Department of Neurology, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, L603, Portland, OR 97239-3098, USA.
Neuro Oncol. 2011 Feb;13(2):251-60. doi: 10.1093/neuonc/noq172. Epub 2010 Dec 16.
This study aims to compare gadoteridol with ferumoxytol for contrast-enhanced and perfusion-weighted (PW) MRI of intracranial tumors. The final analysis included 26 patients, who underwent 3 consecutive days of 3T MRI. Day 1 consisted of anatomical pre- and postcontrast images, and PW MRI was acquired using gadoteridol (0.1 mmol/kg). On Day 2, the same MRI sequences were obtained with ferumoxytol (510 mg) and on Day 3, the anatomical images were repeated to detect delayed ferumoxytol-induced signal changes. The T₁-weighted images were evaluated qualitatively and quantitatively for enhancement volume and signal intensity (SI) changes; PW data were used to estimate the relative cerebral blood volume (rCBV). All 26 lesions showed 24-hour T₁-weighted ferumoxytol enhancement; 16 also had T₂-weighted hypointensities. In 6 patients, ferumoxytol-induced signal changes were noted in areas with no gadoteridol enhancement. Significantly greater (P< .0001) SI changes were seen with gadoteridol, and qualitative analyses (lesion border delineation, internal morphology, contrast enhancement) also showed significant preferences (P= .0121; P = .0015; P < .0001, respectively) for this agent. There was no significant difference in lesion enhancement volumes between contrast materials. The ferumoxytol-rCBV values were significantly higher (P = .0016) compared with the gadoteridol-rCBV values. In conclusion, ferumoxytol provides important information about tumor biology that complements gadoteridol imaging. The rCBV measurements indicate areas of tumor undergoing rapid growth, whereas the 24-hour scans mark the presence of inflammatory cells. Both of these functions provide useful information about tumor response to treatment. We suggest that dynamic and anatomical imaging with ferumoxytol warrant further assessment in brain tumor therapy.
本研究旨在比较钆特醇和铁氧体用于颅内肿瘤的对比增强和灌注加权（PW）MRI。最终分析纳入了 26 例患者，他们在 3 天内接受了 3T MRI 检查。第 1 天包括解剖学的对比前和对比后图像，并且使用钆特醇（0.1mmol/kg）进行 PW MRI 采集。第 2 天，使用铁氧体（510mg）获得相同的 MRI 序列，第 3 天，重复解剖学图像以检测延迟的铁氧体引起的信号变化。T₁ 加权图像进行定性和定量评估，以评估增强体积和信号强度（SI）变化；PW 数据用于估计相对脑血容量（rCBV）。所有 26 个病变均在 24 小时 T₁ 加权铁氧体增强时显示；16 个病变还显示 T₂ 加权低信号。在 6 例患者中，在没有钆特醇增强的区域观察到铁氧体诱导的信号变化。与钆特醇相比，铁氧体显示出更显著的（P<.0001）SI 变化，并且定性分析（病变边界描绘、内部形态、对比增强）也显示出对该药物的明显偏好（P=.0121；P =.0015；P <.0001，分别）。两种造影剂的病变增强体积无显著差异。铁氧体-rCBV 值明显高于钆特醇-rCBV 值（P =.0016）。总之，铁氧体提供了关于肿瘤生物学的重要信息，补充了钆特醇成像。rCBV 测量值指示肿瘤快速生长的区域，而 24 小时扫描则标记了炎症细胞的存在。这两种功能都提供了有关肿瘤对治疗反应的有用信息。我们建议进一步评估铁氧体的动态和解剖成像在脑肿瘤治疗中的作用。
