1
|
Dadfar SM, Roemhild K, Drude NI, von Stillfried S, Knüchel R, Kiessling F, Lammers T. Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications. Adv Drug Deliv Rev 2019; 138:302-325. [PMID: 30639256 PMCID: PMC7115878 DOI: 10.1016/j.addr.2019.01.005] [Citation(s) in RCA: 549] [Impact Index Per Article: 109.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/19/2018] [Accepted: 01/04/2019] [Indexed: 12/27/2022]
Abstract
Many different iron oxide nanoparticles have been evaluated over the years, for a wide variety of biomedical applications. We here summarize the synthesis, surface functionalization and characterization of iron oxide nanoparticles, as well as their (pre-) clinical use in diagnostic, therapeutic and theranostic settings. Diagnostic applications include liver, lymph node, inflammation and vascular imaging, employing mostly magnetic resonance imaging but recently also magnetic particle imaging. Therapeutic applications encompass iron supplementation in anemia and advanced cancer treatments, such as modulation of macrophage polarization, magnetic fluid hyperthermia and magnetic drug targeting. Because of their properties, iron oxide nanoparticles are particularly useful for theranostic purposes. Examples of such setups, in which diagnosis and therapy are intimately combined and in which iron oxide nanoparticles are used, are image-guided drug delivery, image-guided and microbubble-mediated opening of the blood-brain barrier, and theranostic tissue engineering. Together, these directions highlight the versatility and the broad applicability of iron oxide nanoparticles, and indicate the integration in future medical practice of multiple iron oxide nanoparticle-based materials.
Collapse
Affiliation(s)
- Seyed Mohammadali Dadfar
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany
| | - Karolin Roemhild
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany; Institute of Pathology, Medical Faculty, RWTH Aachen University Clinic, Aachen, Germany
| | - Natascha I Drude
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany; Department of Nuclear Medicine, RWTH Aachen University Clinic, Aachen, Germany; Leibniz Institute for Interactive Materials - DWI, RWTH Aachen University, Aachen, Germany
| | - Saskia von Stillfried
- Institute of Pathology, Medical Faculty, RWTH Aachen University Clinic, Aachen, Germany
| | - Ruth Knüchel
- Institute of Pathology, Medical Faculty, RWTH Aachen University Clinic, Aachen, Germany
| | - Fabian Kiessling
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany
| | - Twan Lammers
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany; Department of Pharmaceutics, Utrecht University, Utrecht, The Netherlands; Department of Targeted Therapeutics, University of Twente, Enschede, The Netherlands.
| |
Collapse
|
2
|
Hanna RF, Ward TJ, Chow DS, Lagana SM, Moreira RK, Emond JC, Weintraub JL, Prince MR. An evaluation of the sensitivity of MRI at detecting hepatocellular carcinoma in cirrhotic patients utilizing an explant reference standard. Clin Imaging 2014; 38:693-7. [PMID: 24997104 DOI: 10.1016/j.clinimag.2014.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 05/16/2014] [Accepted: 05/28/2014] [Indexed: 12/25/2022]
|
3
|
Sofue K, Tsurusaki M, Miyake M, Sakurada A, Arai Y, Sugimura K. Detection of hepatic metastases by superparamagnetic iron oxide-enhanced MR imaging: prospective comparison between 1.5-T and 3.0-T images in the same patients. Eur Radiol 2010; 20:2265-73. [PMID: 20428875 DOI: 10.1007/s00330-010-1798-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Revised: 03/03/2010] [Accepted: 03/04/2010] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To prospectively compare the diagnostic performance of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging at 3.0 T and 1.5 T for detection of hepatic metastases. METHODS A total of 28 patients (18 men, 10 women; mean age, 61 years) with 80 hepatic metastases were prospectively examined by SPIO-enhanced MR imaging at 3.0 T and 1.5 T. T1-weighted gradient-recalled-echo (GRE) images, T2*-weighted GRE images and T2-weighted fast spin-echo (SE) images were acquired. The tumour-to-liver contrast-to-noise ratio (CNR) of the lesions was calculated. Three observers independently reviewed each image. Image artefacts and overall image quality were analysed, sensitivity and positive predictive value for the detection of hepatic metastases were calculated, and diagnostic accuracy using the receiver-operating characteristics (ROC) method was evaluated. RESULTS The tumour-to-liver CNRs were significantly higher at 3.0 T. Chemical shift and motion artefact were more severe, and overall image quality was worse on T2-weighted fast SE images at 3.0 T. Overall image quality of the two systems was similar on T1-weighted GRE images and T2*-weighted GRE images. Sensitivity and area under the ROC curve for the 3.0-T image sets were significantly higher. CONCLUSION SPIO-enhanced MR imaging at 3.0 T provided better diagnostic performance for detection of hepatic metastases than 1.5 T.
