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Cerebral blood volume mapping with ferumoxytol in dynamic susceptibility contrast perfusion MRI: Comparison to standard of care
Background Cerebral blood volume (CBV) mapping with a dynamic susceptibility contrast (DSC) perfusion technique has become a clinical tool in diagnosing and follow‐up of brain tumors. Ferumoxytol, a long‐circulating iron oxide nanoparticle, has been tested for CBV mapping, but the optimal dose has n...
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Published in: | Journal of magnetic resonance imaging 2018-08, Vol.48 (2), p.441-448 |
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container_title | Journal of magnetic resonance imaging |
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creator | Varallyay, Csanad G. Nesbit, Eric Horvath, Andrea Varallyay, Peter Fu, Rongwei Gahramanov, Seymur Muldoon, Leslie L. Li, Xin Rooney, William D. Neuwelt, Edward A. |
description | Background
Cerebral blood volume (CBV) mapping with a dynamic susceptibility contrast (DSC) perfusion technique has become a clinical tool in diagnosing and follow‐up of brain tumors. Ferumoxytol, a long‐circulating iron oxide nanoparticle, has been tested for CBV mapping, but the optimal dose has not been established.
Purpose
To compare ferumoxytol DSC of two different doses to standard of care gadoteridol by analyzing time–intensity curves and CBV maps in normal‐appearing brain regions.
Study Type
Retrospective.
Subjects
Fifty‐four patients with various brain disorders.
Field Strength/Sequence
3T MRI. DSC‐MRI was performed with 0.1 mmol/kg gadoteridol and 1 day later with ferumoxytol in doses of 1 or 2 mg/kg.
Assessment
Signal changes during first pass, relative CBV (rCBV) in normal‐appearing thalamus, putamen, and globus pallidus, and contrast‐to‐noise ratio (CNR) of the CBV maps were compared between gadoteridol and various doses of ferumoxytol using an automated method. To subjectively assess the quality of the CBV maps, two blinded readers also assessed visual conspicuity of the putamen.
Statistical Tests
Linear mixed effect model was used for statistical comparison.
Results
Compared to gadoteridol, 1 mg/kg ferumoxytol showed no difference in CNR (P = 0.6505), peak ΔR2*, and rCBV in the putamen (P = 0.2669, 0.0871) or in the thalamus (P = 0.517, 0.9787); 2 mg/kg ferumoxytol increased peak ΔR2* as well as the CNR (P < 0.0001), but also mildly increased rCBV in putamen and globus pallidus (P = 0.0005, 0.0012). Signal intensities during first pass remained highly above the noise level, with overlapping of 95% confidence intervals with noise only in 3 out of 162 tested regions. Compared to gadoteridol, the visual image quality showed mild improvement with 1 mg/kg (P = 0.02) and marked improvement with 2 mg/kg ferumoxytol (P < 0.0001).
Data Conclusion
1 mg/kg ferumoxytol provides similar imaging results to standard gadoteridol for DSC‐MRI, and 2 mg/kg has a benefit of increased CNR, but may also result in mildly increased rCBV values.
Level of Evidence: 3
Technical Efficacy: Stage 1
J. MAGN. RESON. IMAGING 2018;48:441–448. |
doi_str_mv | 10.1002/jmri.25943 |
format | article |
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Cerebral blood volume (CBV) mapping with a dynamic susceptibility contrast (DSC) perfusion technique has become a clinical tool in diagnosing and follow‐up of brain tumors. Ferumoxytol, a long‐circulating iron oxide nanoparticle, has been tested for CBV mapping, but the optimal dose has not been established.
Purpose
To compare ferumoxytol DSC of two different doses to standard of care gadoteridol by analyzing time–intensity curves and CBV maps in normal‐appearing brain regions.
Study Type
Retrospective.
Subjects
Fifty‐four patients with various brain disorders.
Field Strength/Sequence
3T MRI. DSC‐MRI was performed with 0.1 mmol/kg gadoteridol and 1 day later with ferumoxytol in doses of 1 or 2 mg/kg.
