Ferumoxytol magnetic resonance angiography: a dose-finding study in patients with chronic kidney disease

Stoumpos, S., Hennessy, M., Vesey, A. T., Radjenovic, A. , Kasthuri, R., Kingsmore, D. B., Mark, P. B. and Roditi, G. (2019) Ferumoxytol magnetic resonance angiography: a dose-finding study in patients with chronic kidney disease. European Radiology, 29(7), pp. 3543-3552. (doi: 10.1007/s00330-019-06137-4) (PMID:30919067)

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Abstract

Objectives: Ferumoxytol is an alternative to gadolinium-based compounds as a vascular contrast agent for magnetic resonance angiography (MRA), particularly for patients with chronic kidney disease (CKD). However, dose-related efficacy data are lacking. We aimed to determine the optimal (minimum effective) dose of ferumoxytol for MRA in patients with CKD. Methods: Ferumoxytol-enhanced MRA (FeMRA) was performed at 3.0 T in patients with CKD after dose increments up to a total of 4 mg/kg. Image quality was assessed by contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) in the abdominal aorta and inferior vena cava. Quadratic regression analyses were performed to estimate the effects of dose increments on CNR and SNR. Results: Twenty-three patients underwent FeMRA (mean age 60 [SD 13] years, 87% men, 48% had diabetic nephropathy) with cumulative doses of 0, 1, 2, 3 and 4 mg/kg of ferumoxytol. On regression analyses, a parabolic relationship was observed between ferumoxytol dose and signal with progressive signal loss using doses exceeding 4 mg/kg. A dose of 3 mg/kg achieved ≥ 75% of predicted peak CNR and SNR and images were deemed of excellent diagnostic quality. Conclusions: In patients with CKD undergoing FeMRA, a dose of 3 mg/kg provides excellent arterial and venous enhancement. The benefits of increasing the dose to a theoretically optimal value of 4 mg/kg appear to be negligible and likely of minimal, if any, diagnostic value.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Roditi, Dr Giles and Kasthuri, Dr Ram and Mark, Dr Patrick and Stoumpos, Dr Sokratis and Kingsmore, Mr David and Radjenovic, Dr Aleksandra
Authors: Stoumpos, S., Hennessy, M., Vesey, A. T., Radjenovic, A., Kasthuri, R., Kingsmore, D. B., Mark, P. B., and Roditi, G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:European Radiology
Publisher:Springer
ISSN:0938-7994
ISSN (Online):1432-1084
Published Online:27 March 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in European Radiology 29(7):3543-3552
Publisher Policy:Reproduced under a Creative Commons License

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