Related Experiment Video

Updated: Jan 22, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

10.2K

Ferumoxytol-enhanced MRI for surveillance of pediatric cerebral arteriovenous malformations

Yuhao Huang1, Timothy G Singer1, Michael Iv2

  • 11Division of Pediatric Neurosurgery and.

Journal of Neurosurgery. Pediatrics
|July 20, 2019
PubMed
Abstract

Insights

Blood pool ferumoxytol-enhanced MRI (Fe-MRI) shows promise for monitoring pediatric arteriovenous malformations (AVMs). This noninvasive imaging technique performed similarly to digital subtraction angiography (DSA) in detecting residual or recurrent AVMs, offering a safer alternative for children.

Area of Science:

  • Pediatric Neuroradiology
  • Vascular Imaging
  • Medical Imaging

Background:

  • Children with intracranial arteriovenous malformations (AVMs) require regular surveillance.
  • Digital subtraction angiography (DSA) is the current standard but involves significant radiation exposure.
  • Minimizing radiation risk in pediatric patients is crucial due to long-term health implications.

Purpose of the Study:

  • To evaluate the efficacy of MRI enhanced with a blood pool ferumoxytol (Fe) contrast agent (Fe-MRI) for surveillance of residual or recurrent intracranial AVMs in children.
  • To compare the diagnostic performance of Fe-MRI with digital subtraction angiography (DSA).
  • To assess the potential of Fe-MRI as a noninvasive alternative to DSA.

Main Methods:

  • Retrospective cohort study of pediatric patients with AVMs who underwent both DSA and 3-T Fe-MRI surveillance.
  • Independent assessment of Fe-enhanced spoiled gradient recalled acquisition in steady state (Fe-SPGR) and arterial spin labeling (ASL) MRI sequences by blinded neuroradiologists.
  • DSA served as the gold standard for comparison; radiation exposure from DSA was quantified.

Main Results:

  • Fe-SPGR MRI demonstrated excellent agreement with DSA (κ = 1.00) for AVM surveillance.
  • Fe-SPGR MRI achieved 100% sensitivity and 100% specificity in detecting residual AVMs.
  • Arterial spin labeling (ASL) showed poorer agreement (κ = 0.53) and lower sensitivity (72%) compared to Fe-SPGR and DSA.
  • Fe-MRI provided high diagnostic confidence for radiologists.

Conclusions:

  • Fe-MRI, particularly Fe-SPGR sequences, is a highly accurate and reliable tool for surveillance of residual or recurrent intracranial AVMs in children.
  • Fe-MRI offers a noninvasive alternative to DSA, significantly reducing radiation exposure for pediatric patients.
  • Further multicenter studies are warranted to confirm the efficacy of Fe-MRI in broader clinical practice.
Keywords:
ASLAVMDSAMRIarterial spin labelingarteriovenous malformationferumoxytolperfusionvascular disorders

More Related Videos

Whole-body PET/MRI of Pediatric Patients: The Details That Matter10:02

Whole-body PET/MRI of Pediatric Patients: The Details That Matter

Published on: December 19, 2017

15.2K
Induction and Micro-CT Imaging of Cerebral Cavernous Malformations in Mouse Model05:12

Induction and Micro-CT Imaging of Cerebral Cavernous Malformations in Mouse Model

Published on: September 4, 2017

11.3K

Related Concept Videos

Principles of Disease Surveillance01:26

Principles of Disease Surveillance

Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
479
Immune Surveillance by NK Cells and Phagocytes01:25

Immune Surveillance by NK Cells and Phagocytes

Immune surveillance is an integral part of the innate immune system, involving the continuous monitoring of peripheral tissues to detect and respond to pathogens, infected cells, or cancerous cells. This surveillance is conducted primarily by natural killer (NK) cells and phagocytes, which employ distinct but complementary mechanisms to identify and eliminate threats.
Natural Killer Cells: The Fast Responders
NK cells are large granular lymphocytes found in the blood and lymphatic system. These...
7.9K
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
214
Self-Evaluation: Self-Enhancement and Self-Verification03:00

Self-Evaluation: Self-Enhancement and Self-Verification

Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...
5.7K
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
263
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
196