Cargando…

Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

OBJECTIVES: Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) agent that is taken up by splenic tissue. This study describes our initial institutional experience of ferumoxytol-enhanced MRI (feMRI) for differentiating intrapancreatic splenules (IPS) from other pancreatic lesions. ME...

Descripción completa

Detalles Bibliográficos
Autores principales: Muehler, M. R., Rendell, V. R., Bergmann, L. L., Winslow, E. R., Reeder, S. B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131292/
https://www.ncbi.nlm.nih.gov/pubmed/33377995
http://dx.doi.org/10.1007/s00261-020-02883-y
_version_ 1783694676932427776
author Muehler, M. R.
Rendell, V. R.
Bergmann, L. L.
Winslow, E. R.
Reeder, S. B.
author_facet Muehler, M. R.
Rendell, V. R.
Bergmann, L. L.
Winslow, E. R.
Reeder, S. B.
author_sort Muehler, M. R.
collection PubMed
description OBJECTIVES: Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) agent that is taken up by splenic tissue. This study describes our initial institutional experience of ferumoxytol-enhanced MRI (feMRI) for differentiating intrapancreatic splenules (IPS) from other pancreatic lesions. METHODS: In this retrospective study, patients with computed tomographic imaging that identified small enhancing lesions in the tail of the pancreas subsequently underwent feMRI for further characterization. The feMRI protocol included T2-weighted (T2w) imaging with and without fat suppression (FS), R2* mapping, diffusion-weighted imaging (DWI), and T1-weighted (T1w) imaging with FS, prior to contrast injection. Immediately after slow intravenous infusion with 3 mg/kg body weight ferumoxytol, T1w was repeated. Delayed imaging with all sequences were obtained 24–72 h after ferumoxytol administration. RESULTS: Seven patients underwent feMRI. In two patients, the pancreatic lesions were presumed as pancreatic neuroendocrine tumor (PNET) from feMRI and in the remaining 5 IPS. One of the two patients with PNET was symptomatic for NET. In another symptomatic patient with pathologically proven duodenal NET and suspected PNET, the pancreatic lesion was proven to be an IPS on feMRI. IPS demonstrated strong negative enhancement in feMRI on T2w and increased R2* values consistent with splenic tissue, while the presumed PNETs did not enhance. T2w FS was helpful on the pre-contrast images to identify IPS, while R2* did on post-contrast images. Neither DWI nor T1w contributed to differentiating PNETs from IPS. CONCLUSIONS: This study demonstrates the potential utility of feMRI as a helpful adjunct diagnostic tool for differentiating IPS from other pancreatic lesions. Further studies in larger patient cohorts are needed.
format Online
Article
Text
id pubmed-8131292
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-81312922021-05-24 Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors Muehler, M. R. Rendell, V. R. Bergmann, L. L. Winslow, E. R. Reeder, S. B. Abdom Radiol (NY) Pancreas OBJECTIVES: Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) agent that is taken up by splenic tissue. This study describes our initial institutional experience of ferumoxytol-enhanced MRI (feMRI) for differentiating intrapancreatic splenules (IPS) from other pancreatic lesions. METHODS: In this retrospective study, patients with computed tomographic imaging that identified small enhancing lesions in the tail of the pancreas subsequently underwent feMRI for further characterization. The feMRI protocol included T2-weighted (T2w) imaging with and without fat suppression (FS), R2* mapping, diffusion-weighted imaging (DWI), and T1-weighted (T1w) imaging with FS, prior to contrast injection. Immediately after slow intravenous infusion with 3 mg/kg body weight ferumoxytol, T1w was repeated. Delayed imaging with all sequences were obtained 24–72 h after ferumoxytol administration. RESULTS: Seven patients underwent feMRI. In two patients, the pancreatic lesions were presumed as pancreatic neuroendocrine tumor (PNET) from feMRI and in the remaining 5 IPS. One of the two patients with PNET was symptomatic for NET. In another symptomatic patient with pathologically proven duodenal NET and suspected PNET, the pancreatic lesion was proven to be an IPS on feMRI. IPS demonstrated strong negative enhancement in feMRI on T2w and increased R2* values consistent with splenic tissue, while the presumed PNETs did not enhance. T2w FS was helpful on the pre-contrast images to identify IPS, while R2* did on post-contrast images. Neither DWI nor T1w contributed to differentiating PNETs from IPS. CONCLUSIONS: This study demonstrates the potential utility of feMRI as a helpful adjunct diagnostic tool for differentiating IPS from other pancreatic lesions. Further studies in larger patient cohorts are needed. Springer US 2020-12-30 2021 /pmc/articles/PMC8131292/ /pubmed/33377995 http://dx.doi.org/10.1007/s00261-020-02883-y Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Pancreas
Muehler, M. R.
Rendell, V. R.
Bergmann, L. L.
Winslow, E. R.
Reeder, S. B.
Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors
title Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors
title_full Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors
title_fullStr Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors
title_full_unstemmed Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors
title_short Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors
title_sort ferumoxytol-enhanced mr imaging for differentiating intrapancreatic splenules from other tumors
topic Pancreas
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131292/
https://www.ncbi.nlm.nih.gov/pubmed/33377995
http://dx.doi.org/10.1007/s00261-020-02883-y
work_keys_str_mv AT muehlermr ferumoxytolenhancedmrimagingfordifferentiatingintrapancreaticsplenulesfromothertumors
AT rendellvr ferumoxytolenhancedmrimagingfordifferentiatingintrapancreaticsplenulesfromothertumors
AT bergmannll ferumoxytolenhancedmrimagingfordifferentiatingintrapancreaticsplenulesfromothertumors
AT winslower ferumoxytolenhancedmrimagingfordifferentiatingintrapancreaticsplenulesfromothertumors
AT reedersb ferumoxytolenhancedmrimagingfordifferentiatingintrapancreaticsplenulesfromothertumors