Comparison of ferumoxytol and gadolinium enhancement changes in response to Avastin in high grade glioma patients
Andrea Horváth1,2,3, Csanád Várallyay1, Daniel Schwartz1, Prakash Ambady1, Péter Bogner4, and Edward Neuwelt1

1Department of Neurology, Oregon Health and Science University, Portland, OR, United States, 2Department of Neurosurgery, University of Pécs, Pécs, Hungary, 3Diagnsotic Center of Pécs, Pécs, Hungary, 4Department of Radiology, University of Pécs, Pécs, Hungary

Synopsis

Ferumoxytol is an alternative, investigational, iron-based MRI contrast agent, which might be beneficial in the accurate diagnosis of treated glioma patients. In this study we investigated how gadolinium and 24 hour ferumoxytol enhancement change as a result of Avastin treatment. The enhancement volumes and normalized signal intensities before and after Avastin treatment were calculated with histogram analysis and were compared between contrast agents. Changes in enhancement volumes and in signal intensities in response to Avastin were not different between contrast agents. Ferumoxytol shows good potential in brain tumor imaging.

Purpose

To test the diagnostic performance of ferumoxytol, an iron-based contrast agent1, by comparing gadolinium and ferumoxytol enhancement in high grade glioma patients treated with Avastin.

Methods

Twenty high grade glioma patients (13 males, 7 females, mean age ± SD: 53.6 ± 10.3 years) with post- gadolinium and 24 hour post- ferumoxytol T1-weighted MR scans before and after Avastin treatment were enrolled in this retrospective study. Enhancement volumes and enhancement signal intensities normalized to white matter signal intensity were measured with histogram analysis. Enhancement volumes and signal intensities were compared between contrast agents and between pre- and post-Avastin scans with repeated measure two-way ANOVA analysis.

Results

Enhancement volume did not differ between contrast agents (P = 0.5246). On the other hand, gadolinium showed higher normalized enhancement signal intensities than ferumoxytol (P = 0.0002). Both enhancement volume and signal intensity decreased in response to Avastin treatment (P = 0.0002 and P = 0.0004, respectively). Changes in enhancement volumes and in signal intensities in response to Avastin were not different between contrast agents (P = 0.8081 and P = 0.6305, respectively).

Conclusion

Gadolinium and ferumoxytol enhancement showed similar changes in response to Avastin therapy. Ferumoxytol seems to perform well in the diagnosis follow up of treated glioma patients and it shows high potential as an alternative contrast agent.

Acknowledgements

No acknowledgement found.

References

1 E. A. Neuwelt, B. E. Hamilton, C. G. Varallyay, W. R. Rooney, R. D. Edelman, P. M. Jacobs, and S. G. Watnick, 'Ultrasmall Superparamagnetic Iron Oxides (Uspios): A Future Alternative Magnetic Resonance (Mr) Contrast Agent for Patients at Risk for Nephrogenic Systemic Fibrosis (Nsf)?', Kidney Int, 75 (2009), 465-74.

Figures

Pre-contrast T1-, post-gadolinium T1- and 24 hour post ferumoxytol T1-weighted scans from a high grade glioma patient before and after Avastin treatment.

Results of the two-way ANOVA analysis. A. Comparison of changes in enhancement volumes in response to Avastin. B. Comparison of changes in normalized enhancement signal intensities in response to Avastin.



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
4193