Ferumoxytol-enhanced MRI differentiation of meningioma from dural metastases: a pilot study with immunohistochemical observations

Bronwyn Hamilton, Randall (Randy) Woltjer, Joao Prola-Netto, Gary Nesbit, Seymur Gahramanov, Thao Pham, Jaime Wagner, Edward Neuwelt

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Malignant dural neoplasms are not reliably distinguished from benign dural neoplasms with contrast-enhanced magnetic resonance imaging (MRI). MRI enhancement in central nervous system (CNS) diseases imaged with ferumoxytol has been attributed to intracellular uptake in macrophages rather than vascular leakage. We compared imaging to histopathology and immunohistochemistry in meningiomas and dural metastases having ferumoxytol-enhanced MRI (FeMRI) and gadolinium-enhanced MRI (GdMRI) in order to correlate enhancement patterns to macrophage presence and vascular state. All patients having extraaxial CNS tumors were retrospectively selected from one of two ongoing FeMRI studies. Enhancement was compared between GdMRI and FeMRI. Diagnoses were confirmed histologically and/or by characteristic imaging. Tumor and vascular histology was reviewed. Immunohistochemical staining for CD68 (a macrophage marker), Connexin-43 (Cx43) (a marker of normal gap junctions), and smooth muscle actin (SMA) as a marker of vascularity, was performed in seven study cases with available tissue. Immunohistochemistry was performed on archival material from 33 subjects outside of the current study as controls: 20 WHO grade I cases of meningioma and 13 metastatic tumors. Metastases displayed marked delayed enhancement on FeMRI, similar to GdMRI. Four patients with dural metastases and one patient with meningioma showed similar enhancement on FeMRI and GdMRI. Five meningiomas with typical enhancement on GdMRI lacked enhancement on FeMRI. Enhancement on FeMRI was better associated with decreased Cx43 expression than intralesional macrophages. These pilot data suggest that FeMRI may better differentiate metastatic disease from meningiomas than GdMRI, and that differences in tumor vasculature rather than macrophage presence could underlie differences in contrast enhancement.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of Neuro-Oncology
DOIs
StateAccepted/In press - Jul 8 2016

Fingerprint

Ferrosoferric Oxide
Meningioma
Magnetic Resonance Imaging
Gadolinium
Neoplasm Metastasis
Macrophages
Blood Vessels
Connexin 43
Neoplasms
Immunohistochemistry
Central Nervous System Neoplasms
Gap Junctions
Central Nervous System Diseases
Smooth Muscle
Actins
Histology
Staining and Labeling

Keywords

  • Blood–brain barrier
  • Contrast agents
  • Extraaxial masses
  • Ferumoxytol
  • Immunohistochemistry
  • MRI

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology

Cite this

Ferumoxytol-enhanced MRI differentiation of meningioma from dural metastases : a pilot study with immunohistochemical observations. / Hamilton, Bronwyn; Woltjer, Randall (Randy); Prola-Netto, Joao; Nesbit, Gary; Gahramanov, Seymur; Pham, Thao; Wagner, Jaime; Neuwelt, Edward.

In: Journal of Neuro-Oncology, 08.07.2016, p. 1-9.

Research output: Contribution to journalArticle

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