Ferumoxtran-10-Enhanced MR Lymphangiography: Does Contrast-Enhanced Imaging Alone Suffice for Accurate Lymph Node Characterization?

Harisinghani, Mukesh G.; Saksena, Mansi; Hahn, Peter F.; King, Benjamin; Kim, John; Torabi, Maha; Weissleder, Ralph

doi:10.2214/ajr.04.1287

Cited by 111 publications

(63 citation statements)

References 13 publications

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“…Several reports have addressed diagnostic criteria regarding benign and malignant lymph nodes (6,16,17). We found no disagreements between inflammatory nodes and a malignant node overtaken by tumors.…”

Section: Explanation Of Diagnostic Standardssupporting

confidence: 47%

“…The enhancement ratio of lymph nodes were analyzed by T1-weighted values, T2-weighted values, T2* time values, and T2 time values in previous studies (32)(33)(34). Studies have shown that T1SI enhances the fatty hilum of lymph nodes, which may simulate a metastatic deposit in postcontrast T2-weighted images (33).…”

Section: Possible Value Of T2 Enhancement Ratiomentioning

confidence: 99%

“…Studies have shown that T1SI enhances the fatty hilum of lymph nodes, which may simulate a metastatic deposit in postcontrast T2-weighted images (33). T2-weighted imaging can be a good subjective indicator reflecting enhancement levels, but it does not reflect actual T2 relaxation time changes due to varying prescan parameters and system stability (34). The T2* value was tested but its signal diminished quickly to background levels at longer TEs, which prohibits accurate calculation of T2* or R2' values (35).…”

Section: Possible Value Of T2 Enhancement Ratiomentioning

confidence: 99%

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Possible pathological basis for false diagnoses of lymph nodes by USPIO‐enhanced MRI in rabbits

Lei

Xue

et al. 2010

Magnetic Resonance Imaging

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Purpose: To determine the cause of misdiagnosis of lymph nodes in ultrasmall superparamagnetic iron oxide (USPIO) enhanced magnetic resonance imaging (MRI) using histological findings in rabbit tumor and inflammatory models.Materials and Methods: Thirty-six rabbits were randomly divided into inflammatory and tumor groups. MRI of the popliteal fossa was performed before and 24 hours after USPIO administration. Diagnoses of popliteal lymph nodes were evaluated based on dedicated criteria and were compared with histological and electronic microscopic findings.Results: There were 46 inflammatory and 26 metastatic lymph nodes. Sensitivity, specificity, and positive and negative predictive values of the diagnosis of nodal metastasis were 84.6%, 87.0%, 78.6%, and 90.9%, respectively. There were four false-negatives with subcapsular metastatic foci and six false-positives with predominant cortex and paracortex hyperplasia. Electron microscopy showed that in inflammatory nodes, cytophagic bubbles contain many USPIO particles, while in metastatic nodes they contained predominantly cellular residues.Conclusion: Diagnosis of lymph node malignancy is largely determined by the location and number of metastatic tumor cells. A profound understanding of the physiological role of macrophages in nodes with tumor burden will contribute to better diagnoses for clinical application. THE ACCURATE DETECTION of metastasis in lymph nodes is crucial for the prognosis and treatment plans of patients with malignant tumor. In the last few years ultrasmall superparamagnetic iron oxide (USPIO) agents have revolutionized lymph node imaging and have introduced functional imaging to conventional magnetic resonance imaging (MRI) (1-3). The nanoparticles are internalized by macrophages within the lymph nodes, and these intracellular iron-containing particles cause changes in magnetic properties detectable by MRI. These differences in signal intensity between normal and metastatic nodes can be easily detected visually (3). Several clinical studies have demonstrated that USPIO-enhanced MR is a particularly promising technique that improves the sensitivity and specificity of metastatic lymph node detection in pelvic, head and neck, chest, and other malignancies (2,4-13).Despite lots of promising results concerning USPIOenhanced MRI, there are still many important challenges to overcome, in which one problem is false-positive and false-negative results, affecting the accuracy of diagnosis (2,4-12). Harisinghani et al (2) reported that there were metastasis nodes that went undetected, and the false diagnosis was not negligible.In this work we established an animal model of inflammation and tumor in rabbit to thoroughly analyze the USPIO enhancement pattern of nodes. We used all types of images strictly paralleling the histologic microstructure of nodes in order to identify possible reasons for false diagnoses to refine the imaging diagnostic criteria of malignancy in lymph nodes. MATERIALS AND METHODS Animal ModelsThe experiments were performed using 36...

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Section: Explanation Of Diagnostic Standardssupporting

confidence: 47%

Section: Possible Value Of T2 Enhancement Ratiomentioning

confidence: 99%

Section: Possible Value Of T2 Enhancement Ratiomentioning

confidence: 99%

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Possible pathological basis for false diagnoses of lymph nodes by USPIO‐enhanced MRI in rabbits

Lei

Xue

et al. 2010

Magnetic Resonance Imaging

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“…The diffi culty in the detection of lymph nodes by this technique was considered to be due to the fact that the morphology and degree of distension of the stomach changed between the pre-and post-contrast T2*-weighted images, and this occurred likewise for the CT images, which were performed on different days. Harisinghani et al [31] emphasized that, in comparison to T2*-weighted images, T1-and T2-weighted images were more suitable for the identifi cation of lymph nodes because of the high spatial resolution. Therefore, we selected the method in which we detected lymph nodes on postcontrast T1-and T2-weighted images and evaluated them on post-contrast T2*-weighted images.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of lymph node metastases in gastric cancer using magnetic resonance imaging with ultrasmall superparamagnetic iron oxide (USPIO): diagnostic performance in post-contrast images using new diagnostic criteria

et al. 2008

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“…It has also been suggested that there is no significant difference in diagnostic precision between paired MRI and post-contrast MRI alone for an experienced reviewer (79). In this case, contrast material could be injected in the patient at a site remote from the MR suite, and the patient could return the next day for a single MRI examination.…”

Section: Sentinel Lymph Node Detection With Spio (Interstitial Mr Lymmentioning

confidence: 99%

A comprehensive literatures update of clinical researches of superparamagnetic resonance iron oxide nanoparticles for magnetic resonance imaging

Wáng

Idée

2017

Quant. Imaging Med. Surg.

199

116

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Ferumoxtran-10-Enhanced MR Lymphangiography: Does Contrast-Enhanced Imaging Alone Suffice for Accurate Lymph Node Characterization?

Abstract: On ferumoxtran-10-enhanced MR lymphangiography, contrast-enhanced images alone may suffice for lymph node characterization. However, a certain level of interpretation experience may be required before contrast-enhanced images can be used alone.

Cited by 111 publications

References 13 publications

Possible pathological basis for false diagnoses of lymph nodes by USPIO‐enhanced MRI in rabbits

Possible pathological basis for false diagnoses of lymph nodes by USPIO‐enhanced MRI in rabbits

Evaluation of lymph node metastases in gastric cancer using magnetic resonance imaging with ultrasmall superparamagnetic iron oxide (USPIO): diagnostic performance in post-contrast images using new diagnostic criteria

A comprehensive literatures update of clinical researches of superparamagnetic resonance iron oxide nanoparticles for magnetic resonance imaging

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