title: Multicenter clinical trial of ultrasmall superparamagnetic iron oxide in the evaluation of mediastinal lymph nodes in patients with primary lung carcinoma.
abstract: The purpose of this study was to evaluate the clinical efficacy of ultrasmall superparamagnetic iron oxide particles as a magnetic resonance (MR) contrast agent in differentiating metastatic from benign lymph nodes. Eighteen patients with primary lung malignancy and suspected regional lymph node metastases underwent MR imaging before and after Combidex(R) infusion in a multi-institutional study. All MR sequences were interpreted by one or more board-certified radiologists experienced in imaging thoracic malignancy. Each patient was evaluated for the number and location of lymph nodes, homogeneity of nodal signal, and possible change of MR signal post contrast. All patients underwent resection or sampling of the MR-identified lymph node(s) 1-35 day(s) post contrast MR imaging. In all, 27 lymph nodes or nodal groups were available for histopathologic correlation. Combidex had a sensitivity of 92% and a specificity of 80% in identifying pathologically confirmed metastatic mediastinal lymph nodes. Based on our preliminary data, Combidex MR imaging may provide additional functional information useful in the staging of mediastinal lymph nodes.
authors.affiliation: University of Iowa College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
authors.forename: B C
authors.initials: BC
authors.lastname: Nguyen
authors.forename: W
authors.initials: W
authors.lastname: Stanford
authors.forename: B H
authors.initials: BH
authors.lastname: Thompson
authors.forename: N P
authors.initials: NP
authors.lastname: Rossi
authors.forename: K H
authors.initials: KH
authors.lastname: Kernstine
authors.forename: J A
authors.initials: JA
authors.lastname: Kern
authors.forename: R A
authors.initials: RA
authors.lastname: Robinson
authors.forename: J K
authors.initials: JK
authors.lastname: Amorosa
authors.forename: J F
authors.initials: JF
authors.lastname: Mammone
authors.forename: E K
authors.initials: EK
authors.lastname: Outwater
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007501:Iron / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D009367:Neoplasm Staging; D010087:Oxides / Q000008:administration & dosage; D010316:Particle Size; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; C097921:ferumoxtran-10; D007501:Iron; D052203:Ferrosoferric Oxide