Intranodal signal suppression in pelvic MR lymphography of prostate cancer patients: a quantitative comparison of ferumoxtran-10 and ferumoxytol

Oscar A Debats; Ansje S Fortuin; Hanneke J M Meijer; Thomas Hambrock; Geert J S Litjens; Jelle O Barentsz; Henkjan J Huisman

doi:10.7717/peerj.2471

Intranodal signal suppression in pelvic MR lymphography of prostate cancer patients: a quantitative comparison of ferumoxtran-10 and ferumoxytol

PeerJ. 2016 Oct 20:4:e2471. doi: 10.7717/peerj.2471. eCollection 2016.

Authors

Oscar A Debats¹, Ansje S Fortuin², Hanneke J M Meijer³, Thomas Hambrock¹, Geert J S Litjens¹, Jelle O Barentsz¹, Henkjan J Huisman¹

Affiliations

¹ Department of Radiology and Nuclear Medicine, Radboudumc , Nijmegen , The Netherlands.
² Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands; Department of Radiology, Ziekenhuis Gelderse Vallei, Ede, The Netherlands.
³ Department of Radiation Oncology, Radboudumc , Nijmegen , The Netherlands.

Abstract

Objectives: The key to MR lymphography is suppression of T2* MR signal in normal lymph nodes, while retaining high signal in metastatic nodes. Our objective is to quantitatively compare the ability of ferumoxtran-10 and ferumoxytol to suppress the MR signal in normal pelvic lymph nodes.

Methods: In 2010, a set of consecutive patients who underwent intravenous MR Lymphography (MRL) were included. Signal suppression in normal lymph nodes in T2*-weighted images due to uptake of USPIO (Ultra-Small Superparamagnetic Particles of Iron Oxide) was quantified. Signal suppression by two USPIO contrast agents, ferumoxtran-10 and ferumoxytol was compared using Wilcoxon's signed rank test.

Results: Forty-four patients were included, of which all 44 had a ferumoxtran-10 MRL and 4 had additionally a ferumoxytol MRL. A total of 684 lymph nodes were identified in the images, of which 174 had been diagnosed as metastatic. USPIO-induced signal suppression in normal lymph nodes was significantly stronger in ferumoxtran-10 MRL than in ferumoxytol MRL (p < 0.005).

Conclusions: T2* signal suppression in normal pelvic lymph nodes is significantly stronger with ferumoxtran-10 than with ferumoxytol, which may affect diagnostic accuracy.

Keywords: Lymph node metastases; MR lymphography; Prostate cancer; USPIO contrast agents.

Grants and funding

This project was funded by Grant KUN2007-3971 from the Dutch Cancer Society. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.