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• W2043467591 abstract "Purpose/Objective(s)Ferumoxytol is a ferromagnetic nanoparticle with lymphotrophic biokinetics. Ferumoxytol is delivered to lymph nodes via normal macrophages. MRI is successful in suppressing normal lymph nodes containing Ferumoxytol. The purpose of this study is to validate this agent's safety and determine its role as a lymph node contrast agent in the prostate cancer population.Materials/MethodsA nonrandomized prospective evaluation of 136 prostate cancer patients. All patients received IV Ferumoxytol. T2 MEDIC and T2* sequence imaging of the abdomen and pelvis were performed approximately 24 hours after Ferumoxytol infusion. All patients tolerated the infusion and were successfully imaged. Patients were monitored for 2 hours, and presented for imaging 24 hours post-infusion. Images were reviewed by 2 board certified radiologists with consensus interpretation. Lymph nodes were considered abnormal if they did not suppress after Ferumoxytol infusion. Thirty-three patients subsequently underwent imaged guided lymph node biopsy. Radiology-pathology correlation was performed.ResultsSix patients demonstrated adverse reactions to the Ferumoxytol. Four patients demonstrated nasal congestion with sneezing. These patients were treated with 25-50 mg IV diphenhydramine to complete resolution. One patient experienced a moderate vasovagal reaction treated with saline bolus and IV atropine. One patient developed back spasms, treated with 0.5 mg of midazolam and IV normal saline. Forty-two patients demonstrated abnormal lymph node consistent with metastatic disease based on imaging criteria. Thirty-three of these patients underwent image guided lymph node biopsy, 1 underwent mediastinoscopy, and 1 underwent pelvic lymph node exoneration. A total of 74 lymph nodes were sampled. Ninety percent of these demonstrated metastatic prostate carcinoma, 3% demonstrated lymphoma, and 7% were normal. Forty-nine percent of all malignant lymph nodes did not fulfill traditional imaging criteria for malignancy. All of the normal lymph nodes on biopsy were femoral lymph nodes demonstrating heterogeneous peripheral hypointense T2* signal and heterogeneous central hyperintense T2* signal.ConclusionsFerumoxytol is a safe lymphatic contrast agent, with mild side effects documented in less than 2% of the patient population in this study. Ferumoxytol can be used to evaluate for the presence of lymphatic dissemination of metastatic disease in prostate cancer patients, with a lower limit of resolution of focal lymph node metastases of 3-4 mm. This improved resolution carries implications for therapeutic radiation planning in the setting of newly diagnosed or recurrent/metastatic prostate carcinoma. Ferumoxytol may play a significant future role as a lymphatic contrast agent in the early dissemination of lymphatic metastatic disease. Purpose/Objective(s)Ferumoxytol is a ferromagnetic nanoparticle with lymphotrophic biokinetics. Ferumoxytol is delivered to lymph nodes via normal macrophages. MRI is successful in suppressing normal lymph nodes containing Ferumoxytol. The purpose of this study is to validate this agent's safety and determine its role as a lymph node contrast agent in the prostate cancer population. Ferumoxytol is a ferromagnetic nanoparticle with lymphotrophic biokinetics. Ferumoxytol is delivered to lymph nodes via normal macrophages. MRI is successful in suppressing normal lymph nodes containing Ferumoxytol. The purpose of this study is to validate this agent's safety and determine its role as a lymph node contrast agent in the prostate cancer population. Materials/MethodsA nonrandomized prospective evaluation of 136 prostate cancer patients. All patients received IV Ferumoxytol. T2 MEDIC and T2* sequence imaging of the abdomen and pelvis were performed approximately 24 hours after Ferumoxytol infusion. All patients tolerated the infusion and were successfully imaged. Patients were monitored for 2 hours, and presented for imaging 24 hours post-infusion. Images were reviewed by 2 board certified radiologists with consensus interpretation. Lymph nodes were considered abnormal if they did not suppress after Ferumoxytol infusion. Thirty-three patients subsequently underwent imaged guided lymph node biopsy. Radiology-pathology correlation was performed. A nonrandomized prospective evaluation of 136 prostate