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USPIOs as Targeted Contrast Agents in Cardiovascular Magnetic Resonance Imaging

  • Molecular Imaging (J. Wu and P. Nguyen, Section Editors)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We aim to discuss the diagnostic use of ultrasmall superparamagnetic iron oxide (USPIO) including ferumoxytol in targeted cardiovascular magnetic resonance imaging (MRI).

Recent Findings

Ferumoxytol is the only USPIO clinically available in the USA and is a negatively charged USPIO that has potential use for tracking and characterization of macrophage-infiltrated cardiovascular structures. As an iron supplement that is approved for treatment of iron deficiency anemia, the iron core of ferumoxytol is incorporated into the body once it is phagocytosed by macrophages. In organs or tissues with high-inflammatory cellular infiltration, such as atherosclerotic plaques and myocardial infarction, localization of iron-laden macrophages can be visualized on delayed MRI. The iron core of ferumoxytol alters the magnetic susceptibility and results in shortening of T2* and T2 relaxation rates. Areas with high concentration appear hypointense (negative contrast) on T2 and T2* MRI. Recently, in vitro findings support the potential specificity of ferumoxytol interactions with macrophage subtypes, which has implications for therapeutic interventions. With increasing concerns about gadolinium retention in the brain and other tissues, the value of ferumoxytol-enhanced MR for targeted clinical imaging is aided by its positive safety profile in patients with impaired renal function.

Summary

This paper discusses pharmacokinetic properties of USPIOs with a focus on ferumoxytol, and summarizes relevant in vitro, animal, and human studies investigating the diagnostic use of USPIOs in targeted contrast-enhanced imaging. We also discuss future directions for USPIOs as targeted imaging agents and associated challenges.

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Funding

Dr. Nguyen receives grant support from the American Heart Association (18TPA34170049), the National Heart, Lung, and Blood Institute (R01HL148182), and the Veterans Health Administration (VA-MERIT, I01-CX001901).

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Authors and Affiliations

  1. Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA, 90073, USA

    Yi Lu, Jenny Huang, Natalia V. Neverova & Kim-Lien Nguyen

  2. Diagnostic Cardiovascular Imaging Research Laboratory, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Jenny Huang & Kim-Lien Nguyen

  3. Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, Los Angeles, CA, USA

    Kim-Lien Nguyen

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  1. Yi Lu
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  2. Jenny Huang
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Correspondence to Kim-Lien Nguyen.

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No original experiments were completed in the context of this review paper. Where appropriate, the authors have referenced prior published work and obtain permission for reprint and re-use of figures.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Lu, Y., Huang, J., Neverova, N.V. et al. USPIOs as Targeted Contrast Agents in Cardiovascular Magnetic Resonance Imaging. Curr Cardiovasc Imaging Rep 14, 2 (2021). https://doi.org/10.1007/s12410-021-09552-8

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