MRI diagnosis of CNS inflammatory diseases and primary CNS lymphoma.Methods: Twenty patients with presumptive or known CNS lesions underwent MRI study. Eighteen patients received both gadolinium-based contrast agents (GBCAs) and 1 of 2 USPIO contrast agents (ferumoxytol and ferumoxtran-10) 24 hours apart, which allowed direct comparative analysis. The remaining 2 patients had only USPIO-enhanced MRI because of a renal contraindication to GBCA. Conventional T1-and T2-weighted MRI were acquired before and after contrast administration in all patients, and perfusion MRI for relative cerebral blood volume (rCBV) assessment was obtained in all 9 patients receiving ferumoxytol.Results: USPIO-enhanced MRI showed an equal number of enhancing brain lesions in 9 of 18 patients (50%), more enhancing lesions in 2 of 18 patients (11%), and fewer enhancing lesions in 3 of 18 patients (17%) compared with GBCA-enhanced MRI. Four of 18 patients (22%) showed no MRI enhancement. Dynamic susceptibility-weighted contrast-enhanced perfusion MRI using ferumoxytol showed low rCBV (ratio ,1.0) in 3 cases of demyelination or inflammation, modestly elevated rCBV in 5 cases of CNS lymphoma or lymphoproliferative disorder (range: 1.3-4.1), and no measurable disease in one case.Conclusions: This study showed that USPIO-enhanced brain MRI can be useful in the diagnosis of CNS inflammatory disorders and lymphoma, and is also useful for patients with renal compromise at risk of nephrogenic systemic fibrosis who are unable to receive GBCA. Neurology â 2013;81:256-263 GLOSSARY CNSL 5 CNS lymphoma; DSC 5 dynamic susceptibility-weighted contrast-enhanced; GBCA 5 gadolinium-based contrast agent; NSF 5 nephrogenic systemic fibrosis; PCNSL 5 primary CNS lymphoma; PTLD 5 posttransplant lymphoproliferative disorder; PWI 5 perfusion-weighted imaging; rCBV 5 relative cerebral blood volume; USPIO 5 ultrasmall superparamagnetic iron oxide.

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Section: Resultsmentioning

confidence: 99%

Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL

et al. 2013

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“…Gahramanov et al facts ( 19,22,(29)(30)(31). The inability of the ultrasmall superparamagnetic iron oxide ferumoxytol to cross the disrupted BBB in the short term (minutes to hours) owing to the large size of the iron nanoparticles ( ‫ف‬ 30 nm) and long half-life ( ‫ف‬ 14 hours) provides an attractive alternative to GBCA for blood volume measurements ( 31 ).…”

Section: Experimental Studies: Assessment Of Intracerebral Tumor Bloomentioning

confidence: 99%

“…The inability of the ultrasmall superparamagnetic iron oxide ferumoxytol to cross the disrupted BBB in the short term (minutes to hours) owing to the large size of the iron nanoparticles ( ‫ف‬ 30 nm) and long half-life ( ‫ف‬ 14 hours) provides an attractive alternative to GBCA for blood volume measurements ( 31 ). Ferumoxytol is approved by the U.S. Food and Drug Administration for iron replacement therapy in adults with chronic kidney disease, and its off-label use has shown utility in brain imaging ( 19,29,31 ). Because ferumoxytol is not eliminated by the kidneys , it may also serve as a safe alternative to GBCA in patients who are at risk for nephrogenic systemic fi brosis ( 32 ).…”

Section: Experimental Studies: Assessment Of Intracerebral Tumor Bloomentioning

confidence: 99%

“…To improve the diagnostic accuracy of DSC MR imaging, several methods have been proposed for contrast material extravasation correction, including the use of small-fl ip-angle gradient-echo ( 6,9,24 ) or dual-echo ( 25,26 ) perfusion acquisitions, postprocessing with multiple mathematic correction algorithms ( 23,27,28 ), and the use of blood pool iron oxide contrast agents ( 19,21,22,(29)(30)(31). One of the most common contrast material extravasation correction methods is administration of a loading dose of GBCA before perfusion image acquisition.…”

Section: Experimental Studies: Assessment Of Intracerebral Tumor Bloomentioning

confidence: 99%

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Improved Perfusion MR Imaging Assessment of Intracerebral Tumor Blood Volume and Antiangiogenic Therapy Efficacy in a Rat Model with Ferumoxytol

Gahramanov¹,

Muldoon²,

Li³

et al. 2011

Radiology

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Purpose:To evaluate the consistency of tumor blood volume measurements and antiangiogenic therapy effi cacy assessments with a low-molecular-weight gadolinium-based contrast agent (GBCA, gadodiamide) versus an iron oxide nanoparticle (ferumoxytol) in the presence or absence of a loading dose of contrast agent before perfusion magnetic resonance (MR) imaging (preload method). Materials and Methods:The protocol was approved by the institutional animal care and use committee. U87MG tumor cells were implanted intracerebrally in 13 rats. All 13 rats underwent 11.75-T MR imaging with gadodiamide (60 m L) 13 days after tumor implantation. The next day, nine rats underwent MR imaging with ferumoxytol (60 m L). Immediately after ferumoxytol imaging, six rats received bevacizumab (45 mg/kg). MR imaging was repeated 48 hours after bevacizumab treatment with gadodiamide and 72 hours after treatment with ferumoxytol. Each study included three consecutive dynamic susceptibility-weighted contrast material-enhanced (DSC) MR acquisitions, which were performed without preload, with single-dose preload, and with double-dose preload. Tumor relative cerebral blood volume (rCBV) was estimated from each DSC MR acquisition. Two-way repeated measures analysis of variance was performed to test for differences between groups with both contrast agents. Results:DSC MR imaging with gadodiamide and without preload showed low rCBV ( Յ 1.75) in nine of the 13 tumors; estimated rCBV increased progressively with both single-and double-dose preloads ( P , .001). Conversely, rCBVs obtained with ferumoxytol were high ( . 1.75) and remained constant with all three acquisitions. The magnitude of rCBV decrease after bevacizumab administration was dependent on the dose of gadodiamide preload, whereas the magnitude of rCBV decrease with ferumoxytol was constant regardless of whether contrast agent preload was used. Conclusion:With GBCA, tumor rCBV can be underestimated without preload and becomes dose dependent with preload correction. Conversely, ferumoxytol provides consistent assessment of tumor rCBV and antiangiogenic therapy effi cacy.q RSNA, 2011

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“…Ferumoxytol can be administered as a bolus injection, allowing both first-pass arterial and blood pool imaging [7,9]. It has been broadly applied in both pediatric and adult patients for intracranial, chest, and abdominal vascular MRI [10][11][12][13][14].…”

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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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The Potential of Ferumoxytol Nanoparticle Magnetic Resonance Imaging, Perfusion, and Angiography in Central Nervous System Malignancy

Cited by 171 publications

References 34 publications

Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL

Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL

Improved Perfusion MR Imaging Assessment of Intracerebral Tumor Blood Volume and Antiangiogenic Therapy Efficacy in a Rat Model with Ferumoxytol

Vascular Inflammation in a Growing Iliac Artery Aneurysm

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