cancer patients. All patients received IV Ferumoxytol. T2 MEDIC and T2* sequence imaging of the abdomen and pelvis were performed approximately 24 hours after Ferumoxytol infusion. All patients tolerated the infusion and were successfully imaged. Patients were monitored for 2 hours, and presented for imaging 24 hours post-infusion. Images were reviewed by 2 board certified radiologists with consensus interpretation. Lymph nodes were considered abnormal if they did not suppress after Ferumoxytol infusion. Thirty-three patients subsequently underwent imaged guided lymph node biopsy. Radiology-pathology correlation was performed. ResultsSix patients demonstrated adverse reactions to the Ferumoxytol. Four patients demonstrated nasal congestion with sneezing. These patients were treated with 25-50 mg IV diphenhydramine to complete resolution. One patient experienced a moderate vasovagal reaction treated with saline bolus and IV atropine. One patient developed back spasms, treated with 0.5 mg of midazolam and IV normal saline. Forty-two patients demonstrated abnormal lymph node consistent with metastatic disease based on imaging criteria. Thirty-three of these patients underwent image guided lymph node biopsy, 1 underwent mediastinoscopy, and 1 underwent pelvic lymph node exoneration. A total of 74 lymph nodes were sampled. Ninety percent of these demonstrated metastatic prostate carcinoma, 3% demonstrated lymphoma, and 7% were normal. Forty-nine percent of all malignant lymph nodes did not fulfill traditional imaging criteria for malignancy. All of the normal lymph nodes on biopsy were femoral lymph nodes demonstrating heterogeneous peripheral hypointense T2* signal and heterogeneous central hyperintense T2* signal. Six patients demonstrated adverse reactions to the Ferumoxytol. Four patients demonstrated nasal congestion with sneezing. These patients were treated with 25-50 mg IV diphenhydramine to complete resolution. One patient experienced a moderate vasovagal reaction treated with saline bolus and IV atropine. One patient developed back spasms, treated with 0.5 mg of midazolam and IV normal saline. Forty-two patients demonstrated abnormal lymph node consistent with metastatic disease based on imaging criteria. Thirty-three of these patients underwent image guided lymph node biopsy, 1 underwent mediastinoscopy, and 1 underwent pelvic lymph node exoneration. A total of 74 lymph nodes were sampled. Ninety percent of these demonstrated metastatic prostate carcinoma, 3% demonstrated lymphoma, and 7% were normal. Forty-nine percent of all malignant lymph nodes did not fulfill traditional imaging criteria for malignancy. All of the normal lymph nodes on biopsy were femoral lymph nodes demonstrating heterogeneous peripheral hypointense T2* signal and heterogeneous central hyperintense T2* signal. ConclusionsFerumoxytol is a safe lymphatic contrast agent, with mild side effects documented in less than 2% of the patient population in this study. Ferumoxytol can be used to evaluate for the presence of lymphatic dissemination of metastatic disease in prostate cancer patients, with a lower limit of resolution of focal lymph node metastases of 3-4 mm. This improved resolution carries implications for therapeutic radiation planning in the setting of newly diagnosed or recurrent/metastatic prostate carcinoma. Ferumoxytol may play a significant future role as a lymphatic contrast agent in the early dissemination of lymphatic metastatic disease. Ferumoxytol is a safe lymphatic contrast agent, with mild side effects documented in less than 2% of the patient population in this study. Ferumoxytol can be used to evaluate for the presence of lymphatic dissemination of metastatic disease in prostate cancer patients, with a lower limit of resolution of focal lymph node metastases of 3-4 mm. This improved resolution carries implications for therapeutic radiation planning in the setting of newly diagnosed or recurrent/metastatic prostate carcinoma. Ferumoxytol may play a significant future role as a lymphatic contrast agent in the early dissemination of lymphatic metastatic disease." @default.
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• W2043467591 date "2013-10-01" @default.
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• W2043467591 title "Safety and Efficacy of Ferumoxytol as a Lymphatic Contrast Agent" @default.
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