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The use of ferumoxytol for high-resolution vascular imaging and troubleshooting for abdominal allografts

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Abstract

Ferumoxytol is an ultrasmall superparamagnetic iron oxide which has been used as an off-label intravenous contrast agent for MRI. Unlike gadolinium-based contrast agents, ferumoxytol remains in the intravascular space with a long half-life of 14–21 h. During the first several hours, it acts as a blood-pool agent and has minimal parenchymal enhancement. Studies have shown adequate intravascular signal for up to 72 h after initial contrast bolus. Ferumoxytol has been shown to be safe, even in patients with renal failure. Ferumoxytol has shown promise in a variety of clinical settings. The exquisite resolution enabled by the long intravascular times and lack of background parenchymal enhancement is of particular interest in the vascular imaging of solid organ allografts. Ferumoxytol magnetic resonance angiography (MRA) may identify clinically actionable findings months before ultrasound, CT angiography, or Gadolinium-enhanced MRA. Ferumoxytol MRA is of particular benefit as a troubleshooting tool in the setting of equivocal ultrasound and CT imaging. In the following review, we highlight the use of ferumoxytol for high-resolution MR vascular imaging for abdominal solid organ allografts, with representative cases.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic in Arizona, Phoenix, AZ, USA

    Amar Shah, Anshuman Panda & Ghaneh Fananapazir

  2. University of Arizona School of Medicine, Phoenix, AZ, USA

    Easton Neitzel

  3. Department of Medical Physics, Mayo Clinic in Arizona, Phoenix, AZ, USA

    Anshuman Panda

  4. Department of Radiology, University of California Davis School of Medicine, Sacramento, CA, USA

    Ghaneh Fananapazir

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  1. Amar Shah
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Contributions

Amar Shah, MD MPHS completed the literature review, case image acquisition, and drafting of the manuscript. Easton Neitzel completed the literature review and assisted in drafting of the manuscript. Ghaneh Fananapazir, MD assisted in literature review, drafting of the manuscript, and identification case images for use in review. Anshuman Panda, PhD, provided technical expertise and assisted in the drafting of the manuscript.

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Correspondence to Amar Shah.

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Shah, A., Neitzel, E., Panda, A. et al. The use of ferumoxytol for high-resolution vascular imaging and troubleshooting for abdominal allografts. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04268-x

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