Fei Han

J Finn

Olcay Aksoy

Peng Hu

Takegawa Yoshida

William M Suh

Ziwu Zhou

Journal of Cardiovascular Magnetic Resonance

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WALKING POSTER PRESENTATION Open Access
Ferumoxytol MRA and non-contrast CT fusion
in TAVR candidates with renal failure
Takegawa Yoshida1*, Fei Han1, Ziwu Zhou1, Olcay Aksoy2, William M Suh2, Peng Hu1, J Paul Finn1
From 19th Annual SCMR Scientific Sessions
Los Angeles, CA, USA. 27-30 January 2016
Background
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 suita-
ble alternative to CTA, vascular and valvular calcification
may be accurately displayed over luminal anatomy by
fusing non-contrast CT and FEMRA in these patients.
Methods
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.
Results
In all cases, the calcification was fused successfully with
the 3D FEMRA data and volume rendered images were
generated showing the degree and distribution of calcifi-
cation clearly (figure 1), forming the basis for more con-
fident procedure planning.
1Department of Radiological Sciences, David Geffen School of Medicine at
UCLA, Los Angeles, CA, USA
Full list of author information is available at the end of the article
Figure 1 FEMRA (left), non-contrast CT (middle) and Volume rendered FEMRA with calcium overlay (right) in an 84 year old male
patient with calcific aortic stenosis who had successful TAVR placement.
Yoshida et al. Journal of Cardiovascular Magnetic
Resonance 2016, 18(Suppl 1):Q59
http://www.jcmr-online.com/content/18/S1/Q59
© 2016 Yoshida et al. 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.
Conclusions
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.
Authors’ details
1Department of Radiological Sciences, David Geffen School of Medicine at
UCLA, Los Angeles, CA, USA. 2Division of Cardiology, David Geffen School of
Medicine at UCLA, Los Angeles, CA, USA.
Published: 27 January 2016
doi:10.1186/1532-429X-18-S1-Q59
Cite this article as: Yoshida et al.: Ferumoxytol MRA and non-contrast
CT fusion in TAVR candidates with renal failure. Journal of Cardiovascular
Magnetic Resonance 2016 18(Suppl 1):Q59.
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Yoshida et al. Journal of Cardiovascular Magnetic
Resonance 2016, 18(Suppl 1):Q59
http://www.jcmr-online.com/content/18/S1/Q59
Page 2 of 2


Ferumoxytol MRA and non-contrast CT fusion in TAVR candidates with renal failure

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Ferumoxytol MRA and non-contrast CT fusion in TAVR candidates with renal failure

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