Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Stanford, CA, 94305-5614, USA.
Division of Hematology/Oncology, Department of Pediatrics, Stanford University, Stanford, CA, USA.
Pediatr Radiol. 2022 Feb;52(2):354-366. doi: 10.1007/s00247-021-05098-5. Epub 2021 May 27.
Gadolinium chelates have been used as standard contrast agents for clinical MRI for several decades. However, several investigators recently reported that rare Earth metals such as gadolinium are deposited in the brain for months or years. This is particularly concerning for children, whose developing brain is more vulnerable to exogenous toxins compared to adults. Therefore, a search is under way for alternative MR imaging biomarkers. The United States Food and Drug Administration (FDA)-approved iron supplement ferumoxytol can solve this unmet clinical need: ferumoxytol consists of iron oxide nanoparticles that can be detected with MRI and provide significant T1- and T2-signal enhancement of vessels and soft tissues. Several investigators including our research group have started to use ferumoxytol off-label as a new contrast agent for MRI. This article reviews the existing literature on the biodistribution of ferumoxytol in children and compares the diagnostic accuracy of ferumoxytol- and gadolinium-chelate-enhanced MRI. Iron oxide nanoparticles represent a promising new class of contrast agents for pediatric MRI that can be metabolized and are not deposited in the brain.
钆螯合物已被用作临床 MRI 的标准对比剂数十年。然而，最近有几位研究人员报告称，某些稀土金属（如钆）在大脑中沉积数月甚至数年。这对于儿童来说尤其令人担忧，因为与成年人相比，儿童发育中的大脑更容易受到外源性毒素的影响。因此，正在寻找替代的磁共振成像生物标志物。美国食品和药物管理局（FDA）批准的铁补充剂ferumoxytol 可以解决这一未满足的临床需求：ferumoxytol 由氧化铁纳米颗粒组成，可通过 MRI 检测，并可显著增强血管和软组织的 T1 和 T2 信号。包括我们研究小组在内的几位研究人员已开始将 ferumoxytol 超适应证用于 MRI 的新型对比剂。本文综述了有关 ferumoxytol 在儿童体内的生物分布的现有文献，并比较了 ferumoxytol 和钆螯合物增强 MRI 的诊断准确性。氧化铁纳米颗粒代表了一类用于儿科 MRI 的有前途的新型对比剂，它们可以代谢，并且不会在大脑中沉积。