Assessment
Signal changes during first pass, relative CBV (rCBV) in normal‐appearing thalamus, putamen, and globus pallidus, and contrast‐to‐noise ratio (CNR) of the CBV maps were compared between gadoteridol and various doses of ferumoxytol using an automated method. To subjectively assess the quality of the CBV maps, two blinded readers also assessed visual conspicuity of the putamen.
Statistical Tests
Linear mixed effect model was used for statistical comparison.
Results
Compared to gadoteridol, 1 mg/kg ferumoxytol showed no difference in CNR (P = 0.6505), peak ΔR2*, and rCBV in the putamen (P = 0.2669, 0.0871) or in the thalamus (P = 0.517, 0.9787); 2 mg/kg ferumoxytol increased peak ΔR2* as well as the CNR (P < 0.0001), but also mildly increased rCBV in putamen and globus pallidus (P = 0.0005, 0.0012). Signal intensities during first pass remained highly above the noise level, with overlapping of 95% confidence intervals with noise only in 3 out of 162 tested regions. Compared to gadoteridol, the visual image quality showed mild improvement with 1 mg/kg (P = 0.02) and marked improvement with 2 mg/kg ferumoxytol (P < 0.0001).
Data Conclusion
1 mg/kg ferumoxytol provides similar imaging results to standard gadoteridol for DSC‐MRI, and 2 mg/kg has a benefit of increased CNR, but may also result in mildly increased rCBV values.
Level of Evidence: 3
Technical Efficacy: Stage 1
J. MAGN. RESON. IMAGING 2018;48:441–448.</description><identifier>ISSN: 1053-1807</identifier><identifier>ISSN: 1522-2586</identifier><identifier>EISSN: 1522-2586</identifier><identifier>DOI: 10.1002/jmri.25943</identifier><identifier>PMID: 29314418</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Blood volume ; Brain ; Brain Mapping ; Brain tumors ; Cerebral blood flow ; cerebral blood volume ; Cerebrovascular Circulation ; Confidence intervals ; Conspicuity ; contrast agent ; Contrast Media ; dynamic susceptibility contrast ; Female ; Ferric Compounds - chemistry ; Ferrosoferric Oxide - chemistry ; ferumoxytol ; Field strength ; Gadolinium - chemistry ; Globus pallidus ; Heterocyclic Compounds - chemistry ; Humans ; Image quality ; Iron oxides ; Magnetic Resonance Imaging ; Male ; Mapping ; Mathematical models ; Medical imaging ; Metal Nanoparticles ; Middle Aged ; Nanoparticles ; Neuroimaging ; neuroradiology ; Noise ; Noise levels ; Organometallic Compounds - chemistry ; Perfusion ; Putamen ; Quality assessment ; Retrospective Studies ; Standard of care ; Statistical analysis ; Statistical tests ; Thalamus</subject><ispartof>Journal of magnetic resonance imaging, 2018-08, Vol.48 (2), p.441-448</ispartof><rights>2018 International Society for Magnetic Resonance in Medicine</rights><rights>2018 International Society for Magnetic Resonance in Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4483-33346d9bcf33e5180b5547aa4a1005a6ce51698473ae8a9e0718892ebd6839523</citedby><cites>FETCH-LOGICAL-c4483-33346d9bcf33e5180b5547aa4a1005a6ce51698473ae8a9e0718892ebd6839523</cites><orcidid>0000-0002-6679-6203</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29314418$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Varallyay, Csanad G.</creatorcontrib><creatorcontrib>Nesbit, Eric</creatorcontrib><creatorcontrib>Horvath, Andrea</creatorcontrib><creatorcontrib>Varallyay, Peter</creatorcontrib><creatorcontrib>Fu, Rongwei</creatorcontrib><creatorcontrib>Gahramanov, Seymur</creatorcontrib><creatorcontrib>Muldoon, Leslie L.</creatorcontrib><creatorcontrib>Li, Xin</creatorcontrib><creatorcontrib>Rooney, William D.</creatorcontrib><creatorcontrib>Neuwelt, Edward A.</creatorcontrib><title>Cerebral blood volume mapping with ferumoxytol in dynamic susceptibility contrast perfusion MRI: Comparison to standard of care</title><title>Journal of magnetic resonance imaging</title><addtitle>J Magn Reson Imaging</addtitle><description>Background
Cerebral blood volume (CBV) mapping with a dynamic susceptibility contrast (DSC) perfusion technique has become a clinical tool in diagnosing and follow‐up of brain tumors. Ferumoxytol, a long‐circulating iron oxide nanoparticle, has been tested for CBV mapping, but the optimal dose has not been established.
