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Ultrasmall superparamagnetic iron oxides (USPIOs): a future alternative magnetic resonance (MR) contrast agent for patients at risk for nephrogenic systemic fibrosis (NSF)?
Open accessAbstract
Gadolinium (Gd) based contrast agents (GBCAs) in magnetic resonance imaging (MRI) are used in daily clinical practice and appear safe in most patients; however, nephrogenic systemic fibrosis (NSF) is a recently recognized severe complication associated with GBCAs. It affects primarily patients with renal disease, such as stage 4 or 5 chronic kidney disease (CKD; glomerular filtration rate <30 ml/min per 1.73 m(2)), acute kidney injury, or kidney and liver transplant recipients with kidney dysfunction. Contrast-enhanced MRI and computed tomography (CT) scans provide important clinical information and influence patient management. An alternative contrast agent is needed to obtain adequate imaging results while avoiding the risk of NSF in this vulnerable patient group. One potential alternative is ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles, which provide enhancement characteristics similar to GBCAs. We review our experience in approximately 150 patients on the potential benefits of the USPIOs ferumoxtran-10 and ferumoxytol. We focus on central nervous system (CNS) MRI but also review imaging of other vascular beds. Safety studies, including USPIO administration (ferumoxytol) as iron supplement therapy in CKD patients on and not on dialysis, suggest that decreased kidney function does not alter the safety profile. We conclude that for both CNS MR imaging and MR angiography, USPIO agents like ferumoxytol are a viable option for patients at risk for NSF.
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“SPION with a hydrodynamic diameter of 20-30 nm, which are referred to as ultra-small superparamagnetic iron oxide (USPIO) [154], show a prolonged circulation time and therefore are favorable for lymphography [155], for imaging inflammation [140] and for blood pool imaging [156].”
From Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications (2019) · cites this paper as [154]
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Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications
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Metadata
- Authors
- Neuwelt, E. A., Hamilton, B. E., Varallyay, C. G., Rooney, W. R., Edelman, R. D., Jacobs, P. M., & Watnick, S. G.
- Affiliations
- Oregon Health & Science University (US)
- Northwestern University (US)
- National Cancer Institute (US)
- Corresponding author
- Neuwelt, Edward A.
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2009-03
- Volume
- 75
- Issue
- 5
- Pages
- 465-474
- ISSN
- 0085-2538 (ISSN-L)
- PMC
- PMC2643331
- OpenAlex
- W2069746446
- Cited by
- 267
- References
- 28
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 13 · 2023: 8 · 2022: 7 · 2021: 12 · 2020: 14 · 2019: 19 · 2018: 19 · 2017: 20 · 2016: 18 · 2015: 20 · 2014: 18 · 2013: 24 · 2012: 20
- FWCI
- 7.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Covis Pharma
- National Institutes of Health
- National Cancer Institute (R01CA137488)
- National Institute of Neurological Disorders and Stroke (NS 33618, R01NS053468, R37NS044687, NS34608, R01NS033618, R01NS044687, R01NS034608, NS-44687)
- National Institute of Biomedical Imaging and Bioengineering (EB007258, R01EB007258)
- Topics
- Physical Sciences › Materials Science › Materials Chemistry › Lanthanide and Transition Metal Complexes
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Physical Sciences › Engineering › Biomedical Engineering › Characterization and Applications of Magnetic Nanoparticles
- Keywords
- ultrasmall superparamagnetic iron oxide, ferumoxytol, ferumoxtran-10, nephrogenic systemic fibrosis, gadolinium-based contrast agents, MRI contrast agents, chronic kidney disease, magnetic resonance angiography, iron supplementation, contrast media safety
- MeSH terms
- Central Nervous System, Chronic Disease, Contrast Media, Dextrans, Gadolinium, Glomerular Filtration Rate, Humans, Iron, Kidney Diseases, Magnetic Resonance Imaging, Male, Middle Aged, Oxides, Risk Factors, Magnetic Resonance Angiography, Ferrosoferric Oxide, Nanoparticles, Nephrogenic Fibrosing Dermopathy, Magnetite Nanoparticles
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