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Area of Science:

  • Neuroimaging
  • Radiology
  • Contrast Agents

Background:

  • Cellular uptake of manganese ions as MRI contrast agents can highlight disease processes.
  • Mangafodipir, a manganese chelate, is approved for liver lesion imaging.

Purpose of the Study:

  • To explore the enhancement profile of manganese in multiple sclerosis (MS) patients.
  • Investigate manganese as a potential contrast agent for MS lesion detection.

Main Methods:

  • A case series of 6 adult MS patients was studied.
  • Patients underwent baseline MRI with gadolinium, followed by mangafodipir injection.
  • Post-injection scans were performed at variable time points.

Main Results:

  • Ten out of fourteen new MS lesions showed manganese enhancement with varying characteristics.
  • Manganese enhancement was observed in lesions forming days after injection, persisting for weeks.
  • Some lesions displayed diffuse manganese enhancement larger than gadolinium enhancement or T2-FLAIR abnormalities.

Conclusions:

  • This study demonstrates the first use of a manganese-based contrast agent for enhancing MS lesions.
  • Manganese contrast agents exhibit a distinct temporal and spatial enhancement profile compared to gadolinium.
  • Further research is needed to elucidate manganese uptake mechanisms and cell specificity in MS lesions.