Purpose
To compare ferumoxytol DSC of two different doses to standard of care gadoteridol by analyzing time–intensity curves and CBV maps in normal‐appearing brain regions.
Study Type
Retrospective.
Subjects
Fifty‐four patients with various brain disorders.
Field Strength/Sequence
3T MRI. DSC‐MRI was performed with 0.1 mmol/kg gadoteridol and 1 day later with ferumoxytol in doses of 1 or 2 mg/kg.
Assessment
Signal changes during first pass, relative CBV (rCBV) in normal‐appearing thalamus, putamen, and globus pallidus, and contrast‐to‐noise ratio (CNR) of the CBV maps were compared between gadoteridol and various doses of ferumoxytol using an automated method. To subjectively assess the quality of the CBV maps, two blinded readers also assessed visual conspicuity of the putamen.
Statistical Tests
Linear mixed effect model was used for statistical comparison.
Results
Compared to gadoteridol, 1 mg/kg ferumoxytol showed no difference in CNR (P = 0.6505), peak ΔR2*, and rCBV in the putamen (P = 0.2669, 0.0871) or in the thalamus (P = 0.517, 0.9787); 2 mg/kg ferumoxytol increased peak ΔR2* as well as the CNR (P < 0.0001), but also mildly increased rCBV in putamen and globus pallidus (P = 0.0005, 0.0012). Signal intensities during first pass remained highly above the noise level, with overlapping of 95% confidence intervals with noise only in 3 out of 162 tested regions. Compared to gadoteridol, the visual image quality showed mild improvement with 1 mg/kg (P = 0.02) and marked improvement with 2 mg/kg ferumoxytol (P < 0.0001).
Data Conclusion
1 mg/kg ferumoxytol provides similar imaging results to standard gadoteridol for DSC‐MRI, and 2 mg/kg has a benefit of increased CNR, but may also result in mildly increased rCBV values.
Level of Evidence: 3
Technical Efficacy: Stage 1
J. MAGN. RESON. IMAGING 2018;48:441–448.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood volume</subject><subject>Brain</subject><subject>Brain Mapping</subject><subject>Brain tumors</subject><subject>Cerebral blood flow</subject><subject>cerebral blood volume</subject><subject>Cerebrovascular Circulation</subject><subject>Confidence intervals</subject><subject>Conspicuity</subject><subject>contrast agent</subject><subject>Contrast Media</subject><subject>dynamic susceptibility contrast</subject><subject>Female</subject><subject>Ferric Compounds - chemistry</subject><subject>Ferrosoferric Oxide - chemistry</subject><subject>ferumoxytol</subject><subject>Field strength</subject><subject>Gadolinium - chemistry</subject><subject>Globus pallidus</subject><subject>Heterocyclic Compounds - chemistry</subject><subject>Humans</subject><subject>Image quality</subject><subject>Iron oxides</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Mapping</subject><subject>Mathematical models</subject><subject>Medical imaging</subject><subject>Metal Nanoparticles</subject><subject>Middle Aged</subject><subject>Nanoparticles</subject><subject>Neuroimaging</subject><subject>neuroradiology</subject><subject>Noise</subject><subject>Noise levels</subject><subject>Organometallic Compounds - chemistry</subject><subject>Perfusion</subject><subject>Putamen</subject><subject>Quality assessment</subject><subject>Retrospective Studies</subject><subject>Standard of care</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><subject>Thalamus</subject><issn>1053-1807</issn><issn>1522-2586</issn><issn>1522-2586</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kU1rFTEYhYMotr268QdIwI0IU_M5k7gQ5OJHpSKIrkMmk2lzSSZjkmmdVf-6ud5a1IWrvMn7cDgnB4AnGJ1ihMjLXUjulHDJ6D1wjDkhDeGivV9nxGmDBeqOwEnOO4SQlIw_BEdEUswYFsfgZmuT7ZP2sPcxDvAq-iVYGPQ8u-kCXrtyCUeblhB_rCV66CY4rJMOzsC8ZGPn4nrnXVmhiVNJOhc42zQu2cUJfvpy9gpuY5h1crneS4S56GnQaYBxhEYn-wg8GLXP9vHtuQHf3r39uv3QnH9-f7Z9c94YxgRtKKWsHWRvRkotr5F6zlmnNdP1B7huTX1spWAd1VZoaVGHhZDE9kMrqOSEbsDrg-689MEOxu7NejUnF3RaVdRO_b2Z3KW6iFeqRZTJTlaB57cCKX5fbC4quJrfez3ZuGSFpZC8JaS63YBn_6C7uKSpxlMECUYxRnJPvThQJsWckx3vzGCk9r2qfa_qV68Vfvqn_Tv0d5EVwAfg2nm7_kdKfaytHER_AiMDsBg</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Varallyay, Csanad G.