Ferumoxytol-Enhanced MRI Is Not Inferior to Gadolinium-Enhanced MRI in Detecting Intracranial Metastatic Disease and Metastasis Size.
Ferumoxytol-Enhanced MRI Is Not Inferior to Gadolinium-Enhanced MRI in Detecting Intracranial Metastatic Disease and Metastasis Size.
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DOI：
10.2214/ajr.19.22187
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发表时间：
2020-12
期刊：
影响因子：
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通讯作者：
Neuwelt EA
中科院分区：
文献类型：
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作者：
Hamilton BE;Barajas R;Nesbit GM;Fu R;Ambady P;Taylor M;Neuwelt EA
这项个体内比较研究的目的是研究在检测颅内转移性疾病方面，ferumoxytol增强MRI是否与标准治疗钆增强MRI一样有效。我们回顾性分析了所有接受影像学检查的患者，作为两项正在进行的ferumoxytol增强和钆增强MRI方案研究的一部分，以比较增强转移性病灶的数量和大小。两名神经放射科医生独立测量ferumoxytol增强MR图像和对照钆增强MR图像上的增强转移。转移的数量和大小在个体内进行比较。记录初步诊断。使用线性混合效应模型比较钆增强和ferumoxytol增强MRI之间体积的立方根差异。使用符号秩检验来评估评审员之间的差异。分析了19例脑转移瘤患者的MR图像（7例肺癌、3例乳腺癌、3例黑色素瘤、2例卵巢癌、1例结肠癌、1例肾细胞癌、1例类癌肿瘤和1例子宫癌）。评审员1在ferumoxytol增强MRI上识别出77个肿块，在钆增强MRI上识别出72个肿块。评审员2在ferumoxytol增强MRI上识别出83个肿块，在钆增强MRI上识别出78个肿块。对于审查者1，与钆增强MRI相比，ferumoxytol增强MRI显示每个平面的平均肿瘤尺寸大1.1 mm（p = 0.1887）。对于审查员2，ferumoxytol增强MRI显示每个平面上的平均肿瘤尺寸增大1.0 mm（p = 0.2892）。在造影剂或审查者之间未观察到转移瘤数量或肿瘤大小的显著差异。Ferumoxytol增强MRI对颅内转移性疾病的检测并不劣于钆增强MRI。如果钆增强MRI是禁忌的，那么Ferumoxytol增强MRI可以改善脑转移瘤患者的检查和监测。
The goal of this intraindividual comparison study was to investigate whether ferumoxytol-enhanced MRI is as effective as standard-of-care gadolinium-enhanced MRI in detecting intracranial metastatic disease. We retrospectively reviewed all patients who underwent imaging as part of two ongoing ferumoxytol-enhanced and gadolinium-enhanced MRI protocol studies to compare the number and size of enhancing metastatic lesions. Two neuroradiologists independently measured enhancing metastases on ferumoxytol-enhanced MR images and on control gadolinium-enhanced MR images. The number and size of metastases were compared on an intraindividual basis. Primary diagnoses were recorded. A linear mixed-effects model was used to compare differences in cubic root of volume between gadolinium-enhanced and ferumoxytol-enhanced MRI. A signed rank test was used to evaluate differences between reviewers. MR images from 19 patients with brain metastases were analyzed (seven with lung cancer, three with breast cancer, three with melanoma, two with ovarian cancer, one with colon cancer, one with renal cell carcinoma, one with carcinoid tumor, and one with uterine cancer). Reviewer 1 identified 77 masses on ferumoxytol-enhanced MRI and 72 masses on gadolinium-enhanced MRI. Reviewer 2 identified 83 masses on ferumoxytol-enhanced MRI and 78 masses on gadolinium-enhanced MRI. For reviewer 1, ferumoxytol-enhanced MRI showed a mean tumor size measuring 1.1 mm larger in each plane compared with gadolinium-enhanced MRI (p = 0.1887). For reviewer 2, ferumoxytol-enhanced MRI showed a mean tumor size measuring 1.0 mm larger in each plane (p = 0.2892). No significant differences in number of metastases or tumor sizes were observed between contrast agents or reviewers. Intracranial metastatic disease detection with ferumoxytol-enhanced MRI was not inferior to detection with gadolinium-enhanced MRI. Ferumoxytol-enhanced MRI could improve workup and monitoring of patients with brain metastases if gadolinium-enhanced MRI is contraindicated.