Carotid MR angiography: phase II study of safety and efficacy for MS-325.
OBJECTIVE
To evaluate the safety and efficacy of MS-325 in patients suspected of having carotid arterial disease.


METHODS
Fifty carotid arteries in 26 patients were imaged with three-dimensional spoiled gradient-recalled-echo magnetic resonance (MR) angiography at 5 and 50 minutes after injection of MS-325. MS-325 was administered intravenously as a single dose of 0.01, 0.03, or 0.05 mmol per kilogram of body weight as determined with a dose randomization scheme for four, nine, and 13 patients, respectively. Safety, including clinical laboratory changes and electrocardiographic monitoring, was assessed until approximately 3 days after injection. Conventional contrast agent-enhanced angiography was used as the standard of reference. Independent readers blinded to the dose interpreted the MR angiographic and conventional images. Images were assessed for location and extent of carotid arterial stenosis.


RESULTS
There were no severe or serious adverse events. For the determination of clinically significant stenosis (>70%) on the 5-minute images, sensitivity, specificity, and accuracy (P =.07, three-way comparison) were 100%, 100%, and 100%; 63%, 100%, and 88%; and 40%, 75%, and 55% at 0.01, 0.03, and 0.05 mmol/kg, respectively. Sensitivity and specificity for images at 50 minutes after MS-325 administration showed the same trends as the 5-minute images.


CONCLUSIONS
Overall accuracy for MS-325-enhanced carotid MR angiography performed during steady-state conditions of circulating contrast agent approximately 5 minutes after injection was high (88%-100%) at 0.03 and 0.01 mmol/kg. MS-325 was well tolerated at all evaluated doses.
Bluemke
D A
DA
Department of Radiology, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA. dbluemke@rad.jhu.edu
Stillman
A E
AE
Bis
K G
KG
Grist
T M
TM
Baum
R A
RA
D'Agostino
R
R
Malden
E S
ES
Pierro
J A
JA
Yucel
E K
EK
D016893:Carotid Stenosis / Q000175:diagnosis*; D003287:Contrast Media / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005682:Gadolinium; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography; D009942:Organometallic Compounds / Q000009:adverse effects; D012680:Sensitivity and Specificity
D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium