NEW YORK (Reuters Health), May 12 - In patients with prostate cancer, MRI with the experimental imaging agent ferumoxtran-10 (known as Combidex in the U.S.) appears to be effective in detecting lymph node metastases outside of the routine surgical area, Dutch researchers report in the May issue of Radiology.
"With Combidex MRI, small -- 2 mm -- lymph node metastases can be detected with high accuracy," senior investigator Dr. Jelle Barentsz told Reuters Health.
Barentsz of University Medical Center Nijmegen and colleagues employed the method in 296 men who were at intermediate-to-high risk of lymph node metastases.
Findings were positive in 58 patients and were histopathologically confirmed in 44 patients.
In 18 of these 44 men (41%), the approach showed nodes that were exclusively outside of the routine dissection area. In another 18 patients, positive nodes were seen both inside and outside of the routine dissection area. In the remaining eight patients, MRI findings showed positive nodes only within the routine dissection area.
"With Combidex, in 41% of patients with positive nodes, metastatic nodes which are missed by surgery are detected," said Barentsz in summary.
"Because of its high negative predictive value -- greater than 97% -- a negative Combidex MRI result obviates a diagnostic pelvic lymph node dissection, which saves costs and morbidity," he added.
"Potentially positive Combidex lymph nodes," Barentsz concluded, "can be treated with selective radiotherapy."
By David Douglas
Radiology 2009;251:408-414.
Last Updated: 2009-05-11 12:52:34 -0400 (Reuters Health)
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