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Ferumoxytol in clinical practice: implications for MRI

Brendan J McCullough1, Orpheus Kolokythas, Jeffrey H Maki

  • 1Department of Radiology, University of Washington, Seattle, Washington 98195, USA. brenmcc@uw.edu

Journal of Magnetic Resonance Imaging : JMRI
|October 26, 2012
PubMed

Insights

Ferumoxytol, an iron deficiency anemia treatment, can significantly alter MRI scans for days or months due to its iron oxide composition. This can mask contrast enhancement, leading to nondiagnostic liver imaging.

Area of Science:

  • Radiology
  • Pharmacology
  • Medical Imaging

Background:

  • Ferumoxytol is an FDA-approved parenteral iron replacement therapy for iron deficiency anemia.
  • The drug contains superparamagnetic iron oxide particles with a long intravascular half-life.
  • These particles induce T1, T2, and T2* signal shortening in MRI.

Observation:

  • A patient underwent liver MRI 2 days after receiving ferumoxytol.
  • The radiology team was unaware of the ferumoxytol administration.
  • T1-weighted images showed hyperintensity in blood pools and soft tissues.

Findings:

  • Ferumoxytol administration resulted in obscured enhancement from gadolinium-based contrast agents.
  • The observed signal changes rendered the contrast-enhanced liver MRI nondiagnostic.
  • The effects of ferumoxytol on MRI can persist for days to months post-administration.

Implications:

  • Radiologists must be aware of ferumoxytol's potential to interfere with MRI interpretation.
  • Screening patients for recent ferumoxytol administration is crucial before MRI.
  • Understanding ferumoxytol's impact on MRI is essential for accurate diagnosis.

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