Ferumoxytol MRI for the Detection of Brain Arteriovenous Malformations Lesions in Patients with Hereditary Hemorrhagic Telangiectasia

Motivation: Patients with Hereditary Hemorrhagic Telangiectasia (HHT) have a high likelihood of developing brain AVMs. Guidelines recommend MRI/MRA screening in childhood and adulthood. As part of a novel head-to-abdomen ferumoxytol-enhanced 3T MRI/MRA (FeMR) protocol, we evaluated sensitivity of FeMR for brain AVMs. Goal(s): Develop a FeMR exam to screen for brain AVMs. Compare this protocol to gold-standard x-ray digital subtraction catheter angiograms (DSA). Approach: Conduct 3T FeMR VIBE imaging at multiple resolutions and compare to previously acquired clinical imaging. Results: 0.8mm isotropic resolution has favorable features. All known brain AVMs (detected via noninvasive gadolinium-enhanced 3T MRI and invasive DSA) were detected by 3T FeMR. Impact: The AVIATOR study will enable efficient screening and high-resolution non-invasive follow-up of HHT patients. Quantitative MR techniques may be less subject to inter-operator-dependency, thus providing more objective means for developing a global HHT disease burden score.