Ferumoxytol as an intraprostatic MR contrast agent for lymph node mapping of the prostate: A feasibility study in non-human primates

Sandeep Sankineni, Jeremy Smedley, Marcelino Bernardo, Anna M. Brown, Linda Johnson, Berrend Muller, Gary L. Griffiths, Hisataka Kobayashi, Soroush Rais-Bahrami, Peter A. Pinto, Bradford J. Wood, Brandon Keele, Peter L. Choyke, Baris Turkbey

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background A variety of magnetic resonance (MR) lymphographic agents have been proposed for mapping the lymph nodes draining the prostate. Purpose To investigate the feasibility of using ferumoxytol (an FDA-approved iron oxide agent) for lymph node mapping of the prostate on imaging (MRI) in a non-human primate (NHP) Macaque model. Material and Methods Four NHPs weighing 5-13 kg underwent injection of ferumoxytol after a needle was introduced transrectally under MRI guidance into the prostate using a commercially available intrarectal MRI biopsy guide. Ferumoxytol was administered at dosage in the range of 0.15-0.75 mg Fe/kg in a fixed injection volume of 0.2 mL. T1-weighted MRI was performed at 3 T starting immediately and extending at least 45 min post-injection. Two readers evaluated the images in consensus. The NHPs tolerated the ferumoxytol injections at all doses with no evident side effects. Results It was determined that the lowest dose of 0.15 mg Fe/kg produced the best outcome in terms of lymph node visualization and draining nodes were reliably visualized at this dose and volume. Conclusion Thus, MRI with intraprostatic injection of ferumoxytol may be considered an effective T1 contrast agent for prospective mapping of lymph nodes draining the prostate and, thus, for attempted sentinel lymph node identification in prostate cancer. Large clinical trials to determine safety and efficacy are needed.

Original languageEnglish (US)
Pages (from-to)1396-1401
Number of pages6
JournalActa Radiologica
Volume57
Issue number11
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Fingerprint

Ferrosoferric Oxide
Feasibility Studies
Contrast Media
Primates
Prostate
Magnetic Resonance Spectroscopy
Lymph Nodes
Injections
Macaca
Needles
Prostatic Neoplasms
Clinical Trials
Biopsy
Safety

Keywords

  • Ferumoxytol
  • iron oxide nanoparticles
  • lymph node
  • magnetic resonance imaging (MRI)
  • prostate cancer

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Ferumoxytol as an intraprostatic MR contrast agent for lymph node mapping of the prostate : A feasibility study in non-human primates. / Sankineni, Sandeep; Smedley, Jeremy; Bernardo, Marcelino; Brown, Anna M.; Johnson, Linda; Muller, Berrend; Griffiths, Gary L.; Kobayashi, Hisataka; Rais-Bahrami, Soroush; Pinto, Peter A.; Wood, Bradford J.; Keele, Brandon; Choyke, Peter L.; Turkbey, Baris.

In: Acta Radiologica, Vol. 57, No. 11, 01.11.2016, p. 1396-1401.