</creator><creator>Nesbit, Eric</creator><creator>Horvath, Andrea</creator><creator>Varallyay, Peter</creator><creator>Fu, Rongwei</creator><creator>Gahramanov, Seymur</creator><creator>Muldoon, Leslie L.</creator><creator>Li, Xin</creator><creator>Rooney, William D.</creator><creator>Neuwelt, Edward A.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6679-6203</orcidid></search><sort><creationdate>201808</creationdate><title>Cerebral blood volume mapping with ferumoxytol in dynamic susceptibility contrast perfusion MRI: Comparison to standard of care</title><author>Varallyay, Csanad G. ; Nesbit, Eric ; Horvath, Andrea ; Varallyay, Peter ; Fu, Rongwei ; Gahramanov, Seymur ; Muldoon, Leslie L. ; Li, Xin ; Rooney, William D. ; Neuwelt, Edward A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4483-33346d9bcf33e5180b5547aa4a1005a6ce51698473ae8a9e0718892ebd6839523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood volume</topic><topic>Brain</topic><topic>Brain Mapping</topic><topic>Brain tumors</topic><topic>Cerebral blood flow</topic><topic>cerebral blood volume</topic><topic>Cerebrovascular Circulation</topic><topic>Confidence intervals</topic><topic>Conspicuity</topic><topic>contrast agent</topic><topic>Contrast Media</topic><topic>dynamic susceptibility contrast</topic><topic>Female</topic><topic>Ferric Compounds - chemistry</topic><topic>Ferrosoferric Oxide - chemistry</topic><topic>ferumoxytol</topic><topic>Field strength</topic><topic>Gadolinium - chemistry</topic><topic>Globus pallidus</topic><topic>Heterocyclic Compounds - chemistry</topic><topic>Humans</topic><topic>Image quality</topic><topic>Iron oxides</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Mapping</topic><topic>Mathematical models</topic><topic>Medical imaging</topic><topic>Metal Nanoparticles</topic><topic>Middle Aged</topic><topic>Nanoparticles</topic><topic>Neuroimaging</topic><topic>neuroradiology</topic><topic>Noise</topic><topic>Noise levels</topic><topic>Organometallic Compounds - chemistry</topic><topic>Perfusion</topic><topic>Putamen</topic><topic>Quality assessment</topic><topic>Retrospective Studies</topic><topic>Standard of care</topic><topic>Statistical analysis</topic><topic>Statistical tests</topic><topic>Thalamus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Varallyay, Csanad G.</creatorcontrib><creatorcontrib>Nesbit, Eric</creatorcontrib><creatorcontrib>Horvath, Andrea</creatorcontrib><creatorcontrib>Varallyay, Peter</creatorcontrib><creatorcontrib>Fu, Rongwei</creatorcontrib><creatorcontrib>Gahramanov, Seymur</creatorcontrib><creatorcontrib>Muldoon, Leslie L.</creatorcontrib><creatorcontrib>Li, Xin</creatorcontrib><creatorcontrib>Rooney, William D.</creatorcontrib><creatorcontrib>Neuwelt, Edward A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of magnetic resonance imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Varallyay, Csanad G.</au><au>Nesbit, Eric</au><au>Horvath, Andrea</au><au>Varallyay, Peter</au><au>Fu, Rongwei</au><au>Gahramanov, Seymur</au><au>Muldoon, Leslie L.</au><au>Li, Xin</au><au>Rooney, William D.</au><au>Neuwelt, Edward A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral blood volume mapping with ferumoxytol in dynamic susceptibility contrast perfusion MRI: Comparison to standard of care</atitle><jtitle>Journal of magnetic resonance imaging</jtitle><addtitle>J Magn Reson Imaging</addtitle><date>2018-08</date><risdate>2018</risdate><volume>48</volume><issue>2</issue><spage>441</spage><epage>448</epage><pages>441-448</pages><issn>1053-1807</issn><issn>1522-2586</issn><eissn>1522-2586</eissn><abstract>Background
Cerebral blood volume (CBV) mapping with a dynamic susceptibility contrast (DSC) perfusion technique has become a clinical tool in diagnosing and follow‐up of brain tumors. Ferumoxytol, a long‐circulating iron oxide nanoparticle, has been tested for CBV mapping, but the optimal dose has not been established.