Collapse
Affiliation(s)
- Keitaro Sofue
- Department of Radiology, National Cancer Center, Tokyo, Japan
| | | | | | | | | | | |
Collapse
|
4
|
Differential diagnosis between metastatic tumors and nonsolid benign lesions of the liver using ferucarbotran-enhanced MR imaging. Eur J Radiol 2010; 73:125-30. [DOI: 10.1016/j.ejrad.2008.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 08/01/2008] [Accepted: 09/24/2008] [Indexed: 11/18/2022]
|
5
|
Tanabe M, Ito K, Shimizu A, Fujita T, Onoda H, Yamatogi S, Washida Y, Matsunaga N. Hepatocellular lesions with increased iron uptake on superparamagnetic iron oxide-enhanced magnetic resonance imaging in cirrhosis or chronic hepatitis: comparison of four magnetic resonance sequences for lesion conspicuity. Magn Reson Imaging 2009; 27:801-6. [DOI: 10.1016/j.mri.2008.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 10/08/2008] [Accepted: 11/10/2008] [Indexed: 10/21/2022]
|
6
|
Kim T, Murakami T, Hori M, Onishi H, Tomoda K, Nakamura H. Effect of superparamagnetic iron oxide on tumor-to-liver contrast at T2*-weighted gradient-echo MRI: comparison between 3.0T and 1.5T MR systems. J Magn Reson Imaging 2009; 29:595-600. [PMID: 19243054 DOI: 10.1002/jmri.21384] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To compare 3.0T and 1.5T MR systems in terms of the effect of superparamagnetic iron oxide (SPIO) on tumor-to-liver contrast in T2*-weighted gradient-echo MRI. MATERIALS AND METHODS SPIO-enhanced gradient-echo MR images of the liver with four different TEs (3, 5.3, 6.5, and 8.5 msec) were obtained by means of 1.5T and 3.0T systems. Quantitative analyses of relative signal intensities (SIs) and relative tumor contrast and qualitative analyses of image quality and lesion conspicuity of the liver were performed in 22 patients, 16 of whom had malignant liver tumors. RESULTS With both 1.5T and 3.0T, at TE=8.4 msec, the relative SI of liver and relative tumor contrast were significantly (P<0.01) lower and higher, respectively, than that for any of the other TEs. There were no significant differences in the relative SI of the liver, relative tumor contrast, image quality, and tumor conspicuity for the same TE between the 1.5T and 3.0T systems. CONCLUSION Our results showed that the effect of SPIO on tumor-to-liver contrast at T2*-weighted gradient-echo imaging was similar for the 1.5T and 3.0T systems, and that the 8.4-msec TE was optimal of the four TEs used in this study at 3.0T.
