Open AccessHow to stop using gadolinium chelates for magnetic resonance imaging: clinical-translational experiences with ferumoxytol
Author(s) -
Heike E. DaldrupLink,
Ashok J. Theruvath,
Ali Rashidi,
Cassia Michael,
Robbie G. Majzner,
Sheri L. Spunt,
Stuart B. Goodman,
Michael E. Moseley
Publication year - 2021
Publication title -
pediatric radiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.748
H-Index - 86
eISSN - 1432-1998
pISSN - 0301-0449
DOI - 10.1007/s00247-021-05098-5
Subject(s) - ferumoxytol , gadolinium , medicine , magnetic resonance imaging , biodistribution , neuroradiology , mri contrast agent , food and drug administration , radiology , nuclear medicine , neurology , pharmacology , chemistry , biochemistry , organic chemistry , psychiatry , in vitro
Gadolinium chelates have been used as standard contrast agents for clinical MRI for several decades. However, several investigators recently reported that rare Earth metals such as gadolinium are deposited in the brain for months or years. This is particularly concerning for children, whose developing brain is more vulnerable to exogenous toxins compared to adults. Therefore, a search is under way for alternative MR imaging biomarkers. The United States Food and Drug Administration (FDA)-approved iron supplement ferumoxytol can solve this unmet clinical need: ferumoxytol consists of iron oxide nanoparticles that can be detected with MRI and provide significant T1- and T2-signal enhancement of vessels and soft tissues. Several investigators including our research group have started to use ferumoxytol off-label as a new contrast agent for MRI. This article reviews the existing literature on the biodistribution of ferumoxytol in children and compares the diagnostic accuracy of ferumoxytol- and gadolinium-chelate-enhanced MRI. Iron oxide nanoparticles represent a promising new class of contrast agents for pediatric MRI that can be metabolized and are not deposited in the brain.