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Ferumoxytol MRA and non-contrast CT fusion in TAVR candidates with renal failure
© Yoshida et al. 2016
- Published: 27 January 2016
- Renal Impairment
- Vascular Calcification
- Severe Renal Impairment
- Iodinate Contrast Media
- Transcatheter Aortic Valve Replacement
One of the advantages of CT angiography (CTA) over MRA for transcatheter aortic valve replacement (TAVR) planning is the ability to display aortic valve and arterial calcification accurately. However, in many patients who are TAVR candidates, renal impairment makes iodinated contrast media undesirable or contraindicated. Further, in patients with severe renal impairment, gadolinium based contrast agents may be problematic because of the perceived risk of NSF. We hypothesized that in patients where ferumoxytol-enhanced MRA (FEMRA) is a suitable alternative to CTA, vascular and valvular calcification may be accurately displayed over luminal anatomy by fusing non-contrast CT and FEMRA in these patients.
Nine patients who underwent FEMRA for assessment of arterial access anatomy prior to TAVR had additional non-contrast CT of the thorax and abdomen. CT and MR DICOM data were processed in a commercially available software (Mimics V17.0, Materialize) and the calcium from the CT was isolated and registered to the FEMRA data.
By fusing non-contrast CT and FEMRA, both luminal anatomy and vascular calcification can be accurately defined, addressing one of the main limitations of MR over CT for TAVR planning.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.