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Ferumoxytol-enhanced MRI in patients with prior cardiac transplantation

Colin G Stirrat1, Shirjel Alam2, Thomas J MacGillivray3

  • 1Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.

Open Heart
|November 2, 2019
PubMed
Abstract

Insights

Ultra-small superparamagnetic particles of iron oxide (USPIO)-enhanced MRI shows higher myocardial T2 values in stable cardiac transplant patients, suggesting edema or fibrosis. USPIO-enhanced MRI appears normal, indicating no chronic inflammation, but its role in acute rejection needs further study.

Area of Science:

  • Cardiovascular Imaging
  • Biomedical Engineering
  • Radiology

Background:

  • Cardiac transplant rejection can be identified non-invasively using ultra-small superparamagnetic particles of iron oxide (USPIO)-enhanced MRI.
  • USPIO-enhanced MRI detects cellular inflammation within tissues.

Purpose of the Study:

  • Determine normal reference values for USPIO-enhanced MRI in cardiac transplant patients.
  • Examine USPIO-enhanced MRI's ability to detect myocardial inflammation in transplant rejection.

Main Methods:

  • 1.5T MRI including T2, T2*, and late gadolinium enhancement was performed on 10 volunteers and 11 cardiac transplant patients.
  • T2* imaging was repeated 24 hours post-USPIO (ferumoxytol) infusion at baseline and 3 months.

Main Results:

  • Stable cardiac transplant patients exhibited higher myocardial T2 values (53.8±5.2 ms) compared to healthy volunteers (48.6±1.9 ms; p=0.003).
  • No significant differences were observed in USPIO-induced R2* change between transplant patients and controls (26.6±7.3 vs 22.0±10.4 s⁻¹; p=0.28).
  • T2 values and USPIO-induced R2* changes remained stable at 3-month follow-up in transplant patients.

Conclusions:

  • Stable cardiac transplant patients show increased myocardial T2 values, potentially indicating edema or fibrosis.
  • USPIO-enhanced MRI appears normal and stable, suggesting an absence of chronic macrophage-driven inflammation.
  • Further research is needed to determine if USPIO-enhanced MRI can detect acute cardiac transplant rejection.
Keywords:
MRIUSPIOcardiaccardiac transplantinflammation

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