TY - JOUR
T1 - Dual contrast perfusion MRI in a single imaging session for assessment of pediatric brain tumors
AU - Thompson, Eric M.
AU - Guillaume, Daniel J.
AU - Dósa, Edit
AU - Li, Xin
AU - Nazemi, Kellie J.
AU - Gahramanov, Seymur
AU - Hamilton, Bronwyn E.
AU - Neuwelt, Edward A.
N1 - Funding Information:
Acknowledgments The authors wish to thank Andy Reikto, M.S. for assistance with the figures. Funding: National Cancer Institute at the National Institutes of Health (CA137488-15S1 American Recovery and Reinvestment Act supplement to E.A.N.).
PY - 2012/8
Y1 - 2012/8
N2 - Ferumoxytol, an iron nanoparticle used as an intravascular contrast agent for perfusion magnetic resonance imaging (MRI), has never been explored in the pediatric population. The purpose of this prospective study is to characterize the vascular and permeability properties of pediatric brain tumors using two contrast agents during a single imaging session: ferumoxytol for dynamic susceptibility weighted contrast (DSC) MRI and gadoteridol for dynamic contrast-enhanced (DCE) MRI. In a single imaging session, patients received intravenous ferumoxytol for DSC MRI followed by gadoteridol for DCE MRI. Relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), transfer coefficient (Ktrans), and extravascular extracellular space volume fraction (ve) of the brain lesions were calculated. Patients underwent serial imaging sessions over the course of 2 years. Of the 7 patients enrolled thus far, none has experienced an adverse event. Two patients with medulloblastoma were enrolled preoperatively. In the first, rCBVmax, rCBF, Ktrans max, and ve max values were 3.74, 3.12, 0.47 min -1, and 0.08, respectively, while in the second patient, rCBVmax, rCBF, Ktrans max, and ve max values were 4.72, 3.47, 0.60 min-1, and 0.05, respectively. Four patients were enrolled after new gadolinium enhancement was noted in the tumor resection cavity. In 80 % of these lesions, rCBV was <1 suggestive of pseudoprogression secondary to radiochemotherapy. These preliminary results demonstrate that use of ferumoxytol and gadoteridol contrast agents during a single imaging session is feasible, safe, and appears useful for assessing tumor perfusion and permeability characteristics in children.
AB - Ferumoxytol, an iron nanoparticle used as an intravascular contrast agent for perfusion magnetic resonance imaging (MRI), has never been explored in the pediatric population. The purpose of this prospective study is to characterize the vascular and permeability properties of pediatric brain tumors using two contrast agents during a single imaging session: ferumoxytol for dynamic susceptibility weighted contrast (DSC) MRI and gadoteridol for dynamic contrast-enhanced (DCE) MRI. In a single imaging session, patients received intravenous ferumoxytol for DSC MRI followed by gadoteridol for DCE MRI. Relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), transfer coefficient (Ktrans), and extravascular extracellular space volume fraction (ve) of the brain lesions were calculated. Patients underwent serial imaging sessions over the course of 2 years. Of the 7 patients enrolled thus far, none has experienced an adverse event. Two patients with medulloblastoma were enrolled preoperatively. In the first, rCBVmax, rCBF, Ktrans max, and ve max values were 3.74, 3.12, 0.47 min -1, and 0.08, respectively, while in the second patient, rCBVmax, rCBF, Ktrans max, and ve max values were 4.72, 3.47, 0.60 min-1, and 0.05, respectively. Four patients were enrolled after new gadolinium enhancement was noted in the tumor resection cavity. In 80 % of these lesions, rCBV was <1 suggestive of pseudoprogression secondary to radiochemotherapy. These preliminary results demonstrate that use of ferumoxytol and gadoteridol contrast agents during a single imaging session is feasible, safe, and appears useful for assessing tumor perfusion and permeability characteristics in children.
KW - Brain tumor
KW - DCE MRI
KW - DSC MRI
KW - Ferumoxytol
KW - Pediatric
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U2 - 10.1007/s11060-012-0872-x
DO - 10.1007/s11060-012-0872-x
M3 - Article
C2 - 22528798
AN - SCOPUS:84864282730
SN - 0167-594X
VL - 109
SP - 105
EP - 114
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 1
ER -