MRI using ultrasmall superparamagnetic particles of iron oxide in patients under surveillance for abdominal aortic aneurysms to predict rupture or surgical repair: MRI for abdominal aortic aneurysms to predict rupture or surgery-the MA(3)RS study.
Population screening for abdominal aortic aneurysms (AAA) halves the associated mortality and has led to the establishment of national screening programmes. Prediction of aneurysm growth and rupture is challenging and currently relies on serial diameter measurements with ultrasound. Recently, a novel MRI-based technique using ultrasmall superparamagnetic particles of iron oxide (USPIO) has demonstrated considerable promise as a method of identifying aneurysm inflammation and expansion.



The MA(3)RS study is a prospective observational multicentre cohort study of 350 patients with AAA in three centres across Scotland. All participants will undergo MRI with USPIO and aneurysm expansion will be measured over 2 years with CT in addition to standard clinical ultrasound surveillance. The relationship between mural USPIO uptake and subsequent clinical outcomes, including expansion, rupture and repair, will be evaluated and used to determine whether the technique augments standard risk prediction markers. To ensure adequate sensitivity to answer the primary question, we need to observe 130 events (composite of rupture or repair) with an estimated event rate of 41% over 2 years of follow-up. The MA(3)RS study is currently recruiting and expects to report in 2017.



This is the first study to evaluate the use of USPIO-enhanced MRI to provide additional information to aid risk prediction models in patients with AAA. If successful, this study will lay the foundation for a large randomised controlled trial targeted at applying this technique to determine clinical management.



Current Controlled Trials: ISRCTN76413758.
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Olivia M B
OM
McBride
BHF Glasgow Cardiovascular Research Centre, University of Glasgow , Glasgow , UK.
Colin
C
Berry
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Paul
P
Burns
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Roderick T A
RT
Chalmers
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Barry
B
Doyle
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Rachael
R
Forsythe
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
O James
OJ
Garden
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Kirsteen
K
Goodman
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Catriona
C
Graham
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Peter
P
Hoskins
Forth Valley Royal Hospital, Larbert , UK.
Richard
R
Holdsworth
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Thomas J
TJ
MacGillivray
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Graham
G
McKillop
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Gordon
G
Murray
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Katherine
K
Oatey
BHF Glasgow Cardiovascular Research Centre, University of Glasgow , Glasgow , UK.
Jennifer M J
JM
Robson
BHF Glasgow Cardiovascular Research Centre, University of Glasgow , Glasgow , UK.
Giles
G
Roditi
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Scott
S
Semple
BHF Glasgow Cardiovascular Research Centre, University of Glasgow , Glasgow , UK.
Wesley
W
Stuart
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Edwin J R
EJ
van Beek
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
Alex
A
Vesey
British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science , Edinburgh , UK.
David E
DE
Newby
AORTA, GREAT VESSELS AND TRAUMA; IMAGING AND DIAGNOSTICS