1. MRI Relaxometry for Quantitative Analysis of USPIO Uptake in Cerebral Small Vessel Disease.
- Author
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Thrippleton, Michael J., Blair, Gordon W., Valdes-Hernandez, Maria C., Glatz, Andreas, Semple, Scott I. K., Doubal, Fergus, Vesey, Alex, Marshall, Ian, Newby, David E., and Wardlaw, Joanna M.
- Subjects
CEREBRAL small vessel diseases ,MAGNETIC resonance imaging ,IRON oxides ,MACROPHAGES ,AORTIC aneurysms - Abstract
A protocol for evaluating ultrasmall superparamagnetic particles of iron oxide (USPIO) uptake and elimination in cerebral small vessel disease patients was developed and piloted. B
1 -insensitive R1 measurement was evaluated in vitro. Twelve participants with history of minor stroke were scanned at 3-T MRI including structural imaging, and R1 and R2 * mapping. Participants were scanned (i) before and (ii) after USPIO (ferumoxytol) infusion, and again at (iii) 24–30 h and (iv) one month. Absolute and blood-normalised changes in R1 and R2 * were measured in white matter (WM), deep grey matter (GM), white matter hyperintensity (WMH) and stroke lesion regions. R1 measurements were accurate across a wide range of values. R1 (p < 0.05) and R2 * (p < 0.01) mapping detected increases in relaxation rate in all tissues immediately post-USPIO and at 24–30 h. R2 * returned to baseline at one month. Blood-normalised R1 and R2 * changes post-infusion and at 24–30 h were similar, and were greater in GM versus WM (p < 0.001). Narrower distributions were seen with R2 * than for R1 mapping. R1 and R2 * changes were correlated at 24–30 h (p < 0.01). MRI relaxometry permits quantitative evaluation of USPIO uptake; R2 * appears to be more sensitive to USPIO than R1 . Our data are explained by intravascular uptake alone, yielding estimates of cerebral blood volume, and did not support parenchymal uptake. Ferumoxytol appears to be eliminated at 1 month. The approach should be valuable in future studies to quantify both blood-pool USPIO and parenchymal uptake associated with inflammatory cells or blood-brain barrier leak. [ABSTRACT FROM AUTHOR]- Published
- 2019
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