Collapse
Affiliation(s)
- Tonsok Kim
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | | | | | | | | | | |
Collapse
|
7
|
Ishiyama K, Hashimoto M, Izumi JI, Watarai J, Shibata S, Sato T, Yamamoto Y. Tumor-liver contrast and subjective tumor conspicuity of respiratory-triggered T2-weighted fast spin-echo sequence compared with T2*-weighted gradient recalled-echo sequence for ferucarbotran-enhanced magnetic resonance imaging of hepatic malignant tumors. J Magn Reson Imaging 2008; 27:1322-6. [PMID: 18504744 DOI: 10.1002/jmri.21399] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To compare respiratory-triggered T2-weighted fast spin-echo (RTT2W-FSE) and gradient T2*-weighted recalled-echo (T2*W-GRE) images for visualization of malignant hepatic tumors using ferucarbotran-enhanced magnetic resonance (MR) imaging. MATERIALS AND METHODS Ferucarbotran-enhanced RTT2W-FSE and breath-hold long-TE 2D-fast spoiled gradient recalled acquisition in the steady state (FSPGR) images as T2*W-GRE were used to evaluate 128 malignant hepatic tumors (77 metastases, 37 hepatocellular carcinomas, 14 other) in 62 patients. Tumor-to-liver contrast (TLC) was quantitatively compared using the paired Student's t-test, and the score of lesion conspicuity was qualitatively compared using Wilcoxon's signed rank test. RESULTS The mean TLC of RTT2W-FSE was significantly higher than that of FSPGR (1.10 +/- 0.82 vs. 2.54 +/- 1.42) in all malignant tumors. The score of lesion conspicuity of RTT2W-FSE was significantly higher than that of FSPGR (4.84 +/- 0.52 vs. 4.52 +/- 0.99) in all malignant tumors. CONCLUSION For ferucarbotran-enhanced MR imaging, compared to FSPGR images, RTT2W-FSE images provide greater TLC and subjective conspicuity for malignant tumors.
Collapse
Affiliation(s)
- Koichi Ishiyama
- Department of Radiology, Akita University School of Medicine, Akita, Japan.
| | | | | | | | | | | | | |
Collapse
|
8
|
Double-contrast MRI for accurate staging of hepatocellular carcinoma in patients with cirrhosis. AJR Am J Roentgenol 2008; 190:47-57. [PMID: 18094293 DOI: 10.2214/ajr.07.2595] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the accuracy of a double-contrast MRI protocol in staging of hepatocellular carcinoma (HCC) in patients with cirrhosis. MATERIALS AND METHODS This cross-sectional study was performed at a tertiary liver care center. Forty-eight patients with cirrhosis underwent double-contrast MRI for clinical care and liver transplantation. For each MRI examination, superparamagnetic iron oxide was infused, and 2D T2*-weighted spoiled gradient-recalled echo and T2-weighted echo-train spin-echo MR images were obtained for assessment of phagocytic function. Immediately afterward, a low-molecular-weight gadolinium compound was injected, and 3D T1-weighted spoiled gradient-recalled echo images were acquired dynamically for assessment of vascularity. Two blinded radiologists independently reviewed all MR images and assigned per-lesion and per-patient cancer confidence scores to determine the American Liver Tumor Study Group tumor stage. The imaging-based cancer scores and tumor stages were correlated with pathology reports. Performance parameters were computed for imaging-based measurements. RESULTS Of the 48 study subjects, 25 had HCC (three, T1; 18, T2; one, T3; one, T4a; two, T4b). In total, there were 37 HCC nodules. The accuracy of MRI in prediction of pathologic tumor stage was 81-85% depending on the radiologist. Per-patient and per-lesion sensitivity in the diagnosis of HCC were 96% and 81% for one radiologist and 96% and 89% for the other. CONCLUSION A double-contrast MRI protocol has high accuracy in staging of HCC in patients with cirrhosis.
