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Feasibility and potential role of ferumoxytol-enhanced neuroimaging in HIV-associated neurocognitive disorder |
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| Authors: | Beau K. Nakamoto Cecilia M. Shikuma Debra Ogata-Arakaki Tracie Umaki Edward A. Neuwelt Bruce T. Shiramizu Dominic C. Chow Nisha I. Parikh Kalpana J. Kallianpur Bronwyn E. Hamilton |
| Affiliation: | 1. Hawaii Center for AIDS, University of Hawaii, Honolulu, HI, USA 2. Straub Clinics and Hospital, Honolulu, HI, USA 8. Hawaii Center for AIDS, John A. Burns School of Medicine, University of Hawaii at Manoa, 3675 Kilauea Ave. Young Bldg 5th Floor, Honolulu, HI, 96816, USA 4. Department of Neurology, Oregon Health & Science University, Portland, OR, USA 5. Department of Neurosurgery, Oregon Health & Science University, Portland, OR, USA 6. Portland Veterans Affairs Medical Center, Portland, OR, USA 7. Department of Cardiology, Queen’s Medical Center, Honolulu, HI, USA 3. Department of Radiology, Oregon Health & Science University, Portland, OR, USA |
| Abstract: | We assessed ferumoxytol-enhanced brain MRI to identify monocyte/macrophage accumulation in HIV-associated neurocognitive disorder (HAND). Four HIV-infected subjects with undetectable HIV RNA levels on antiretroviral therapy, HIV DNA level in CD14+ cells ≥10 copies/106 cells, and cognitive impairment underwent ferumoxytol-enhanced brain MRI. On post-ferumoxytol susceptibility-weighted images, all HIV-infected subjects demonstrated a diffuse “tram track” appearance in the perivascular regions of cortical and deep white matter vessels suggesting ferumoxytol uptake in monocytes/macrophages. This finding was not present in an HIV-seronegative control. While ferumoxytol may have potential as an imaging biomarker for monocyte/macrophage accumulation in patients with HAND, future study is needed. |
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