Soenke Heinrich Bartling MD, Presenter: Nothing to Disclose

Johannes Budjan, Abstract Co-Author: Nothing to Disclose

Hagit Aviv, Abstract Co-Author: Nothing to Disclose

Henrik J. Michaely MD, Abstract Co-Author: Consultant, Bayer AG

Stefan Haneder MD, Abstract Co-Author: Nothing to Disclose

Wolfhard Semmler MD, PhD, Abstract Co-Author: Support, SMS GmbH

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Nothing to Disclose

Steffen J. Diehl MD, Abstract Co-Author: Nothing to Disclose

Shlomo Margel, Abstract Co-Author: Nothing to Disclose

Maliha Sadick, Abstract Co-Author: Nothing to Disclose

Within interventional radiology, embolization therapy is a key procedure. Current embolization materials are not visible (clinical) or solely visible either in X-ray/CT or MRI (research). Particles visible within MRI and X-ray/CT simultaneously would allow direct particle detection in multimodal setups at all times and could therefore be beneficial to prevent miscarriage of embolization material and would allow direct therapy control. Furthermore complimentary advantages of CT and MRI can be combined for follow-up studies. Here, we developed and tested first multimodal-visible embolization particles.

To reduce the chance of adverse reactions and to ease approval for clinical use substances have been used that are approved and being used on a routine-base in diagnostic imaging: X-ray visible iodine was combined with MRI visible Iron (Fe 2+) in a macroparticle (diameter 60-200µm). Its core - consisting of copolymerized monomer MAOETIB [2-methacryloyloxyethyl(2,3,5-triiodobenzoate)] - was coated with paramagnetic iron oxide nanoparticles (USPIO, 150 nm). After ex-vivo testing, including CNR measurements (n=5), its ability to embolize tissue was tested in an established tumor embolization model in six rabbits. X-ray angiography, CT and MR imaging was performed on clinical scanners (Philipps Integris, Dual-source Definition CT, 3 Tesla Magnetom Tim Trio MRI, Siemens) before, during and after application of particles to the catheterized renal artery. Histology was prepared for analysis of the embolization effects.  

The particles provided a sufficient image contrast on X-ray angiography, CT (CNR: 13.5 ±2.4) and MRI (CNR: 6.6 ±0.6). Successful embolization of renal tissue was confirmed by angiography as well as by particles residing within the kidney as seen in corresponding areas in MRI and CT. Dynamic imaging during embolization provided real-time imaging of inflow of embolization particles within angiography, CT and MRI. Histology allowed a direct visualization of the residing particles as well as associated thrombosis in kidney arteries.

A multimodal-visible embolization material was successfully developed and tested in animal models.

Once introduced in clinical radiology it may provide advantages for prevention of miscarriage, improved therapy control and multimodal interventional setups, also for reduction of radiation exposure.

Bartling, S, Budjan, J, Aviv, H, Michaely, H, Haneder, S, Semmler, W, Schoenberg, S, Diehl, S, Margel, S, Sadick, M, First Multimodal Embolization Particles Being Visible in MR Imaging and X-ray/CT.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006647.html