Single-dose contrast agent for intraoperative MR imaging of intrinsic brain tumors by using ferumoxtran-10.
OBJECTIVE
Intraoperative MR imaging (IMRI) has advantages over conventional framed and frameless techniques. IMRI, however, also has some drawbacks, especially related to interpretation of gadolinium-enhanced intraoperative imaging resulting from surgically induced blood brain barrier injury, vascular changes, and hemorrhage. Ultra-small superparamagnetic iron particles like ferumoxtran-10 have a long plasma half-life and are trapped by reactive cells within the tumor. These trapped particles provide a method to demonstrate enhancing lesions without the artifact of repeat gadolinium administration in the face of blood brain barrier and vascular injury.


METHODS
We present a review of the literature and the cases of two patients who underwent surgery in which IMRI with ferumoxtran-10 was used.


RESULTS
Ultra-small superparamagnetic iron particles represent a method to demonstrate enhancing intrinsic brain tumors without the drawbacks of intraoperative gadolinium enhancement. These lesions appear even on low-field strength IMRI. Ferumoxtran-10, administered preoperatively, provides a stable imaging marker, even after surgical manipulation of the brain.


CONCLUSIONS
Fermumoxtran-10 provides a way to lessen artifactual enhancement during IMRI related to the administration of gadolinium.
Hunt
Matthew A
MA
Department of Neurosurgery, Oregon Health and Science University, Portland, OR 97239, USA.
Bagó
Attila G
AG
Neuwelt
Edward A
EA
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage*; D003911:Dextrans; D052203:Ferrosoferric Oxide; D006801:Humans; D007430:Intraoperative Care; D007501:Iron / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D010087:Oxides / Q000008:administration & dosage*
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; C097921:ferumoxtran-10; D007501:Iron; D052203:Ferrosoferric Oxide