Dataset Information

Comparison of ferumoxytol-based cerebral blood volume estimates using quantitative R1 and R2* relaxometry.

ABSTRACT: PURPOSE:Cerebral perfusion is commonly assessed clinically with dynamic susceptibility contrast MRI using a bolus injection of gadolinium-based contrast agents, resulting in semi-quantitative values of cerebral blood volume (CBV). Steady-state imaging with ferumoxytol allows estimation of CBV with the potential for higher precision and accuracy. Prior CBV studies have focused on the signal disrupting T2* effects, but ferumoxytol also has high signal-enhancing T1 relaxivity. The purpose of this study was to investigate and compare CBV estimation using T1 and T2*, with the goal of understanding the contrast mechanisms and quantitative differences. METHODS:Changes in R1 (1/T1 ) and R2* (1/ T2*) were measured after the administration of ferumoxytol using high-resolution quantitative approaches. Images were acquired at 3.0T and R1 was estimated from an ultrashort echo time variable flip angle approach, while R2* was estimated from a multiple gradient echo sequence. Twenty healthy volunteers were imaged at two doses. CBV was derived and compared from relaxometry in gray and white matter using different approaches. RESULTS:R1 measurements showed a linear dependence of blood R1 with respect to dose in large vessels, in contrast to the nonlinear dose-dependence of blood R2* estimates. In the brain parenchyma, R2* showed linear dose-dependency whereas R1 showed nonlinearity. CBV calculations based on R2* changes in tissue and ferumoxytol blood concentration estimates based on R1 relaxivity showed the lowest variability in our cohort. CONCLUSIONS:CBV measurements were successfully derived using a combined approach of R1 and R2* relaxometry. Magn Reson Med 79:3072-3081, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

SUBMITTER: Rivera-Rivera LA

PROVIDER: S-EPMC5843511 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Comparison of ferumoxytol-based cerebral blood volume estimates using quantitative R<sub>1</sub> and R2* relaxometry.

Rivera-Rivera Leonardo A LA Schubert Tilman T Knobloch Gesine G Turski Patrick A PA Wieben Oliver O Reeder Scott B SB Johnson Kevin M KM

Magnetic resonance in medicine 20171102 6

<h4>Purpose</h4>Cerebral perfusion is commonly assessed clinically with dynamic susceptibility contrast MRI using a bolus injection of gadolinium-based contrast agents, resulting in semi-quantitative values of cerebral blood volume (CBV). Steady-state imaging with ferumoxytol allows estimation of CBV with the potential for higher precision and accuracy. Prior CBV studies have focused on the signal disrupting T2* effects, but ferumoxytol also has high signal-enhancing T<sub>1</sub> relaxivity. Th ...[more]

PMID: 29096054

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Project description:BACKGROUND:Cerebral blood volume (CBV) mapping with a dynamic susceptibility contrast (DSC) perfusion technique has become a clinical tool in diagnosing and follow-up of brain tumors. Ferumoxytol, a long-circulating iron oxide nanoparticle, has been tested for CBV mapping, but the optimal dose has not been established. PURPOSE:To compare ferumoxytol DSC of two different doses to standard of care gadoteridol by analyzing time-intensity curves and CBV maps in normal-appearing brain regions. STUDY TYPE:Retrospective. SUBJECTS:Fifty-four patients with various brain disorders. FIELD STRENGTH/SEQUENCE:3T MRI. DSC-MRI was performed with 0.1 mmol/kg gadoteridol and 1 day later with ferumoxytol in doses of 1 or 2 mg/kg. ASSESSMENT:Signal changes during first pass, relative CBV (rCBV) in normal-appearing thalamus, putamen, and globus pallidus, and contrast-to-noise ratio (CNR) of the CBV maps were compared between gadoteridol and various doses of ferumoxytol using an automated method. To subjectively assess the quality of the CBV maps, two blinded readers also assessed visual conspicuity of the putamen. STATISTICAL TESTS:Linear mixed effect model was used for statistical comparison. RESULTS:Compared to gadoteridol, 1 mg/kg ferumoxytol showed no difference in CNR (P = 0.6505), peak ?R2*, and rCBV in the putamen (P = 0.2669, 0.0871) or in the thalamus (P = 0.517, 0.9787); 2 mg/kg ferumoxytol increased peak ?R2* as well as the CNR (P < 0.0001), but also mildly increased rCBV in putamen and globus pallidus (P = 0.0005, 0.0012). Signal intensities during first pass remained highly above the noise level, with overlapping of 95% confidence intervals with noise only in 3 out of 162 tested regions. Compared to gadoteridol, the visual image quality showed mild improvement with 1 mg/kg (P = 0.02) and marked improvement with 2 mg/kg ferumoxytol (P < 0.0001). DATA CONCLUSION:1 mg/kg ferumoxytol provides similar imaging results to standard gadoteridol for DSC-MRI, and 2 mg/kg has a benefit of increased CNR, but may also result in mildly increased rCBV values. LEVEL OF EVIDENCE:3 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;48:441-448.

Dataset Information

Comparison of ferumoxytol-based cerebral blood volume estimates using quantitative R1 and R2* relaxometry.

Publications

Comparison of ferumoxytol-based cerebral blood volume estimates using quantitative R<sub>1</sub> and R2* relaxometry.

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