Improvement of image quality and diagnostic accuracy of novel ferumoxytol-enhanced magnetic resonance coronary angiography: compared to non-contrast enhanced imaging.
Jian He, Wen Qian, Zhou Dong et al.
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In 30 seconds
This retrospective analysis of a prospective clinical trial compared ferumoxytol-enhanced with non-contrast coronary magnetic resonance angiography (CMRA) in 29 patients, using invasive coronary angiography as the reference standard. Ferumoxytol improved image contrast and diagnostic performance. Per patient, sensitivity increased from 52.2 % (95 % CI: 30.6 %-73.2 %) to 100 % (95 % CI: 85.2 %-100 %) (p < 0.001), while specificity remained 100 % (95 % CI: 54.1 %-100 %). Improvements were also seen across assessable segments, particularly in the middle coronary segments.
Key findings
- Ferumoxytol-enhanced CMRA increased per-patient sensitivity from 52.2 % (95 % CI: 30.6 %-73.2 %) to 100 % (95 % CI: 85.2 %-100 %) (p < 0.001); specificity remained 100 %.
- Across 225/261 assessable segments, sensitivity rose from 32.4 % to 88.2 %, NPV from 89.1 % to 97.9 %, and accuracy from 88.4 % to 96.9 % (all p < 0.001).
- In middle coronary segments, sensitivity increased from 20.0 % to 80.0 %, with PPV, NPV, and accuracy also improving.
Why it matters
Coronary MR angiography may offer a noninvasive way to assess coronary artery disease, but diagnostic performance can vary by vessel segment. These results indicate that ferumoxytol enhancement can improve image quality and detection performance, especially in middle segments, and may be relevant when a gadolinium-free contrast approach is being considered.
What to keep in mind
The analysis included 29 patients and was retrospective, despite drawing on a prospective trial. The abstract does not report external validation.