Evaluation of renal quantitative T2* changes on MRI following administration of ferumoxytol as a T2* contrast agent

Abstract

Sandeep S Hedgire,1 Shaunagh McDermott,1 Gregory R Wojtkiewicz,1 Seyed Mahdi Abtahi,1 Mukesh Harisinghani,1 Jason L Gaglia21Center for Systems Biology, Massachusetts General Hospital, Richard B Simches Research Center, 2Joslin Diabetes Center, Boston, MA, USAPurpose: To evaluate the time-dependent changes in regional quantitative T2* maps of the kidney following intravenous administration of ferumoxytol.Materials and methods: Twenty-four individuals with normal kidney function underwent T2*-weighted MRI of the kidney before, immediately after, and 48 hours after intravenous administration of ferumoxytol at a dose of 4 mg/kg (group A, n=12) or 6 mg/kg (group B, n=12). T2* values were statistically analyzed using two-tailed paired t-tests.Results: In group A, the percentage changes from baseline to immediate post and baseline to 48 hours were 85.3% and 64.2% for the cortex and 90.8% and 64.6% for the medulla, respectively. In group B, the percentage changes from baseline to immediate post and baseline to 48 hours were 85.2% and 73.4% for the cortex and 94.5% and 74% for the medulla, respectively. This difference was significant for both groups (P<0.0001).Conclusion: There is significant and differential uptake of ferumoxytol in the cortex and medulla of physiologically normal kidneys. This differential uptake may offer the ability to interrogate renal cortex and medulla with possible clinical applications in medical renal disease and transplant organ assessment. We propose an organ of interest based dose titration of ferumoxytol to better differentiate circulating from intracellular ferumoxytol particles.Keywords: USPIO, ferumoxytol, renal MRI, T2* weighted imaging