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AJNR - American Journal of Neuroradiology

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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

View larger version (59K): [in a new window]   FIG 1. Preoperative gadolinium-enhanced (A), ferumoxtran-10-enhanced (B), and intraoperative ferumoxtran-10-enhanced T1-weighted MR images (C) with arrow pointing to the enhancing lesion from patient 1. Panels B and C were obtained approximately 24 hours after ferumoxtran-10 administration.

View larger version (53K): [in a new window]   FIG 2. Preoperative gadolinium-enhanced (A), ferumoxtran-10-enhanced (B), and intraoperative ferumoxtran-10-enhanced T1-weighted MR images (C) from patient 2. Panels B and C were obtained approximately 24 hours after ferumoxtran-10 administration.

View larger version (49K): [in a new window]   FIG 3. Intraoperative post-resection T1-weighted MR image from patient 2, demonstrating residual enhancing lesion posteriorly (arrow). This lesion was then localized by using integrated frameless stereotaxy and resected.

View larger version (87K): [in a new window]   FIG 4. Postoperative T1-weighted MR imaging from patient 1 performed 72 hours after surgery, without (A) and with (B) gadolinium. No residual areas of significant gadolinium enhancement are seen.

View larger version (71K): [in a new window]   FIG 5. Postoperative T1-weighted MR imaging from patient 2 performed 24 hours after surgery, without (A) and with (B) gadolinium. No significant gadolinium-enhancing areas are seen, although they may be masked by residual T1 signal intensity. These images demonstrate the difficulty with postoperative imaging in the face of blood products and hemostatic agents.

View larger version (82K): [in a new window]   FIG 6. Photomicrograph of 10x (A) and 20x (B) views of patient 2’s tumor. Modified Perl’s stain with diaminobenzidine shows that iron does not stain the tumor cells, but does stain reactive cells, morphologically consistent with astrocytes (arrows).