FerumoxytolEnhanced MRI to Image Inflammation Wit

Authors: David M Hasan Matthew Amans Tarik Tihan Christopher Hess Yi Guo Soonmee Cha Hua Su Alastair J Martin Michael T Lawton Edward A Neuwelt David A Saloner William L Young

Publish Date: 2012/05/15

Volume: 3, Issue: 1, Pages: 166-173

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Abstract

Inflammation cell infiltration and cytokine expression are seen in the vascular walls and intervening stroma of resected brain arteriovenous malformation bAVM specimens even in unruptured and previously untreated lesions Macrophages may play a critical role in bAVM progression to rupture and could serve as a marker for rupture risk We assessed feasibility of imaging macrophages within the bAVM nidus using ferumoxytolenhanced magnetic resonance imaging MRI in four patients with already diagnosed bAVMs using ironsensitive imaging ISI T2 GE MRI sequence Patients were imaged at baseline and at either 1 day n = 2 or 5 days n = 2 after infusion of 5 mg/kg of ferumoxytol Residual intravascular ferumoxytol obscured evaluation for uptake in bAVM vascular walls and stroma at the 1day time point The two cases imaged at 5 days showed less intravascular tracer but had signal loss in the nidal region consistent with ferumoxytol localization One case underwent surgical resection there was prominent vascular wall CD68 staining Ferumoxytolenhanced MRI for assessing bAVM inflammatory cell burden appears feasible and has the potential to be developed as a biomarker to study lesional inflammatory events

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