title: Multicentre dose-ranging study on the efficacy of USPIO ferumoxtran-10 for liver MR imaging.
abstract: OBJECTIVE
  A dose ranging multicentre phase-II clinical trial was conducted to evaluate the efficacy of ultrasmall superparamagnetic iron oxide (USPIO) ferumoxtran-10 for magnetic resonance (MR) imaging of focal hepatic lesions.
  
  
  METHODS
  Ninety-nine patients with focal liver lesions received USPIO at a dose of 0.8 (n = 35), 1.1 (n = 32), or 1.7 (n = 32) mg Fe/kg. Liver MR imaging was performed before and after USPIO with T1-weighted and T2-weighted pulse sequences. Images were analysed by two independent readers for additional information (lesion detection, exclusion, characterization and patient management). Signal intensity (SI) based quantitative measurements were also taken.
  
  
  RESULTS
  Post-contrast medium MR imaging showed additional information in 71/97 patients (73%) for reader one and 83/96 patients (86%) for reader two. The results with all three doses were statistically significant (P < 0.05). Signal intensity analysis revealed that all three doses increased liver SI on T1-weighted images and decreased liver SI on T2-weighted images. On T2-weighted images metastases increased in contrast relative to normal hepatic parenchyma whereas haemangiomas decreased in contrast. On T2-weighted images there was statistically improved efficacy at the intermediate dose, which did not improve at the highest dose.
  
  
  CONCLUSIONS
  Ultrasmall superparamagnetic iron oxide was an effective contrast agent for liver MR imaging at all doses and a dose of 1.1 mg Fe/kg was recommended for future clinical trials.
authors.affiliation: Departments of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, USA.
authors.forename: S
authors.initials: S
authors.lastname: Saini
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.forename: R L
authors.initials: RL
authors.lastname: Baron
authors.forename: D A
authors.initials: DA
authors.lastname: Turner
authors.forename: P R
authors.initials: PR
authors.lastname: Ros
authors.forename: P F
authors.initials: PF
authors.lastname: Hahn
authors.forename: W C
authors.initials: WC
authors.lastname: Small
authors.forename: E E
authors.initials: EE
authors.lastname: Delange
authors.forename: A E
authors.initials: AE
authors.lastname: Stillman
authors.forename: R R
authors.initials: RR
authors.lastname: Edelman
authors.forename: V M
authors.initials: VM
authors.lastname: Runge
authors.forename: E K
authors.initials: EK
authors.lastname: Outwater
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000556:secondary; D003287:Contrast Media / Q000008:administration & dosage; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007501:Iron / Q000008:administration & dosage; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000008:administration & dosage; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; C097921:ferumoxtran-10; D007501:Iron; D052203:Ferrosoferric Oxide