title: Ferumoxytol as an intraprostatic MR contrast agent for lymph node mapping of the prostate: a feasibility study in non-human primates.
abstract: Background A variety of magnetic resonance (MR) lymphographic agents have been proposed for mapping the lymph nodes draining the prostate. Purpose To investigate the feasibility of using ferumoxytol (an FDA-approved iron oxide agent) for lymph node mapping of the prostate on imaging (MRI) in a non-human primate (NHP) Macaque model. Material and Methods Four NHPs weighing 5-13 kg underwent injection of ferumoxytol after a needle was introduced transrectally under MRI guidance into the prostate using a commercially available intrarectal MRI biopsy guide. Ferumoxytol was administered at dosage in the range of 0.15-0.75 mg Fe/kg in a fixed injection volume of 0.2 mL. T1-weighted MRI was performed at 3 T starting immediately and extending at least 45 min post-injection. Two readers evaluated the images in consensus. The NHPs tolerated the ferumoxytol injections at all doses with no evident side effects. Results It was determined that the lowest dose of 0.15 mg Fe/kg produced the best outcome in terms of lymph node visualization and draining nodes were reliably visualized at this dose and volume. Conclusion Thus, MRI with intraprostatic injection of ferumoxytol may be considered an effective T1 contrast agent for prospective mapping of lymph nodes draining the prostate and, thus, for attempted sentinel lymph node identification in prostate cancer. Large clinical trials to determine safety and efficacy are needed.
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sankineni
authors.affiliation: 2 Washington National Primate Research Center, UW, Seattle, WA, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Smedley
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Marcelino
authors.initials: M
authors.lastname: Bernardo
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Brown
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Johnson
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.|3 Department of Urology, AMC University Hospital, Amsterdam, the Netherlands.|4 Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA.
authors.forename: Berrend
authors.initials: B
authors.lastname: Muller
authors.affiliation: 5 Clinical Research Directorate/CMRP, Leidos Biomedical Research, Inc. (formerly SAIC-Frederick, Inc.), Frederick National Laboratory for Cancer Research, Frederick, MD, USA.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Griffiths
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Hisataka
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: 4 Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA.|6 Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.|7 Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Soroush
authors.initials: S
authors.lastname: Rais-Bahrami
authors.affiliation: 4 Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA.|8 Center for Interventional Oncology, NCI and Radiology and Imaging Sciences, Clinical Center, NIH, Bethesda, MD, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
authors.affiliation: 8 Center for Interventional Oncology, NCI and Radiology and Imaging Sciences, Clinical Center, NIH, Bethesda, MD, USA.
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Wood
authors.affiliation: 9 AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc. (formerly SAIC-Frederick, Inc.), Frederick National Laboratory, Frederick, MD, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Keele
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.affiliation: 1 Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
mesh_terms: D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage; D005240:Feasibility Studies; D052203:Ferrosoferric Oxide / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D015552:Injections, Intralesional; D008207:Lymphatic Metastasis; D008253:Macaca mulatta; D008297:Male; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D052203:Ferrosoferric Oxide
keywords: Ferumoxytol; iron oxide nanoparticles; lymph node; magnetic resonance imaging (MRI); prostate cancer