USPIO-enhanced magnetic resonance imaging for nodal staging in patients with head and neck cancer.

Abstract

PURPOSE:

To determine the accuracy of ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) for nodal staging in patients with head and neck cancer.

MATERIALS AND METHODS:

Twenty patients with carcinomas of the upper aerodigestive tract were prospectively enrolled. MRI was performed before and 24-36 hours after intravenous infusion of an USPIO agent, ferumoxtran-10 (Sinerem; Guerbet, France; and Combidex; Advanced Magnetics) at a dose of 2.6 mg Fe/kg using T2-weighted spin-echo and gradient-echo sequences. Surgery was performed the same day or the day after the ferumoxtran-10-enhanced MR examination. Based on MRI, selected nodes were surgically removed and directly correlated with pathology using hematoxylin-eosin (H&E) and Perls stainings.

RESULTS:

A total of 63 nodes were studied; 36 were nonmetastatic, 25 metastatic, and two inflammatory. Ferumoxtran-10-enhanced MRI allowed diagnosis of 24 metastatic and 30 nonmetastatic nodes, yielding a sensitivity of 96%, a specificity of 78.9%, a positive predictive value of 75%, and a negative predictive value of 96.8%, compared to 64%, 78.9%, 66.6%, and 76.9%, respectively, for nonenhanced MRI. Accuracy of ferumoxtran-10-enhanced MRI was 85.7%. The gradient-echo T2-weighted sequence was the most accurate to detect signal loss in nonmetastatic nodes.

CONCLUSION:

USPIO-enhanced MRI is useful for nodal staging of patients with head and neck cancers.

• Authors: Luís Curvo-Semedo, Mónica Diniz, Jorge Miguéis, Maria-José Julião, Paula Martins, Alda Pinto, Filipe Caseiro-Alves
• Journal: Journal of magnetic resonance imaging : JMRI (J Magn Reson Imaging) Vol. 24 Issue 1 Pg. 123-31 (Jul 2006) ISSN: 1053-1807 [Print] United States
• PMID: 16755542 (Publication Type: Clinical Trial, Phase III, Journal Article)
• Copyright: (c) 2006 Wiley-Liss, Inc.

Chemical References

• Contrast Media
• Dextrans
• Magnetite Nanoparticles
• Oxides
• ferumoxtran-10
• Iron
• Ferrosoferric Oxide

Topics

• Adult
• Aged
• Carcinoma (pathology)
• Contrast Media (pharmacology)
• Dextrans
• Female
• Ferrosoferric Oxide
• Head and Neck Neoplasms (pathology)
• Humans
• Iron (pharmacology)
• Lymphatic System (pathology)
• Magnetic Resonance Imaging (methods)
• Magnetite Nanoparticles
• Male
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Staging (methods)
• Oxides (pharmacology)
• Predictive Value of Tests