Purpose
To compare ferumoxytol DSC of two different doses to standard of care gadoteridol by analyzing time–intensity curves and CBV maps in normal‐appearing brain regions.
Study Type
Retrospective.
Subjects
Fifty‐four patients with various brain disorders.
Field Strength/Sequence
3T MRI. DSC‐MRI was performed with 0.1 mmol/kg gadoteridol and 1 day later with ferumoxytol in doses of 1 or 2 mg/kg.
Assessment
Signal changes during first pass, relative CBV (rCBV) in normal‐appearing thalamus, putamen, and globus pallidus, and contrast‐to‐noise ratio (CNR) of the CBV maps were compared between gadoteridol and various doses of ferumoxytol using an automated method. To subjectively assess the quality of the CBV maps, two blinded readers also assessed visual conspicuity of the putamen.
Statistical Tests
Linear mixed effect model was used for statistical comparison.
Results
Compared to gadoteridol, 1 mg/kg ferumoxytol showed no difference in CNR (P = 0.6505), peak ΔR2*, and rCBV in the putamen (P = 0.2669, 0.0871) or in the thalamus (P = 0.517, 0.9787); 2 mg/kg ferumoxytol increased peak ΔR2* as well as the CNR (P < 0.0001), but also mildly increased rCBV in putamen and globus pallidus (P = 0.0005, 0.0012). Signal intensities during first pass remained highly above the noise level, with overlapping of 95% confidence intervals with noise only in 3 out of 162 tested regions. Compared to gadoteridol, the visual image quality showed mild improvement with 1 mg/kg (P = 0.02) and marked improvement with 2 mg/kg ferumoxytol (P < 0.0001).
Data Conclusion
1 mg/kg ferumoxytol provides similar imaging results to standard gadoteridol for DSC‐MRI, and 2 mg/kg has a benefit of increased CNR, but may also result in mildly increased rCBV values.
Level of Evidence: 3
Technical Efficacy: Stage 1
J. MAGN. RESON. IMAGING 2018;48:441–448.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29314418</pmid><doi>10.1002/jmri.25943</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6679-6203</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Blood volume Brain Brain Mapping Brain tumors Cerebral blood flow cerebral blood volume Cerebrovascular Circulation Confidence intervals Conspicuity contrast agent Contrast Media dynamic susceptibility contrast Female Ferric Compounds - chemistry Ferrosoferric Oxide - chemistry ferumoxytol Field strength Gadolinium - chemistry Globus pallidus Heterocyclic Compounds - chemistry Humans Image quality Iron oxides Magnetic Resonance Imaging Male Mapping Mathematical models Medical imaging Metal Nanoparticles Middle Aged Nanoparticles Neuroimaging neuroradiology Noise Noise levels Organometallic Compounds - chemistry Perfusion Putamen Quality assessment Retrospective Studies Standard of care Statistical analysis Statistical tests Thalamus |
title | Cerebral blood volume mapping with ferumoxytol in dynamic susceptibility contrast perfusion MRI: Comparison to standard of care |
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