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Open Access 01-07-2019 | Magnetic Resonance Imaging | Magnetic Resonance

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

Authors: Sokratis Stoumpos, Martin Hennessy, Alex T. Vesey, Aleksandra Radjenovic, Ram Kasthuri, David B. Kingsmore, Patrick B. Mark, Giles Roditi

Published in: European Radiology | Issue 7/2019

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.

Key Points

• Ferumoxytol is used off-label as an MRI contrast agent but dose-related data are lacking.

• In patients with CKD requiring MR angiography, a dose of 3 mg/kg provides excellent vascular enhancement.

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Title: Ferumoxytol magnetic resonance angiography: a dose-finding study in patients with chronic kidney disease
Authors: Sokratis Stoumpos
Martin Hennessy
Alex T. Vesey
Aleksandra Radjenovic
Ram Kasthuri
David B. Kingsmore
Patrick B. Mark
Giles Roditi
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Angiography
MR Angiography
Chronic Kidney Disease
Published in: European Radiology / Issue 7/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06137-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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