title: Coronary MR angiography using citrate-coated very small superparamagnetic iron oxide particles as blood-pool contrast agent: initial experience in humans.
abstract: OBJECTIVE
  To evaluate very small superparamagnetic iron oxide particles (VSOP-C184) as blood-pool contrast agent for coronary MR angiography (CMRA) in humans.
  
  
  METHODS
  Six healthy volunteers and 14 patients with suspected coronary artery disease underwent CMRA after administration of VSOP-C184 at the following doses: 20 μmol Fe/kg (4 patients), 40 μmol Fe/kg (5 patients), 45 μmol Fe/kg (6 healthy volunteers), and 60 μmol Fe/kg (5 patients). In healthy volunteers, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and vessel edge definition (VED) of contrast-enhanced CMRA were compared with non-contrast-enhanced CMRA. In patients, a per-segment intention-to-diagnose evaluation of contrast-enhanced CMRA for detection of significant coronary stenosis (≥50%) was performed.
  
  
  RESULTS
  Three healthy volunteers (45 μmol Fe/kg VSOP-C184) and two patients (60 μmol Fe/kg VSOP-C184) had adverse events of mild or moderate intensity. VSOP-C184 significantly increased CNR (15.1 ± 4.6 versus 6.9 ± 1.9; P = 0.010), SNR (21.7 ± 5.3 versus 15.4 ± 1.6; P = 0.048), and VED (2.3 ± 0.6 versus 1.2 ± 0.2; P < 0.001) compared with non-contrast-enhanced CMRA. In patients, contrast-enhanced CMRA yielded sensitivity, specificity, and diagnostic accuracy for detection of significant coronary stenosis of 86.7%, 71.0%, 73.1%, respectively.
  
  
  CONCLUSIONS
  CMRA using VSOP-C184 was feasible and yielded moderate diagnostic accuracy for detection of significant coronary stenosis within this proof-of-concept setting.
authors.affiliation: Department of Radiology, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Wagner
authors.forename: Susanne
authors.initials: S
authors.lastname: Wagner
authors.forename: Jörg
authors.initials: J
authors.lastname: Schnorr
authors.forename: Eyk
authors.initials: E
authors.lastname: Schellenberger
authors.forename: Dietmar
authors.initials: D
authors.lastname: Kivelitz
authors.forename: Lasse
authors.initials: L
authors.lastname: Krug
authors.forename: Marc
authors.initials: M
authors.lastname: Dewey
authors.forename: Michael
authors.initials: M
authors.lastname: Laule
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Matthias
authors.initials: M
authors.lastname: Taupitz
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012016:Reference Values; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D059629:Signal-To-Noise Ratio
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; C427127:superparamagnetic blood pool agent; C065507:ferumoxides; D052203:Ferrosoferric Oxide