Magnetic Resonance Sentinel Lymph Node Imaging of the Prostate with Gadofosveset Trisodium–Albumin

• Published in: Academic radiology Vol. 22; no. 5; pp. 646 - 652
• Main Authors: Turkbey, Baris, MD, Hoyt, Robert F., DVM, MS, Agarwal, Harsh K., PhD, Bernardo, Marcelino, BS, Sankineni, Sandeep, MD, Johnson, Linda, BS, Grant, Kinzya B., MD, Rais-Bahrami, Soroush, MD, Kobayashi, Hisataka, MD, PhD, Wood, Bradford J., MD, Pinto, Peter A., MD, Griffiths, Gary L., PhD, Choyke, Peter L., MD
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-05-2015
• Subjects: Gadofosveset trisodium; human serum albumin; lymph node; MRI; Radiology; MRI; human serum albumin; lymph node; Gadofosveset trisodium
• ISSN: 1076-6332; 1878-4046
• DOI: 10.1016/j.acra.2014.12.021

Rationale and Objectives To determine if intraprostatic injection of gadofosveset trisodium mixed with human serum albumin (HSA) can identify sentinel lymph nodes (LNs) draining the prostate on magnetic resonance imaging (MRI) in a canine model. Materials and Methods Three male canines weighing between 25.7 and 41.3 kg were anesthetized, placed in a 3-T MRI, and a needle was placed transrectally into one side of the prostate using a commercially available intrarectal needle guide. Gadofosveset trisodium premixed with 10% HSA was then administered at doses ranging from 0.1 to 2.5 mL. T1W MRI was performed immediately after injection, and two readers evaluated images for visualization of LNs draining the prostate. Results Intraprostatic injection of 0.2 mL gadofosveset trisodium premixed with HSA identified the draining periprostatic LNs in all cases. Delayed images demonstrated upper echelon nodes in the pelvis and the abdomen. Higher volume injections resulted in excessive periprostatic extravasation, whereas lower volume injections resulted in suboptimal visualization of LNs. Conclusions We demonstrate that gadofosveset trisodium (premixed with 10% HSA) injected intraprostatically at 0.2 mL visualized LNs draining the prostate. This approach can be readily adapted for clinical applications such as sentinel LN imaging in prostate cancer patients before surgery.