Collapse
|
9
|
Kim MJ, Kim JH, Choi JY, Park SH, Chung JJ, Kim KW, Mitchell DG. Optimal TE for SPIO-enhanced gradient-recalled echo MRI for the detection of focal hepatic lesions. AJR Am J Roentgenol 2006; 187:W255-66. [PMID: 16928903 DOI: 10.2214/ajr.05.0706] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The objective of our study was to determine the optimal TE for superparamagnetic iron oxide (SPIO)-enhanced gradient-recalled echo (GRE) MRI for the detection of focal hepatic lesions. MATERIALS AND METHODS Ferucarbotran-enhanced GRE sequences, performed on a 1.5-T MR system, were used to evaluate 131 lesions (38 hepatocellular carcinomas, 37 metastases, 21 hemangiomas, 7 cholangiocarcinomas, 15 cysts, and 13 miscellaneous lesions) at four different TEs: 9, 13.5, 18, and 22.5 milliseconds. The lesion-to-liver signal difference-to-noise ratio (SDNR) was compared among the four GRE sequences by paired Student's t tests and among lesion types by an independent samples Student's t test. The McNemar test was used to compare the sensitivity for the detection of focal hepatic lesions. Wilcoxon's signed rank test was used to compare the subjective lesion conspicuity. RESULTS The SDNRs of lesions on GRE images obtained at a TE of 13.5 milliseconds (mean +/- SD, 60 +/- 24) were significantly (p < 0.001) higher than those at TEs of 9 (55 +/- 23), 18 (55 +/- 22), and 22.5 milliseconds (47 +/- 19). The SDNR was highest at a TE of 13.5 milliseconds for SPIO-uptake lesions and was comparable on images obtained with TEs of 18 and 13.5 milliseconds for non-SPIO-uptake lesions. The non-SPIO-uptake lesions showed a significantly higher SDNR than the SPIO-uptake lesions at a TE of 22.5 milliseconds (p = 0.007). The overall sensitivity for lesion detection was not significantly different among the four GRE sequences, and the subjective ratings of lesion conspicuity were comparable for images obtained using TEs of 8, 13.5, and 18 milliseconds, but the ratings of lesion conspicuity were significantly lower for images obtained using a TE of 22.5 milliseconds (p < 0.001). CONCLUSION For ferucarbotran-enhanced MRI, lesion SDNR was highest on images obtained using a TE of 13.5 milliseconds, but the sensitivity and lesion conspicuity were comparable at TEs of 9 and 18 milliseconds. The SDNR of liver lesions varied according to the lesion's potential capability of taking up SPIO agents.
Collapse
Affiliation(s)
- Myeong-Jin Kim
- Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-ku Shinchon-dong 134, Seoul 120-752, Republic of Korea.
| | | | | | | | | | | | | |
Collapse
|
10
|
Kim SH, Choi D, Lim HK, Kim MJ, Jang KM, Kim SH, Lee WJ, Lee J, Jeon YH, Lim JH. Detection of hepatic VX2 carcinomas with ferucarbotran-enhanced magnetic resonance imaging in rabbits: Comparison of nine pulse sequences. Eur J Radiol 2006; 59:413-23. [PMID: 16678373 DOI: 10.1016/j.ejrad.2006.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Revised: 03/07/2006] [Accepted: 03/15/2006] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the diagnostic performance of a variety of magnetic resonance imaging (MRI) sequences, in order to identify the most effective ferucarbotran-enhanced sequence for the detection of multiple small hepatic VX2 carcinomas in rabbits. METHODS Fifteen rabbits with experimentally induced 135 VX2 carcinomas in the liver underwent ferucarbotran-enhanced MRI using the following nine pulse sequences: a fat-suppressed fast spin-echo (FSE) sequence with two echo times (TE) (proton density- and T2-weighted images), four different T2*-weighted fast multiplanar GRASS (gradient-recalled acquisition in the steady state) (FMPGR) with the combination of three TEs (9, 12, 15 ms, respectively) and two flip angles (20 degrees , 80 degrees, respectively), T2*-weighted fast multiplanar spoiled GRASS (FMPSPGR), T1-weighted FMPSPGR, and dynamic T1-weighted FMPSPGR. All images were reviewed by three radiologists with quantitative and qualitative analysis. RESULTS Tumor-to-liver contrast-to-noise ratio of the proton density-weighted FSE sequence was significantly higher than those of the others (p<0.05). The lesion conspicuities of proton density- and T2-weighted FSE and T2*-weighted FMPGR (TE/flip angle, 9/20 degrees and 12/20 degrees ) images were better and the image artifacts of T2*-weighted FMPGR (TE/flip angle, 15/20 degrees and 12/80 degrees ) and T2*-weighted FMPSPGR images were more prominent than those of the others (p<0.05). The lesion detection in T2- and proton density-weighted FSE and T2*-weighted FMPGR (TE/flip angle, 12/20 degrees ) images were superior to those of the others and for the detection of very small hepatic tumors of less than 5 mm, the sensitivities of these sequences were less than 30%. CONCLUSION Ferucarbotran-enhanced T2- and proton density-weighted FSE and T2*-weighed FMPGR (TE/flip angle, 12/20 degrees ) images were found to be the most effective pulse sequences for the detection of multiple small hepatic VX2 carcinomas but these sequences were limited in the detection of very small hepatic tumors of less than 5 mm in size.
