title: Using iron oxide nanoparticles to diagnose CNS inflammatory diseases and PCNSL.
abstract: OBJECTIVE
  The study goal was to assess the benefits and potential limitations in the use of ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles in the MRI diagnosis of CNS inflammatory diseases and primary CNS lymphoma.
  
  
  METHODS
  Twenty patients with presumptive or known CNS lesions underwent MRI study. Eighteen patients received both gadolinium-based contrast agents (GBCAs) and 1 of 2 USPIO contrast agents (ferumoxytol and ferumoxtran-10) 24 hours apart, which allowed direct comparative analysis. The remaining 2 patients had only USPIO-enhanced MRI because of a renal contraindication to GBCA. Conventional T1- and T2-weighted MRI were acquired before and after contrast administration in all patients, and perfusion MRI for relative cerebral blood volume (rCBV) assessment was obtained in all 9 patients receiving ferumoxytol.
  
  
  RESULTS
  USPIO-enhanced MRI showed an equal number of enhancing brain lesions in 9 of 18 patients (50%), more enhancing lesions in 2 of 18 patients (11%), and fewer enhancing lesions in 3 of 18 patients (17%) compared with GBCA-enhanced MRI. Four of 18 patients (22%) showed no MRI enhancement. Dynamic susceptibility-weighted contrast-enhanced perfusion MRI using ferumoxytol showed low rCBV (ratio <1.0) in 3 cases of demyelination or inflammation, modestly elevated rCBV in 5 cases of CNS lymphoma or lymphoproliferative disorder (range: 1.3-4.1), and no measurable disease in one case.
  
  
  CONCLUSIONS
  This study showed that USPIO-enhanced brain MRI can be useful in the diagnosis of CNS inflammatory disorders and lymphoma, and is also useful for patients with renal compromise at risk of nephrogenic systemic fibrosis who are unable to receive GBCA.
authors.affiliation: Department of Neurosurgery, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Farrell
authors.forename: Bronwyn E
authors.initials: BE
authors.lastname: Hamilton
authors.forename: Edit
authors.initials: E
authors.lastname: Dósa
authors.forename: Endre
authors.initials: E
authors.lastname: Rimely
authors.forename: Morad
authors.initials: M
authors.lastname: Nasseri
authors.forename: Seymur
authors.initials: S
authors.lastname: Gahramanov
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Lacy
authors.forename: Eugene P
authors.initials: EP
authors.lastname: Frenkel
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Doolittle
authors.forename: Paula M
authors.initials: PM
authors.lastname: Jacobs
authors.forename: Edward A
authors.initials: EA
authors.lastname: Neuwelt
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005290:Ferric Compounds; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053758:Nanoparticles
chemical_list: D005290:Ferric Compounds; C000499:ferric oxide