Conclusion

A macrophage-specific MR contrast agent allows the detection of small and otherwise undetectable lymph node metastases in patients with cancer. This has an important clinical impact, as the diagnosis will be more precise and less invasive to obtain. Subsequently, this will reduce morbidity and health care costs. However, thorough knowledge of sequence parameters and planes, lymph node anatomy, appearance of normal and abnormal nodes and pitfalls is essential when using this technique. This implies a very important role for education by expert radiologists, MR-manufacturers and contrast agent companies.

Figure 3.6. A 51-year-old patient with prostate cancer and generalized lymph node metastases. Siemens Task Card showing MR images (A,C,D) 24 hours post-ferumoxtran-10 and (B) CTA-MRL fusion. A High resolution T|-weighted sequence. B MRL-CTA merged image showing pathologic nodes in red and normal nodes in green. With the help of a segmentation technique pathologic nodes ("white" on A and C) are indicated by a red color and normal node as green, and thus relation between vessels and nodes can be seen. C 3D T2-weighted sequence. D Tj-weighted MRA sequence shows vessels and segmented nodes.

Figure 3.6. A 51-year-old patient with prostate cancer and generalized lymph node metastases. Siemens Task Card showing MR images (A,C,D) 24 hours post-ferumoxtran-10 and (B) CTA-MRL fusion. A High resolution T|-weighted sequence. B MRL-CTA merged image showing pathologic nodes in red and normal nodes in green. With the help of a segmentation technique pathologic nodes ("white" on A and C) are indicated by a red color and normal node as green, and thus relation between vessels and nodes can be seen. C 3D T2-weighted sequence. D Tj-weighted MRA sequence shows vessels and segmented nodes.

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