Contrast-enhanced MRI lights up prostate nodes
Dutch hospital demonstrates repeatable accuracy of USPIO-based protocol on metastastic lesions
Fexumoxtran-10-enhanced MRI is as accurate for detecting the lymphatic spread of prostate cancer when performed in a community hospital as it is in academic settings.
A prospective trial involving 120 patients at Catherina Hospital in Eindhoven, the Netherlands, found that MRI enhanced with the iron oxide nanoparticle was 89% sensitive and 99% specific for differentiating between metastatic and nonmetastatic prostate lymph nodes.
Its negative and positive predictive values were 94% and 98%, respectively.
Ferumoxtran-10-enhanced MRI comfortably outperformed multislice CT. It was 44% sensitive and 96% specific to metastatic nodes. Its positive and negative predictive values were 67% and 91%, respectively.
The results are not surprising to radiologists familiar with the long research history of ferumoxtran-10. In 2003, researchers at Massachusetts General Hospital established that the agent was 100% sensitive on a patient basis and 90% sensitive on a nodal basis for this application. (NEJM 2003; 348(25): 2491-2499).
The more recent Catherina Hospital trial demonstrates that this performance can be duplicated by nonexpert physicians.
"The trial shows the value of this protocol in a community hospital among physicians who previously did not have experience with it. Only a small learning curve is involved," said Dr. Harrie van den Bosch, director of cardiovascular MRI at Catharina.
The Catherina Hospital study is part of a multicenter Dutch trial involving more than 400 patients. Staff radiologist Dr. Alette Wilhelmina Daniels-Gooszen presented the team's results at the 2006 International Society for Magnetic Resonance in Medicine meeting held in Seattle in May.
Ferumoxtran-10 consists of dextran-coated iron oxide particles averaging 10 nm in diameter. Macrophages take up the agent following intravenous administration and then transport it to lymph nodes involved to aid in diagnosing metastatic activity.
Developed by Advanced Magnetics in Cambridge, MA, the MRI contrast agent was licensed for distribution by Cytogen in the U.S. under the trade name Combidex and to Guerbet in Europe under the name Sinerem.
The FDA issued an approvable letter, subject to certain conditions, for Combidex in March 2005. Advanced Magnetics is seeking a broad indication for the differentiation of metastatic from nonmetastatic lymph nodes in all cancers. The company plans to respond to an FDA request for more clinical performance data before year's end.
Sinerem is moving toward European Commission approval and may achieve it by 2008, according to Daniels-Gooszen.
Can Contrast-Enhanced Mammography be a Viable Screening Alternative to Breast MRI?
June 17th 2025While the addition of contrast-enhanced mammography (CEM) to digital breast tomosynthesis (DBT) led to over a 13 percent increase in false positive cases, researchers also noted over double the cancer yield per 1,000 women in comparison to DBT alone.
FDA Clears Enhanced MRI-Guided Laser Ablation System
June 5th 2025An alternative to an open neurosurgical approach, the Visualase V2 MRI-Guided Laser Ablation System reportedly utilizes laser interstitial thermal therapy (LITT) for targeted soft tissue ablation in patients with brain tumors and focal epilepsy.
Possible Real-Time Adaptive Approach to Breast MRI Suggests ‘New Era’ of AI-Directed MRI
June 3rd 2025Assessing the simulated use of AI-generated suspicion scores for determining whether one should continue with full MRI or shift to an abbreviated MRI, the authors of a new study noted comparable sensitivity, specificity, and positive predictive value for biopsies between the MRI approaches.
