Initial clinical experience with dextran-coated superparamagnetic iron oxide for detection of lymph node metastases in patients with head and neck cancer.
OBJECTIVE
To investigate the efficacy of magnetic resonance (MR) imaging with dextran-coated superparamagnetic iron oxide in the differentiation of metastatic and benign nodes in patients with head and neck cancer.


METHODS
MR imaging was performed before and after intravenous administration of iron oxide in 12 patients. Ninety-one pathologically proved nodes were visually analyzed, and 66 lymph nodes were quantitatively analyzed by measuring signal intensity in visually selected regions of interest.


RESULTS
Forty of 42 histologically proved metastatic nodes and 41 of 49 benign nodes were detected, yielding 95% sensitivity and 84% specificity. The signal intensity ratio of benign nodes was substantially lower than that of metastatic nodes, indicating better differentiation of metastatic and benign nodes. Furthermore, 13 of 14 normal-sized nodes were detected.


CONCLUSIONS
MR imaging with iron oxide can enable specific differentiation of metastatic and benign nodes in patients with head and neck cancer. This agent may potentially enhance the detection of metastatic lymph nodes and deserves further investigation.
Anzai
Y
Y
Department of Radiological Sciences, University of California, Los Angeles 90024-1721.
Blackwell
K E
KE
Hirschowitz
S L
SL
Rogers
J W
JW
Sato
Y
Y
Yuh
W T
WT
Runge
V M
VM
Morris
M R
MR
McLachlan
S J
SJ
Lufkin
R B
RB
D000328:Adult; D000368:Aged; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007501:Iron; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides
D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide