BACKGROUND AND PURPOSE: Cellular uptake of the manganese ion, when administered as a contrast agent for MR imaging, can noninvasively highlight cellular activity and disease processes in both animals and humans. The purpose of this study was to explore the enhancement profile of manganese in patients with multiple sclerosis. MATERIALS AND METHODS: Mangafodipir is a manganese chelate that was clinically approved for MR imaging of liver lesions. We present a case series of 6 adults with multiple sclerosis who were scanned at baseline with gadolinium, then injected with mangafodipir, and followed at variable time points thereafter. RESULTS: Fourteen new lesions formed during or shortly before the study, of which 10 demonstrated manganese enhancement of varying intensity, timing, and spatial pattern. One gadolinium-enhancing extra-axial mass, presumably a meningioma, also demonstrated enhancement with manganese. Most interesting, manganese enhancement was detected in lesions that formed in the days after mangafodipir injection, and this enhancement persisted for several weeks, consistent with contrast coming from intracellular uptake of manganese. Some lesions demonstrated a diffuse pattern of manganese enhancement in an area larger than that of both gadolinium enhancement and T2-FLAIR signal abnormality. CONCLUSIONS: This work demonstrates the first use of a manganese-based contrast agent to enhance MS lesions on MR imaging. Multiple sclerosis lesions were enhanced with a temporal and spatial profile distinct from that of gadolinium. Further experiments are necessary to uncover the mechanism of manganese contrast enhancement as well as cell-specific uptake.
BACKGROUND AND PURPOSE: Cellular uptake of the manganese ion, when administered as a contrast agent for MR imaging, can noninvasively highlight cellular activity and disease processes in both animals and humans. The purpose of this study was to explore the enhancement profile of manganese in patients with multiple sclerosis. MATERIALS AND METHODS:Mangafodipir is a manganese chelate that was clinically approved for MR imaging of liver lesions. We present a case series of 6 adults with multiple sclerosis who were scanned at baseline with gadolinium, then injected with mangafodipir, and followed at variable time points thereafter. RESULTS: Fourteen new lesions formed during or shortly before the study, of which 10 demonstrated manganese enhancement of varying intensity, timing, and spatial pattern. One gadolinium-enhancing extra-axial mass, presumably a meningioma, also demonstrated enhancement with manganese. Most interesting, manganese enhancement was detected in lesions that formed in the days after mangafodipir injection, and this enhancement persisted for several weeks, consistent with contrast coming from intracellular uptake of manganese. Some lesions demonstrated a diffuse pattern of manganese enhancement in an area larger than that of both gadolinium enhancement and T2-FLAIR signal abnormality. CONCLUSIONS: This work demonstrates the first use of a manganese-based contrast agent to enhance MS lesions on MR imaging. Multiple sclerosis lesions were enhanced with a temporal and spatial profile distinct from that of gadolinium. Further experiments are necessary to uncover the mechanism of manganese contrast enhancement as well as cell-specific uptake.
Authors: Kadharbatcha S Saleem; Jon M Pauls; Mark Augath; Torsten Trinath; Burkhard A Prause; Tsutomu Hashikawa; Nikos K Logothetis Journal: Neuron Date: 2002-05-30 Impact factor: 17.173
Authors: D E Goodkin; W D Rooney; R Sloan; P Bacchetti; L Gee; M Vermathen; E Waubant; M Abundo; S Majumdar; S Nelson; M W Weiner Journal: Neurology Date: 1998-12 Impact factor: 9.910
Authors: R P Sutcliffe; D Lewis; P A Kane; B C Portmann; J G O'Grady; J B Karani; M Rela; N D Heaton Journal: Clin Radiol Date: 2010-12-23 Impact factor: 2.350
Authors: K G Toft; S O Hustvedt; D Grant; I Martinsen; P B Gordon; G A Friisk; A J Korsmo; T Skotland Journal: Acta Radiol Date: 1997-07 Impact factor: 1.701
Authors: D M Sudarshana; G Nair; J T Dwyer; B Dewey; S U Steele; D J Suto; T Wu; B A Berkowitz; A P Koretsky; I C M Cortese; D S Reich Journal: AJNR Am J Neuroradiol Date: 2019-08-01 Impact factor: 3.825
Authors: Martina Absinta; Govind Nair; Pascal Sati; Irene C M Cortese; Massimo Filippi; Daniel S Reich Journal: Neurol Neuroimmunol Neuroinflamm Date: 2015-09-03
Authors: Chiaki Komatsu; Yolandi van der Merwe; Lin He; Anisha Kasi; Jeffrey R Sims; Maxine R Miller; Ian A Rosner; Neil J Khatter; An-Jey A Su; Joel S Schuman; Kia M Washington; Kevin C Chan Journal: J Neurosci Methods Date: 2022-02-22 Impact factor: 2.390