Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles--initial clinical experience.

Abstract

PURPOSE:

To evaluate the clinical and biologic safety of ultrasmall superparamagnetic iron oxide particles (AMI-227) as a contrast agent for magnetic resonance (MR) lymphography and to assess their efficacy for the differentiation of metastatic and benign nodes in patients with urologic and pelvic cancer.

MATERIALS AND METHODS:

Thirty adults suspected of having lymph node metastases underwent MR imaging before and 22-26 hours after intravenous infusion of AMI-227 (1.7 mg Fe/kg). Sixty histopathologically proved lymph nodes were analyzed on MR images, and 29 of these nodes were also analyzed quantitatively.

RESULTS:

AMI-227 was well tolerated with no major side effects. It allowed the detection of 10 additional nodes relative to those detected at MR imaging without AMI-227. None of the 27 metastatic nodes showed a decrease in signal intensity (SI) on AMI-227-enhanced images; nine of 27 metastatic nodes showed an increase in SI on T1-weighted images, probably resulting from altered capillary permeability in the tumor. A visually perceptible reduction in SI, indicating active AMI-227 uptake, was observed on postcontrast T2- and T2*-weighted images in 16 of 21 benign nodes. The SI ratio of benign nodes was lower than that of metastatic nodes on T2- and T2*-weighted images. The sensitivity of AMI-227-enhanced MR lymphography was 100%, and the specificity was 80%.

CONCLUSION:

AMI-227 is safe and may facilitate the differentiation of metastatic and benign nodes in patients with urologic and pelvic cancers.

• Authors: M F Bellin, C Roy, K Kinkel, D Thoumas, S Zaim, D Vanel, C Tuchmann, F Richard, D Jacqmin, A Delcourt, E Challier, T Lebret, P Cluzel
• Journal: Radiology (Radiology) Vol. 207 Issue 3 Pg. 799-808 (Jun 1998) ISSN: 0033-8419 [Print] United States
• PMID: 9609907 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

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

Topics

• Adult
• Aged
• Aged, 80 and over
• Contrast Media (adverse effects)
• Dextrans
• Diagnosis, Differential
• Female
• Ferrosoferric Oxide
• France
• Humans
• Iron
• Lymphatic Metastasis
• Magnetic Resonance Imaging (instrumentation, methods, statistics & numerical data)
• Magnetite Nanoparticles
• Male
• Middle Aged
• Oxides
• Particle Size
• Pelvic Neoplasms (diagnosis)
• Safety
• Sensitivity and Specificity
• Urologic Neoplasms (diagnosis)