Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL

Brian T. Farrell, Bronwyn Hamilton, Edit Dosa, Endre Rimely, Morad Nasseri, S. Gahramanov, Cynthia A. Lacy, Eugene P. Frenkel, Nancy Doolittle, Paula M. Jacobs, Edward Neuwelt

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Objective: The study goal was to assess the benefits and potential limitations in the use of ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles in the MRI diagnosis of CNS inflammatory diseases and primary CNS lymphoma. Methods: Twenty patients with presumptive or known CNS lesions underwent MRI study. Eighteen patients received both gadolinium-based contrast agents (GBCAs) and 1 of 2 USPIO contrast agents (ferumoxytol and ferumoxtran-10) 24 hours apart, which allowed direct comparative analysis. The remaining 2 patients had only USPIO-enhanced MRI because of a renal contraindication to GBCA. Conventional T1- and T2-weighted MRI were acquired before and after contrast administration in all patients, and perfusion MRI for relative cerebral blood volume (rCBV) assessment was obtained in all 9 patients receiving ferumoxytol. Results: USPIO-enhanced MRI showed an equal number of enhancing brain lesions in 9 of 18 patients (50%), more enhancing lesions in 2 of 18 patients (11%), and fewer enhancing lesions in 3 of 18 patients (17%) compared with GBCA-enhanced MRI. Four of 18 patients (22%) showed no MRI enhancement. Dynamic susceptibility-weighted contrast-enhanced perfusion MRI using ferumoxytol showed low rCBV (ratio ,1.0) in 3 cases of demyelination or inflammation, modestly elevated rCBV in 5 cases of CNS lymphoma or lymphoproliferative disorder (range: 1.3-4.1), and no measurable disease in one case. Conclusions: This study showed that USPIO-enhanced brainMRI can be useful in the diagnosis of CNS inflammatory disorders and lymphoma, and is also useful for patients with renal compromise at risk of nephrogenic systemic fibrosis who are unable to receive GBCA.

Original languageEnglish (US)
Pages (from-to)256-263
Number of pages8
JournalNeurology
Volume81
Issue number3
DOIs
StatePublished - Jul 16 2013

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Central Nervous System Diseases
Nanoparticles
Contrast Media
Gadolinium
Ferrosoferric Oxide
Lymphoma
Perfusion
Nephrogenic Fibrosing Dermopathy
ferric oxide
Iron Oxide
Central Nervous System
Kidney
Lymphoproliferative Disorders
Demyelinating Diseases
ferumoxtran-10
Inflammation

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL. / Farrell, Brian T.; Hamilton, Bronwyn; Dosa, Edit; Rimely, Endre; Nasseri, Morad; Gahramanov, S.; Lacy, Cynthia A.; Frenkel, Eugene P.; Doolittle, Nancy; Jacobs, Paula M.; Neuwelt, Edward.

In: Neurology, Vol. 81, No. 3, 16.07.2013, p. 256-263.

Research output: Contribution to journalArticle

Farrell, BT, Hamilton, B, Dosa, E, Rimely, E, Nasseri, M, Gahramanov, S, Lacy, CA, Frenkel, EP, Doolittle, N, Jacobs, PM & Neuwelt, E 2013, 'Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL', Neurology, vol. 81, no. 3, pp. 256-263. https://doi.org/10.1212/WNL.0b013e31829bfd8f
Farrell, Brian T. ; Hamilton, Bronwyn ; Dosa, Edit ; Rimely, Endre ; Nasseri, Morad ; Gahramanov, S. ; Lacy, Cynthia A. ; Frenkel, Eugene P. ; Doolittle, Nancy ; Jacobs, Paula M. ; Neuwelt, Edward. / Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL. In: Neurology. 2013 ; Vol. 81, No. 3. pp. 256-263.
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AU - Hamilton, Bronwyn

AU - Dosa, Edit

AU - Rimely, Endre

AU - Nasseri, Morad

AU - Gahramanov, S.

AU - Lacy, Cynthia A.

AU - Frenkel, Eugene P.

AU - Doolittle, Nancy

AU - Jacobs, Paula M.

AU - Neuwelt, Edward

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N2 - Objective: The study goal was to assess the benefits and potential limitations in the use of ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles in the MRI diagnosis of CNS inflammatory diseases and primary CNS lymphoma. Methods: Twenty patients with presumptive or known CNS lesions underwent MRI study. Eighteen patients received both gadolinium-based contrast agents (GBCAs) and 1 of 2 USPIO contrast agents (ferumoxytol and ferumoxtran-10) 24 hours apart, which allowed direct comparative analysis. The remaining 2 patients had only USPIO-enhanced MRI because of a renal contraindication to GBCA. Conventional T1- and T2-weighted MRI were acquired before and after contrast administration in all patients, and perfusion MRI for relative cerebral blood volume (rCBV) assessment was obtained in all 9 patients receiving ferumoxytol. Results: USPIO-enhanced MRI showed an equal number of enhancing brain lesions in 9 of 18 patients (50%), more enhancing lesions in 2 of 18 patients (11%), and fewer enhancing lesions in 3 of 18 patients (17%) compared with GBCA-enhanced MRI. Four of 18 patients (22%) showed no MRI enhancement. Dynamic susceptibility-weighted contrast-enhanced perfusion MRI using ferumoxytol showed low rCBV (ratio ,1.0) in 3 cases of demyelination or inflammation, modestly elevated rCBV in 5 cases of CNS lymphoma or lymphoproliferative disorder (range: 1.3-4.1), and no measurable disease in one case. Conclusions: This study showed that USPIO-enhanced brainMRI can be useful in the diagnosis of CNS inflammatory disorders and lymphoma, and is also useful for patients with renal compromise at risk of nephrogenic systemic fibrosis who are unable to receive GBCA.

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