National Cancer Institute - NCI Division of Cancer Treatment and ...

Dr. Edward A. Neuwelt, Oregon Health & Science University.
In 2005, results from DMIST showed no
difference in detecting breast cancer for
the general population of women in the
trial. However, women with dense breasts,
who are pre- or perimenopausal (women
who had a last menstrual period within
12 months of their mammograms), or who
are younger than age 50 may benefit from
having a digital rather than a film mammogram.
The results were reported September
16 in a special online publication
of the New England Journal of Medicine
and at the 2005 annual meeting of ACRIN.
The results of this large clinical trial of
about 50,000 women, led by Drs. Etta D.
Pisano, University of North Carolina at Chapel
Hill, and Edward Hendrick, Northwestern
University, will give clinicians better
guidance and greater choice in deciding
which women would benefit most from
various forms of mammography.
30 minutes after gadolinium 24 hours after ferumoxytol
MRI in the operating room
26 hours after ferumoxytol
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Digital mammography images can be electronically
adjusted by the radiologist, and subtle differences
between tissues may be noted.
Magnetic resonance images of a patient
with high-grade brain tumors. The ferumoxytol
shows larger areas of the three
tumors and can also be seen on a special
magnetic resonance machine used in the
operating room without giving more contrast
agent. The larger target volume of
the tumors at surgery and the persistent
enhancement allows the surgeon to see
if all the tumor has been removed during
the operation.
Pisano ED, Gatsonis C, Hendrick E, Yaffe M, Baum
JK, Acharyya S, Conant EF, Fajardo LL, Bassett
L, D’Orsi C, Jong R, Rebner M; Digital Mammographic
Imaging Screening Trial (DMIST) Investigators
Group. Diagnostic performance of digital
versus film mammography for breast-cancer
screening. N Engl J Med 2005:353;1773–83.
Pilot Study Evaluates Use of
Ferumoxytol in Magnetic
Resonance Studies of Brain Tumors
A CIP-funded pilot study at Oregon Health
& Science University is investigating the
potential role of ferumoxytol in the evaluation
of malignant brain tumors. Ferumoxytol
is an iron oxide nanoparticle that
targets phagocytic cells and can be used
for MRI of pathology that has a significant
phagocytic component. The investigators
compared ferumoxytol imaging, perfusion,
and magnetic resonance angiography
(MRA) with gadolinium imaging. The
results from this pilot study of 12 patients
with brain tumors indicated that, after
administration of ferumoxytol, the tumors
were detectable on magnetic resonance
studies at various field strengths, including
an intraoperative 0.15-Tesla magnet.
In addition, there was less early leakage
out of the blood vessels after injection of
ferumoxytol in comparison to gadolinium.
Further investigations are required to evaluate
whether magnetic resonance studies
with ferumoxytol would be superior or
complementary to studies with gadolinium
for assessing tumor perfusion and
predicting tumor response to therapy.
Neuwelt EA, Várallyay CG, Manninger S, Solymosi
D, Haluska M, Hunt MA, Nesbit G, Stevens
A, Jerosch-Herold M, Jacobs PM, Hoffman JM.
Potential of ferumoxytol nanoparticle in MR
imaging, perfusion, and angiography of CNS
malignancy. Manuscript in preparation.