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01-09-2008 | Vascular-Interventional

MR imaging of thrombi using EP-2104R, a fibrin-specific contrast agent: initial results in patients

Authors: Elmar Spuentrup, Rene M. Botnar, Andrea J. Wiethoff, Tareq Ibrahim, Sebastian Kelle, Marcus Katoh, Murat Özgun, Eike Nagel, Josef Vymazal, Phil B. Graham, Rolf W. Günther, David Maintz

Published in: European Radiology | Issue 9/2008

Abstract

This study was an initial phase II trial in humans of molecular magnetic resonance (MR) imaging for improved visualization of thrombi in vessel territories potentially responsible for stroke using a new fibrin-specific contrast agent (EP-2104R). Eleven patients with thrombus in the left ventricle (n = 2), left or right atrium (n = 4), thoracic aorta (n = 4) or carotid artery (n = 1) as verified by an index examination (ultrasound, computed tomograpy, or conventional MR) were enrolled. All MR imaging was performed on 1.5 T whole-body MR-system using an inversion-recovery black-blood gradient-echo sequence. The same sequence was performed before and 2–6 h after low-dose intravenous administration of 4 μmol/kg EP-2104R. Two investigators assessed image quality and signal amplification. Furthermore, contrast-to-noise ratios (CNR) between the clot and the blood pool/surrounding soft tissue before and after administration of the contrast agent were compared using Student’s t-test. MR imaging and data analysis were successfully completed in 10 patients. No major adverse effects occurred. On enhanced images, thrombi demonstrated high signal amplification, typically at the clot surface, with a significantly increased contrast in comparison to the surrounding blood pool and soft tissue (CNR for clot vs. blood pool, unenhanced and enhanced: 6 ± 8 and 29 ± 14; CNR for clot vs. soft tissue, unenhanced and enhanced: 0 ± 4 and 21 ± 13; P < 0.01 for both comparisons). EP-2104R allows for molecular MR imaging of thrombi potentially responsible for stroke. High contrast between thrombus and surrounding blood and soft tissues can be achieved with enhanced imaging.

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Title: MR imaging of thrombi using EP-2104R, a fibrin-specific contrast agent: initial results in patients
Authors: Elmar Spuentrup
Rene M. Botnar
Andrea J. Wiethoff
Tareq Ibrahim
Sebastian Kelle
Marcus Katoh
Murat Özgun
Eike Nagel
Josef Vymazal
Phil B. Graham
Rolf W. Günther
David Maintz
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: European Radiology / Issue 9/2008
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-008-0965-2

At a glance: The STEP trials

Springer Medicine

MR imaging of thrombi using EP-2104R, a fibrin-specific contrast agent: initial results in patients

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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