Improved Detection of Bone Metastases in Children and Young Adults with Ferumoxytol-enhanced MRI

作者：Ali Rashidi, Lucia Baratto, Ashok J. Theruvath, Elton B. Greene, Praveen Jayapal, K. Elizabeth Hawk, Rong Lü, Jayne Seekins, Sheri L. Spunt, Allison Pribnow, Heike E. Daldrup‐Link · 发表于：Radiology Imaging Cancer · 年份：2023 · DOI：10.1148/rycan.220080 · 被引用次数：13 · 研究领域：MRI in cancer diagnosis、Bone and Joint Diseases、Advanced MRI Techniques and Applications

Purpose To evaluate if ferumoxytol can improve the detection of bone marrow metastases at diffusion-weighted (DW) MRI in pediatric and young adult patients with cancer. Materials and Methods In this secondary analysis of a prospective institutional review board–approved study (ClinicalTrials.gov identifier NCT01542879), 26 children and young adults (age range: 2–25 years; 18 males) underwent unenhanced or ferumoxytol-enhanced whole-body DW MRI between 2015 and 2020. Two reviewers determined the presence of bone marrow metastases using a Likert scale. One additional reviewer measured signal-to-noise ratios (SNRs) and tumor-to-bone marrow contrast. Fluorine 18 (18F) fluorodeoxyglucose (FDG) PET and follow-up chest CT, abdominal and pelvic CT, and standard (non–ferumoxytol enhanced) MRI served as the reference standard. Results of different experimental groups were compared using generalized estimation equations, Wilcoxon rank sum test, and Wilcoxon signed rank test. Results The SNR of normal bone marrow was significantly lower at ferumoxytol-enhanced MRI compared with unenhanced MRI at baseline (21.380 ± 19.878 vs 102.621 ± 94.346, respectively; P = .03) and after chemotherapy (20.026 ± 7.664 vs 54.110 ± 48.022, respectively; P = .006). This led to an increased tumor-to-marrow contrast on ferumoxytol-enhanced MRI scans compared with unenhanced MRI scans at baseline (1397.474 ± 938.576 vs 665.364 ± 440.576, respectively; P = .07) and after chemotherapy (1099.205 ± 864.604 vs 500...