Quantitative comparison of delayed ferumoxytol T1 enhancement with immediate gadoteridol enhancement in high grade gliomas

Andrea Horváth, Csanad G. Varallyay, Daniel Schwartz, Gerda B. Toth, Joao P. Netto, Ramon Barajas, Péter Várallyay, László Szidonya, Jenny Firkins, Emily Youngers, Rongwei Fu, Prakash Ambady, Péter Bogner, Edward A. Neuwelt

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Purpose: Delayed ferumoxytol enhancement on T1-weighted images appears visually similar to gadoteridol enhancement. The purpose of this study was to quantitatively compare ferumoxytol T1 enhancement to gadoteridol enhancement with an objective, semi-automated method. Methods: 206 sets of post-gadoteridol and 24 h post-ferumoxytol T1-weighted scans from 58 high grade glioma patients were analyzed (9 pre-chemoradiation, 111 < 90 days post-chemoradiation, 21 > 90 days post-chemoradiation, 65 post-bevacizumab scans). Enhancement volumes and signal intensities normalized to normal appearing tissue proximal to enhancement were calculated with a semi-automated method. Enhancement cube root volumes (D) and signal intensities (SI) were compared between the 2 contrast agents, and relative difference of D and SI were compared in different treatment groups with multivariate analysis. Within patient differences in D and SI before and after treatment with bevacizumab or steroid were assessed in 26 patients in each treatment group. Results: When compared to gadoteridol, ferumoxytol D was 13.83% smaller and SI was 7.24% lower (P < 0.0001). The relative differences in D and SI between the 2 contrast agents were not significantly different between treatment groups (P > 0.05). Relative difference in D and SI did not change significantly in response to bevacizumab (P = 0.5234 and P = 0.2442, respectively) or to steroid (P = 0.3774, P = 0.0741) in the within patient comparison. Conclusion: The correlation between the 2 contrast agents’ enhancement size and signal intensity and their similar behavior in response to therapy suggest that ferumoxytol can be used for revealing enhancement in high grade glioma patients. Magn Reson Med 80:224–230, 2018.

Original languageEnglish (US)
Pages (from-to)224-230
Number of pages7
JournalMagnetic Resonance in Medicine
Volume80
Issue number1
DOIs
StatePublished - Jul 2018

Keywords

  • USPIO
  • alternative contrast agent
  • delayed enhancement
  • ferumoxytol
  • gadoteridol
  • glioblastoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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