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MR imaging of mediastinal lymph nodes: evaluation using a superparamagnetic contrast agent
H K Pannu1, K P Wang, T L Borman
1Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Journal of Magnetic Resonance Imaging : JMRI
|December 6, 2000
Summary
Ultrasmall superparamagnetic iron oxide (ferumoxtran-10) can alter lymph node signal intensity in lung cancer patients. However, a lack of signal change in T2-weighted MR images is not specific for malignancy.
Area of Science:
- Medical Imaging
- Oncology
- Radiology
Background:
- Accurate characterization of lymph nodes is crucial for lung cancer staging.
- Magnetic Resonance (MR) imaging offers potential for non-invasive lymph node assessment.
Purpose of the Study:
- To evaluate the utility of ultrasmall superparamagnetic iron oxide (ferumoxtran-10) as an intravenous MR contrast agent for characterizing lymph nodes in lung cancer patients.
Main Methods:
- Twelve patients with known or suspected lung cancer underwent pre- and postcontrast MR scans of the chest.
- Signal intensity analysis and bronchoscopic fine needle aspiration were performed.
- T1-weighted, T2-weighted, and gradient-echo MR sequences were utilized.
Main Results:
- Ferumoxtran-10 altered lymph node signal intensity.
- A lack of signal intensity change on T2-weighted images was observed in all four patients with biopsy-proven lung cancer.
- This lack of signal change was also seen in some patients with benign disease, resulting in 100% sensitivity but only 37.5% specificity for tumor involvement.
Conclusions:
- Ferumoxtran-10 can change lymph node signal intensity on MR images.
- Lack of signal change is not a definitive indicator of malignancy, as it can also occur with inflammatory changes.
- Further studies with larger patient cohorts are needed to fully define the role of ferumoxtran-10 in lung cancer lymph node characterization.