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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:1084-1088, May 2005
© 2005 American Society of Neuroradiology

BRAIN

Single-Dose Contrast Agent for Intraoperative MR Imaging of Intrinsic Brain Tumors by Using Ferumoxtran-10

Matthew A. Hunt^a, Attila G. Bagó^b and Edward A. Neuwelt^a

^a Department of Neurosurgery, Oregon Health and Science University, Portland, OR
^b Department of Neurology, Oregon Health and Science University, Portland, OR

Address correspondence to Edward A. Neuwelt, MD, 3181 SW Sam Jackson Park Road, Mailcode L603, Portland, OR 97239

BACKGROUND AND PURPOSE: Intraoperative MR imaging (IMRI) has advantages over conventional framed and frameless techniques. IMRI, however, also has some drawbacks, especially related to interpretation of gadolinium-enhanced intraoperative imaging resulting from surgically induced blood brain barrier injury, vascular changes, and hemorrhage. Ultra-small superparamagnetic iron particles like ferumoxtran-10 have a long plasma half-life and are trapped by reactive cells within the tumor. These trapped particles provide a method to demonstrate enhancing lesions without the artifact of repeat gadolinium administration in the face of blood brain barrier and vascular injury.

METHODS: We present a review of the literature and the cases of two patients who underwent surgery in which IMRI with ferumoxtran-10 was used.

RESULTS: Ultra-small superparamagnetic iron particles represent a method to demonstrate enhancing intrinsic brain tumors without the drawbacks of intraoperative gadolinium enhancement. These lesions appear even on low-field strength IMRI. Ferumoxtran-10, administered preoperatively, provides a stable imaging marker, even after surgical manipulation of the brain.

CONCLUSION: Fermumoxtran-10 provides a way to lessen artifactual enhancement during IMRI related to the administration of gadolinium.

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