Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model

Ronald J H Borra, Hoon Sung Cho, Spencer L. Bowen, Ulrike Attenberger, Grae Arabasz, Ciprian Catana, Lee Josephson, Bruce R. Rosen, Alexander Guimaraes, Jacob M. Hooker

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Simultaneous PET/MR imaging depends on MR-derived attenuation maps (mu-maps) for accurate attenuation correction of PET data. Currently, these maps are derived from gradient-echo-based MR sequences, which are sensitive to susceptibility changes. Iron oxide magnetic nanoparticles have been used in the measurement of blood volume, tumor microvasculature, tumor-associated macrophages, and characterizing lymph nodes. Our aim in this study was to assess whether the susceptibility effects associated with iron oxide nanoparticles can potentially affect measured 18F-FDG PET standardized uptake values (SUV) through effects on MR-derived attenuation maps. Methods: The study protocol was approved by the Institutional Animal Care and Use Committee. Using a Siemens Biograph mMR PET/MR scanner, we evaluated the effects of increasing concentrations of ferumoxytol and ferumoxytol aggregates on MR-derived mu-maps using an agarose phantom. In addition, we performed a baboon experiment evaluating the effects of a single i.v. ferumoxytol dose (10 mg/kg) on the liver, spleen, and pancreas 18F-FDG SUV at baseline (ferumoxytol-naïve), within the first hour and at 1, 3, 5, and 11 weeks. Results: Phantom experiments showed mu-map artifacts starting at ferumoxytol aggregate concentrations of 10 to 20 mg/kg. The in vivo baboon data demonstrated a 53% decrease of observed 18F-FDG SUV compared to baseline within the first hour in the liver, persisting at least 11 weeks. Conclusions: A single ferumoxytol dose can affect measured SUV for at least 3 months, which should be taken into account when administrating ferumoxytol in patients needing sequential PET/MR scans. Advances in knowledge 1. Ferumoxytol aggregates, but not ferumoxytol alone, produce significant artifacts in MR-derived attenuation correction maps at approximate clinical dose levels of 10 mg/kg. 2. When performing simultaneous whole-body 18F-FDG PET/MR, a single dose of ferumoxytol can result in observed SUV decreases up to 53%, depending on the amount of ferumoxytol aggregates in the studied tissue. Implications for patient care Administration of a single, clinically relevant, dose of ferumoxytol can potentially result in changes in observed SUV for a prolonged period of time in the setting of simultaneous PET/MR. These potential changes should be considered in particular when administering ferumoxytol to patients with expected future PET/MR studies, as ferumoxytol-induced SUV changes might interfere with therapy assessment.

Original languageEnglish (US)
Article number6
Pages (from-to)1-12
Number of pages12
JournalEJNMMI Physics
Volume2
Issue number1
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Fingerprint

baboons
Ferrosoferric Oxide
Whole Body Imaging
Papio
attenuation
Imaging techniques
dosage
Iron oxides
iron oxides
liver
Fluorodeoxyglucose F18
Liver
artifacts
Tumors
tumors
Nanoparticles
magnetic permeability
blood volume
pancreas
nanoparticles

Keywords

  • Attenuation correction
  • Ferumoxytol
  • MRI
  • Multimodal imaging
  • PET
  • PET/MR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Biomedical Engineering
  • Instrumentation
  • Radiation

Cite this

Borra, R. J. H., Cho, H. S., Bowen, S. L., Attenberger, U., Arabasz, G., Catana, C., ... Hooker, J. M. (2015). Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model. EJNMMI Physics, 2(1), 1-12. [6]. https://doi.org/10.1186/s40658-015-0109-0

Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging : a pilot study in a baboon model. / Borra, Ronald J H; Cho, Hoon Sung; Bowen, Spencer L.; Attenberger, Ulrike; Arabasz, Grae; Catana, Ciprian; Josephson, Lee; Rosen, Bruce R.; Guimaraes, Alexander; Hooker, Jacob M.

In: EJNMMI Physics, Vol. 2, No. 1, 6, 01.12.2015, p. 1-12.

Research output: Contribution to journalArticle

Borra, RJH, Cho, HS, Bowen, SL, Attenberger, U, Arabasz, G, Catana, C, Josephson, L, Rosen, BR, Guimaraes, A & Hooker, JM 2015, 'Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model', EJNMMI Physics, vol. 2, no. 1, 6, pp. 1-12. https://doi.org/10.1186/s40658-015-0109-0
Borra, Ronald J H ; Cho, Hoon Sung ; Bowen, Spencer L. ; Attenberger, Ulrike ; Arabasz, Grae ; Catana, Ciprian ; Josephson, Lee ; Rosen, Bruce R. ; Guimaraes, Alexander ; Hooker, Jacob M. / Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging : a pilot study in a baboon model. In: EJNMMI Physics. 2015 ; Vol. 2, No. 1. pp. 1-12.
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abstract = "Background: Simultaneous PET/MR imaging depends on MR-derived attenuation maps (mu-maps) for accurate attenuation correction of PET data. Currently, these maps are derived from gradient-echo-based MR sequences, which are sensitive to susceptibility changes. Iron oxide magnetic nanoparticles have been used in the measurement of blood volume, tumor microvasculature, tumor-associated macrophages, and characterizing lymph nodes. Our aim in this study was to assess whether the susceptibility effects associated with iron oxide nanoparticles can potentially affect measured 18F-FDG PET standardized uptake values (SUV) through effects on MR-derived attenuation maps. Methods: The study protocol was approved by the Institutional Animal Care and Use Committee. Using a Siemens Biograph mMR PET/MR scanner, we evaluated the effects of increasing concentrations of ferumoxytol and ferumoxytol aggregates on MR-derived mu-maps using an agarose phantom. In addition, we performed a baboon experiment evaluating the effects of a single i.v. ferumoxytol dose (10 mg/kg) on the liver, spleen, and pancreas 18F-FDG SUV at baseline (ferumoxytol-na{\"i}ve), within the first hour and at 1, 3, 5, and 11 weeks. Results: Phantom experiments showed mu-map artifacts starting at ferumoxytol aggregate concentrations of 10 to 20 mg/kg. The in vivo baboon data demonstrated a 53{\%} decrease of observed 18F-FDG SUV compared to baseline within the first hour in the liver, persisting at least 11 weeks. Conclusions: A single ferumoxytol dose can affect measured SUV for at least 3 months, which should be taken into account when administrating ferumoxytol in patients needing sequential PET/MR scans. Advances in knowledge 1. Ferumoxytol aggregates, but not ferumoxytol alone, produce significant artifacts in MR-derived attenuation correction maps at approximate clinical dose levels of 10 mg/kg. 2. When performing simultaneous whole-body 18F-FDG PET/MR, a single dose of ferumoxytol can result in observed SUV decreases up to 53{\%}, depending on the amount of ferumoxytol aggregates in the studied tissue. Implications for patient care Administration of a single, clinically relevant, dose of ferumoxytol can potentially result in changes in observed SUV for a prolonged period of time in the setting of simultaneous PET/MR. These potential changes should be considered in particular when administering ferumoxytol to patients with expected future PET/MR studies, as ferumoxytol-induced SUV changes might interfere with therapy assessment.",
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