Collapse
Affiliation(s)
- Seong Hyun Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, South Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Kanematsu M, Kondo H, Goshima S, Kato H, Tsuge U, Hirose Y, Kim MJ, Moriyama N. Imaging liver metastases: review and update. Eur J Radiol 2006; 58:217-28. [PMID: 16406434 DOI: 10.1016/j.ejrad.2005.11.041] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 11/25/2005] [Accepted: 11/29/2005] [Indexed: 12/19/2022]
Abstract
The radiologic diagnosis of liver metastasis involves detection, characterization, and tumor staging. Knowledge of the histopathologic changes that occur with metastases provides the best approach to the accurate interpretation of radiologic imaging findings, and in particular, radiologists need to choose appropriate imaging methods based on such knowledge. Because the majority of metastases are hypovascular, the merits of the routine acquisition of hepatic arterial dominant-phase images by contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) are disputable. Hepatic arterial dominant-phase images may be obtained when hypervascular tumors are suspected or three-dimensional CT angiography is necessary. And, imaging during the portal venous phase is essential for detecting metastases, evaluating intrahepatic vessel invasion, and for assessing intratumoral necrosis or fibrosis. Equilibrium- to delayed-phase imaging 3-5 min after contrast administration may improve the detection of intratumoral fibrosis, and occasionally lead to more accurate tissue characterization. MRI offers diagnostic information on vascularity, amount of free water, hemorrhage, fibrosis, necrosis, and water molecule diffusion in metastases. And, liver-specific contrast agents like superparamagnetic iron oxide, liposoluble gadolinium chelate, and manganese may improve the MRI-based diagnosis of liver metastases.
Collapse
Affiliation(s)
- Masayuki Kanematsu
- Department of Radiology Services, Gifu University Hospital, Gifu 501-1194, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Tanimoto A, Wakabayashi G, Shinmoto H, Okuda S, Kuribayashi S, Mukai M. The mechanism of ring enhancement in hepatocellular carcinoma on superparamagnetic iron oxide-enhanced T1-weighted images: an investigation into peritumoral Kupffer cells. J Magn Reson Imaging 2005; 21:230-6. [PMID: 15723373 DOI: 10.1002/jmri.20263] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To investigate the mechanism of ring enhancement on ferumoxides-enhanced T1-weighted (T1W) gradient echo images in malignant focal hepatic lesions. MATERIALS AND METHODS Eighteen patients with hepatocellular carcinoma (HCC) underwent breath-hold T1-, T2-, and T2*-weighted magnetic resonance (MR) images at 1.5-Tesla after ferumoxides administration. The existence of ring enhancement on T1W, and the maximum size of the area showing decreased phagocytic activity on T2W and T2*W, and that of the area showing ring enhancement on T1W were evaluated. The Kupffer cell (KC) density of HCC itself and peritumoral liver parenchyma was assessed with KC stain sections. RESULTS Ring enhancement was noted in 13 of 18 HCC (72%). Peritumoral KC density was increased in the ring enhancement (+) group as compared with the ring enhancement (-) group. In the ring enhancement (+) group, the tumor size measured on T2W was smaller than that measured on either T1W or T2*W, suggesting a sustained T1 relaxation effect and a decreased T2* relaxation effect in the peritumoral regions. CONCLUSION Ring enhancement on superparamagnetic iron oxide (SPIO)-enhanced T1W may correlate with increased KC density and decreased SPIO clustering in KC in peritumoral regions.
Collapse
Affiliation(s)
- Akihiro Tanimoto
- Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo, Japan.
| | | | | | | | | | | |
Collapse
|