What is the clinical evidence from this study?

Study design: Review. Population: Cardiovascular disease. Intervention: Ultrasmall superparamagnetic particles of iron oxide (USPIO).

January 1, 2015Open Access

Vascular and plaque imaging with ultrasmall superparamagnetic particles of iron oxide

SAShirjel AlamCardiac Imaging CSColin StirratElectrophysiology JRJennifer RichardsNational Health Service

Key Result

Ultrasmall superparamagnetic particles of iron oxide (USPIO) contrast agents can detect cellular inflammation non-invasively using cardiovascular magnetic resonance imaging in cardiovascular diseases.

Structured PICO

Population

Patients and preclinical models with cardiovascular diseases involving inflammation (e.g., atherosclerosis, abdominal aortic aneurysms, stroke, myocardial infarction)

Intervention

Ultrasmall superparamagnetic particles of iron oxide (USPIO) contrast agents (e.g., ferumoxtran-10, ferumoxytol) for Cardiovascular Magnetic Resonance (CMR) imaging

Outcome

Detection of cellular inflammation (macrophage uptake) non-invasively using CMRsurrogate

USPIO-enhanced CMR is a promising non-invasive imaging technique for detecting and monitoring macrophage-driven inflammation in vascular diseases such as atherosclerosis and aneurysms.

Limitations

USPIO imaging can be affected by blooming artefact
High concentrations of USPIO can cause signal loss with T1 weighted sequences
Accumulation in the reticulo-endothelial system can affect neighbouring structures
Curvilinear relationship between area of signal intensity reduction and USPIO concentration makes determining overall macrophage burden challenging

Abstract

Cardiovascular Magnetic Resonance (CMR) has become a primary tool for non-invasive assessment of cardiovascular anatomy, pathology and function. Existing contrast agents have been utilised for the identification of infarction, fibrosis, perfusion deficits and for angiography. Novel ultrasmall superparamagnetic particles of iron oxide (USPIO) contrast agents that are taken up by inflammatory cells can detect cellular inflammation non-invasively using CMR, potentially aiding the diagnosis of inflammatory medical conditions, guiding their treatment and giving insight into their pathophysiology. In this review we describe the utilization of USPIO as a novel contrast agent in vascular disease.

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