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- Title
Super High Contrast USPIO-Enhanced Cerebrovascular Angiography Using Ultrashort Time-to-Echo MRI.
- Authors
Timms, Liam; Zhou, Tianyi; Qiao, Ju; Gharagouzloo, Codi; Mishra, Vishala; Lahoud, Rita Maria; Chen, John W.; Harisinghani, Mukesh; Sridhar, Srinivas
- Abstract
Background. Ferumoxytol (Ferahame, AMAG Pharmaceuticals, Waltham, MA) is increasingly used off-label as an MR contrast agent due to its relaxivity and safety profiles. However, its potent T2 ∗ relaxivity limits achievable T1-weighted positive contrast and leads to artifacts in standard MRI protocols. Optimization of protocols for ferumoxytol deployment is necessary to realize its potential. Methods. We present first-in-human clinical results of the Quantitative Ultrashort Time-to-Echo Contrast Enhanced (QUTE-CE) MRA technique using the superparamagnetic iron oxide nanoparticle agent ferumoxytol for vascular imaging of the head/brain in 15 subjects at 3.0T. The QUTE-CE MRA method was implemented on a 3T scanner using a stack-of-spirals 3D Ultrashort Time-to-Echo sequence. Time-of-flight MRA and standard TE T1-weighted (T1w) images were also collected. For comparison, gadolinium-enhanced blood pool phase images were obtained retrospectively from clinical practice. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and intraluminal signal heterogeneity (ISH) were assessed and compared across approaches with Welch's two-sided t -test. Results. Fifteen volunteers (54 ± 17 years old, 9 women) participated. QUTE-CE MRA provided high-contrast snapshots of the arterial and venous networks with lower intraluminal heterogeneity. QUTE-CE demonstrated significantly higher SNR (1707 ± 226), blood-tissue CNR (1447 ± 189), and lower ISH (0.091 ± 0.031) compared to ferumoxytol T1-weighted (551 ± 171 ; 319 ± 144 ; 0.186 ± 0.066 , respectively) and time-of-flight (343 ± 104 ; 269 ± 82 ; 0.190 ± 0.016 , respectively), with p < 0.001 in each comparison. The high CNR increased the depth of vessel visualization. Vessel lumina were captured with lower heterogeneity. Conclusion. Quantitative Ultrashort Time-to-Echo Contrast-Enhanced MR angiography provides approximately 5-fold superior contrast with fewer artifacts compared to other contrast-enhanced vascular imaging techniques using ferumoxytol or gadolinium, and to noncontrast time-of-flight MR angiography, for clinical vascular imaging. This trial is registered with NCT03266848.
- Subjects
CEREBRAL angiography; IRON oxide nanoparticles; DIAGNOSTIC imaging; T-test (Statistics); MEDICAL quality control; BRAIN; RADIOLOGIC technology; CHEMICAL elements; HEAD; RETROSPECTIVE studies; MAGNETIC resonance angiography; MEDICAL records; ACQUISITION of data; CORONARY angiography; COMPARATIVE studies; CONTRAST media; SENSITIVITY &; specificity (Statistics)
- Publication
International Journal of Biomedical Imaging, 2024, Vol 2024, p1
- ISSN
1687-4188
- Publication type
Article
- DOI
10.1155/2024/9763364