An exploratory study of ferumoxtran-10 nanoparticles as a blood-brain barrier imaging agent targeting phagocytic cells in CNS inflammatory lesions.
OBJECTIVE
Iron oxide-based contrast agents have been investigated as more specific MR imaging agents for central nervous system (CNS) inflammation. Ferumoxtran-10 is a virus-size nanoparticle, taken up by reactive cells, that allows visualization of the phagocytic components of CNS lesions. Ferumoxtran-10 was compared with standard gadolinium-enhanced MR images in this exploratory trial to assess its potential in evaluation of CNS lesions with inflammatory aspects, including lymphoma, multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), and vascular lesions.


METHODS
Twenty-three patients with different types of intracranial "inflammatory" lesions underwent standard brain MR with and without gadolinium, followed an average of 10 days later by a ferumoxtran-10 scan. Patients were imaged 24 hours after infusion of 2.6 mg/kg ferumoxtran-10. All MR images were evaluated subjectively by 4 investigators for a difference in enhancement patterns, which could be useful in differential diagnoses.


RESULTS
In 5 cases, (one ADEM, 2 stroke, one cavernous venous vascular malformation, one primary central nervous lymphoma) the ferumoxtran-10 scan showed higher signal intensity, larger area of enhancement, or new enhancing areas compared with gadolinium. Most MS patients showed less enhancement with ferumoxtran-10 than with gadolinium.


CONCLUSIONS
Ferumoxtran-10 showed different enhancement patterns in a variety of CNS lesions with inflammatory components in comparison to gadolinium. The impact of timing and therapy need further evaluation to better assess ferumoxtran-10 in addition to gadolinium as contrast agents for use in diagnosis and monitoring therapy in patients with CNS inflammatory lesions.
Manninger
Sándor P
SP
Department of Radiology, Oregon Health & Science University, Portland, OR, USA.
Muldoon
Leslie L
LL
Nesbit
Gary
G
Murillo
Tulio
T
Jacobs
Paula M
PM
Neuwelt
Edward A
EA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001812:Blood-Brain Barrier / Q000503:physiopathology*; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000473:pathology; D003287:Contrast Media; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000473:pathology; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D019786:Gadolinium DTPA; D006801:Humans; D007249:Inflammation; D007501:Iron; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D049329:Nanostructures; D010087:Oxides; D010586:Phagocytes / Q000473:pathology*
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; C097921:ferumoxtran-10; C064925:gadodiamide; D007501:Iron; D019786:Gadolinium DTPA; D052203:Ferrosoferric Oxide