The efficacy of MRI with ultrasmall superparamagnetic iron oxide particles (USPIO) in head and neck cancers.
BACKGROUND
The objective was to evaluate the diagnostic accuracy of ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) compared to plain MRI in patients with a clinical N+ neck using histology as a gold standard.


METHODS
Twenty-eight patients underwent unenhanced and USPIO-enhanced MRI using T1-weighted spin echo (SE) sequences and high resolution Turbo-Spin-Echo (TSE) T2-weighted sequences, as well as T2-weighted Gradient Echo (GE) sequences in axial and sagittal slice orientation. The signal intensity (SI) decrease was measured by a region of interest evaluation and visual analysis was performed.


RESULTS
Histopathological evaluation of 363 lymph nodes revealed 34 as metastatic. USPIO MRI detected 28 metastases (sensitivity 82.3%) and 329 non-metastatic lymph nodes (specificity 100%). Regarding lymph node size, USPIO MRI was correct in all patients who underwent surgery. One lymph node with microinfiltration of tumor cells was detected by USPIO MRI.


CONCLUSIONS
There were no side-effects during or after application of the contrast agent. This study confirms the efficacy of MRI with USPIO in patients with head and neck cancer. USPIO-enhanced MRI could have an important effect on surgery planning. Because of its high specificity, USPIO-enhanced MRI seems to be a diagnostic modality able to differentiate borderline-sized lymph nodes.
Baghi
Mehran
M
Department of ENT Surgery, University of Frankfurt, 60590 Frankfurt/Main, Germany.
Mack
Martin G
MG
Hambek
Markus
M
Rieger
Joerg
J
Vogl
Thomas
T
Gstoettner
Wolfgang
W
Knecht
Rainald
R
D000328:Adult; D000368:Aged; D005260:Female; D005290:Ferric Compounds; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008280:Magnetics; D008297:Male; D008875:Middle Aged
D005290:Ferric Compounds; C000499:ferric oxide