Research output: Contribution to journalArticle

Sankineni, S, Smedley, J, Bernardo, M, Brown, AM, Johnson, L, Muller, B, Griffiths, GL, Kobayashi, H, Rais-Bahrami, S, Pinto, PA, Wood, BJ, Keele, B, Choyke, PL & Turkbey, B 2016, 'Ferumoxytol as an intraprostatic MR contrast agent for lymph node mapping of the prostate: A feasibility study in non-human primates', Acta Radiologica, vol. 57, no. 11, pp. 1396-1401. https://doi.org/10.1177/0284185115586023
Sankineni, Sandeep ; Smedley, Jeremy ; Bernardo, Marcelino ; Brown, Anna M. ; Johnson, Linda ; Muller, Berrend ; Griffiths, Gary L. ; Kobayashi, Hisataka ; Rais-Bahrami, Soroush ; Pinto, Peter A. ; Wood, Bradford J. ; Keele, Brandon ; Choyke, Peter L. ; Turkbey, Baris. / Ferumoxytol as an intraprostatic MR contrast agent for lymph node mapping of the prostate : A feasibility study in non-human primates. In: Acta Radiologica. 2016 ; Vol. 57, No. 11. pp. 1396-1401.
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abstract = "Background A variety of magnetic resonance (MR) lymphographic agents have been proposed for mapping the lymph nodes draining the prostate. Purpose To investigate the feasibility of using ferumoxytol (an FDA-approved iron oxide agent) for lymph node mapping of the prostate on imaging (MRI) in a non-human primate (NHP) Macaque model. Material and Methods Four NHPs weighing 5-13 kg underwent injection of ferumoxytol after a needle was introduced transrectally under MRI guidance into the prostate using a commercially available intrarectal MRI biopsy guide. Ferumoxytol was administered at dosage in the range of 0.15-0.75 mg Fe/kg in a fixed injection volume of 0.2 mL. T1-weighted MRI was performed at 3 T starting immediately and extending at least 45 min post-injection. Two readers evaluated the images in consensus. The NHPs tolerated the ferumoxytol injections at all doses with no evident side effects. Results It was determined that the lowest dose of 0.15 mg Fe/kg produced the best outcome in terms of lymph node visualization and draining nodes were reliably visualized at this dose and volume. Conclusion Thus, MRI with intraprostatic injection of ferumoxytol may be considered an effective T1 contrast agent for prospective mapping of lymph nodes draining the prostate and, thus, for attempted sentinel lymph node identification in prostate cancer. Large clinical trials to determine safety and efficacy are needed.",
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AU - Bernardo, Marcelino

AU - Brown, Anna M.

AU - Johnson, Linda

AU - Muller, Berrend

AU - Griffiths, Gary L.

AU - Kobayashi, Hisataka

AU - Rais-Bahrami, Soroush

AU - Pinto, Peter A.

AU - Wood, Bradford J.

AU - Keele, Brandon

AU - Choyke, Peter L.

AU - Turkbey, Baris

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N2 - Background A variety of magnetic resonance (MR) lymphographic agents have been proposed for mapping the lymph nodes draining the prostate. Purpose To investigate the feasibility of using ferumoxytol (an FDA-approved iron oxide agent) for lymph node mapping of the prostate on imaging (MRI) in a non-human primate (NHP) Macaque model. Material and Methods Four NHPs weighing 5-13 kg underwent injection of ferumoxytol after a needle was introduced transrectally under MRI guidance into the prostate using a commercially available intrarectal MRI biopsy guide. Ferumoxytol was administered at dosage in the range of 0.15-0.75 mg Fe/kg in a fixed injection volume of 0.2 mL. T1-weighted MRI was performed at 3 T starting immediately and extending at least 45 min post-injection. Two readers evaluated the images in consensus. The NHPs tolerated the ferumoxytol injections at all doses with no evident side effects. Results It was determined that the lowest dose of 0.15 mg Fe/kg produced the best outcome in terms of lymph node visualization and draining nodes were reliably visualized at this dose and volume. Conclusion Thus, MRI with intraprostatic injection of ferumoxytol may be considered an effective T1 contrast agent for prospective mapping of lymph nodes draining the prostate and, thus, for attempted sentinel lymph node identification in prostate cancer. Large clinical trials to determine safety and efficacy are needed.

AB - Background A variety of magnetic resonance (MR) lymphographic agents have been proposed for mapping the lymph nodes draining the prostate. Purpose To investigate the feasibility of using ferumoxytol (an FDA-approved iron oxide agent) for lymph node mapping of the prostate on imaging (MRI) in a non-human primate (NHP) Macaque model. Material and Methods Four NHPs weighing 5-13 kg underwent injection of ferumoxytol after a needle was introduced transrectally under MRI guidance into the prostate using a commercially available intrarectal MRI biopsy guide. Ferumoxytol was administered at dosage in the range of 0.15-0.75 mg Fe/kg in a fixed injection volume of 0.2 mL. T1-weighted MRI was performed at 3 T starting immediately and extending at least 45 min post-injection. Two readers evaluated the images in consensus. The NHPs tolerated the ferumoxytol injections at all doses with no evident side effects. Results It was determined that the lowest dose of 0.15 mg Fe/kg produced the best outcome in terms of lymph node visualization and draining nodes were reliably visualized at this dose and volume. Conclusion Thus, MRI with intraprostatic injection of ferumoxytol may be considered an effective T1 contrast agent for prospective mapping of lymph nodes draining the prostate and, thus, for attempted sentinel lymph node identification in prostate cancer. Large clinical trials to determine safety and efficacy are needed.

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