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MR Lymphangiography: Imaging Strategies to Optimize the Imaging of Lymph Nodes with Ferumoxtran-10¹

¹ From the Departments of Radiology (M.G.H., M.A.S., M.T., P.F.H.) and Pathology (E.B.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and General Electric Global Research, Niskayuna, NY (W.T.D., D.J.B., P.J.D.). Recipient of a Cum Laude award for an education exhibit at the 2002 RSNA scientific assembly. Received September 8, 2003; revision requested November 3 and received December 15; accepted December 23. Address correspondence to M.G.H. (e-mail: mharisinghani@partners.org).

Detection of local or regional metastases to lymph nodes is clinically important in virtually any type of primary tumor. Current imaging techniques rely heavily on the size criterion for characterization of nodal disease. However, size can be an ineffective parameter for diagnosis of tumor spread to lymph nodes. Magnetic resonance (MR) imaging performed before and after administration of ferumoxtran-10 is a promising technique for characterization of lymph nodes in patients with various primary tumors. Normal homogeneous uptake of ferumoxtran-10 in nonmetastatic nodes shortens the T2 and T2*, turning these nodes dark, whereas malignant nodes lack uptake and remain hyperintense. To optimize acquisition strategies, the following factors should be considered: the timing of contrast material–enhanced imaging, the section thickness, the imaging plane, and the imaging parameters for T2*-weighted sequences. In addition, MR imaging with ferumoxtran-10 allows presurgical mapping of lymph nodes and quantitative estimation of T2*.

© RSNA, 2004

Index Terms: Contrast media, 99.12943 • Lymphatic system, MR, 99.12943 • Lymphatic system, neoplasms, 99.83 • Magnetic resonance (MR), contrast media, 99.12943

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