Blood volume measurement using cardiovascular magnetic resonance and ferumoxytol: preclinical validation

Rajiv Ramasawmy, Toby Rogers, Miguel A. Alcantar, Delaney R. McGuirt, Jaffar M. Khan, Peter Kellman, Hui Xue, Anthony Z. Faranesh, Adrienne E. Campbell-Washburn, Robert J. Lederman, Daniel A. Herzka

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The hallmark of heart failure is increased blood volume. Quantitative blood volume measures are not conveniently available and are not tested in heart failure management. We assess ferumoxytol, a marketed parenteral iron supplement having a long intravascular half-life, to measure the blood volume with cardiovascular magnetic resonance (CMR). METHODS: Swine were administered 0.7 mg/kg ferumoxytol and blood pool T1 was measured repeatedly for an hour to characterize contrast agent extraction and subsequent effect on Vblood estimates. We compared CMR blood volume with a standard carbon monoxide rebreathing method. We then evaluated three abbreviated acquisition protocols for bias and precision. RESULTS: Mean plasma volume estimated by ferumoxytol was 61.9 ± 4.3 ml/kg. After adjustment for hematocrit the resultant mean blood volume was 88.1 ± 9.4 ml/kg, which agreed with carbon monoxide measures (91.1 ± 18.9 ml/kg). Repeated measurements yielded a coefficient of variation of 6.9%, and Bland-Altman repeatability coefficient of 14%. The blood volume estimates with abbreviated protocols yielded small biases (mean differences between 0.01-0.06 L) and strong correlations (r2 between 0.97-0.99) to the reference values indicating clinical feasibility. CONCLUSIONS: In this swine model, ferumoxytol CMR accurately measures plasma volume, and with correction for hematocrit, blood volume. Abbreviated protocols can be added to diagnostic CMR examination for heart failure within 8 min.

Original languageEnglish (US)
Pages (from-to)62
Number of pages1
JournalJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
Volume20
Issue number1
DOIs
StatePublished - Sep 10 2018

Keywords

  • Blood volume
  • CMR
  • Ferumoxytol
  • Heart failure
  • MRI
  • T 1 mapping

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Family Practice

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