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 Herzka

Research output: Contribution to journalArticle

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)
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
Externally publishedYes

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Ferrosoferric Oxide
Blood Volume
Magnetic Resonance Spectroscopy
Heart Failure
Plasma Volume
Carbon Monoxide
Hematocrit
Swine
Cardiovascular Models
Contrast Media
Half-Life
Reference Values
Iron

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

Cite this

Blood volume measurement using cardiovascular magnetic resonance and ferumoxytol : preclinical validation. / Ramasawmy, Rajiv; Rogers, Toby; Alcantar, Miguel A.; McGuirt, Delaney R.; Khan, Jaffar M.; Kellman, Peter; Xue, Hui; Faranesh, Anthony Z.; Campbell-Washburn, Adrienne E.; Lederman, Robert J.; Herzka, Daniel.

In: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, Vol. 20, No. 1, 10.09.2018.

Research output: Contribution to journalArticle

Ramasawmy, Rajiv ; Rogers, Toby ; Alcantar, Miguel A. ; McGuirt, Delaney R. ; Khan, Jaffar M. ; Kellman, Peter ; Xue, Hui ; Faranesh, Anthony Z. ; Campbell-Washburn, Adrienne E. ; Lederman, Robert J. ; Herzka, Daniel. / Blood volume measurement using cardiovascular magnetic resonance and ferumoxytol : preclinical validation. In: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 2018 ; Vol. 20, No. 1.
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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.",
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T1 - Blood volume measurement using cardiovascular magnetic resonance and ferumoxytol

T2 - preclinical validation

AU - Ramasawmy, Rajiv

AU - Rogers, Toby

AU - Alcantar, Miguel A.

AU - McGuirt, Delaney R.

AU - Khan, Jaffar M.

AU - Kellman, Peter

AU - Xue, Hui

AU - Faranesh, Anthony Z.

AU - Campbell-Washburn, Adrienne E.

AU - Lederman, Robert J.

AU - Herzka, Daniel

PY - 2018/9/10

Y1 - 2018/9/10

N2 - 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.

AB - 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.

KW - Blood volume

KW - CMR

KW - Ferumoxytol

KW - Heart failure

KW - MRI

KW - T 1 mapping

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