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Borra RJ, Cho HS, Bowen SL, et al. Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model. EJNMMI Phys. 2015;2(1):6doi: 10.1186/s40658-015-0109-0.
Borra, R. J., Cho, H. S., Bowen, S. L., Attenberger, U., Arabasz, G., Catana, C., Josephson, L., Rosen, B. R., Guimaraes, A. R., & Hooker, J. M. (2015). Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model. EJNMMI physics, 2(1), 6. https://doi.org/10.1186/s40658-015-0109-0
Borra, Ronald Jh, et al. "Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model." EJNMMI physics vol. 2,1 (2015): 6. doi: https://doi.org/10.1186/s40658-015-0109-0
Borra RJ, Cho HS, Bowen SL, Attenberger U, Arabasz G, Catana C, Josephson L, Rosen BR, Guimaraes AR, Hooker JM. Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model. EJNMMI Phys. 2015 Dec;2(1):6. doi: 10.1186/s40658-015-0109-0. Epub 2015 Feb 26. PMID: 26501808; PMCID: PMC4544618.
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EJNMMI Phys. 2015 Dec;2(1):6. doi: 10.1186/s40658-015-0109-0. Epub 2015 Feb 26.

Effects of ferumoxytol on quantitative PET measurements in simultaneous PET/MR whole-body imaging: a pilot study in a baboon model.

EJNMMI physics

Ronald Jh Borra, Hoon-Sung Cho, Spencer L Bowen, Ulrike Attenberger, Grae Arabasz, Ciprian Catana, Lee Josephson, Bruce R Rosen, Alexander R Guimaraes, Jacob M Hooker

Affiliations

  1. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. [email protected].
  2. Medical Imaging Centre of Southwest Finland, Department of Diagnostic Radiology, University of Turku and Turku University Hospital, Turku, Finland. [email protected].
  3. Center for Advanced Medical Imaging Sciences, Massachusetts General Hospital, Charlestown, MA, USA. [email protected].
  4. School of Materials Science and Engineering, Chonnam National University, Gwangju, South Korea. [email protected].
  5. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. [email protected].
  6. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany. [email protected].
  7. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. [email protected].
  8. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. [email protected].
  9. Center for Advanced Medical Imaging Sciences, Massachusetts General Hospital, Charlestown, MA, USA. [email protected].
  10. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. [email protected].
  11. Department of Meridian & Acupuncture, Collaborating Center for Traditional Medicine, East-West Medical Research Institute and School of Korean Medicine, Kyung Hee University, Seoul, South Korea. [email protected].
  12. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. [email protected].
  13. Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. [email protected].
  14. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Suite 2301, Charlestown, MA, 02129, USA. [email protected].

PMID: 26501808 PMCID: PMC4544618 DOI: 10.1186/s40658-015-0109-0

Abstract

BACKGROUND: Simultaneous PET/MR imaging depends on MR-derived attenuation maps (mu-maps) for accurate attenuation correction of PET data. Currently, these maps are derived from gradient-echo-based MR sequences, which are sensitive to susceptibility changes. Iron oxide magnetic nanoparticles have been used in the measurement of blood volume, tumor microvasculature, tumor-associated macrophages, and characterizing lymph nodes. Our aim in this study was to assess whether the susceptibility effects associated with iron oxide nanoparticles can potentially affect measured (18)F-FDG PET standardized uptake values (SUV) through effects on MR-derived attenuation maps.

METHODS: The study protocol was approved by the Institutional Animal Care and Use Committee. Using a Siemens Biograph mMR PET/MR scanner, we evaluated the effects of increasing concentrations of ferumoxytol and ferumoxytol aggregates on MR-derived mu-maps using an agarose phantom. In addition, we performed a baboon experiment evaluating the effects of a single i.v. ferumoxytol dose (10 mg/kg) on the liver, spleen, and pancreas (18)F-FDG SUV at baseline (ferumoxytol-naïve), within the first hour and at 1, 3, 5, and 11 weeks.

RESULTS: Phantom experiments showed mu-map artifacts starting at ferumoxytol aggregate concentrations of 10 to 20 mg/kg. The in vivo baboon data demonstrated a 53% decrease of observed (18)F-FDG SUV compared to baseline within the first hour in the liver, persisting at least 11 weeks.

CONCLUSIONS: A single ferumoxytol dose can affect measured SUV for at least 3 months, which should be taken into account when administrating ferumoxytol in patients needing sequential PET/MR scans. Advances in knowledge 1. Ferumoxytol aggregates, but not ferumoxytol alone, produce significant artifacts in MR-derived attenuation correction maps at approximate clinical dose levels of 10 mg/kg. 2. When performing simultaneous whole-body (18)F-FDG PET/MR, a single dose of ferumoxytol can result in observed SUV decreases up to 53%, depending on the amount of ferumoxytol aggregates in the studied tissue. Implications for patient care Administration of a single, clinically relevant, dose of ferumoxytol can potentially result in changes in observed SUV for a prolonged period of time in the setting of simultaneous PET/MR. These potential changes should be considered in particular when administering ferumoxytol to patients with expected future PET/MR studies, as ferumoxytol-induced SUV changes might interfere with therapy assessment.

Keywords: Attenuation correction; Ferumoxytol; MRI; Multimodal imaging; PET; PET/MR

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