Molecular magnetic resonance imaging (MRI) of inflamed myocardium using ferucarbotran in patients with acute myocardial infarction

Methods The clinical study NIMINI-1 was performed as a prospective, non-randomised, non-blinded, single agent phase III clinical trial. Twenty patients who had experienced either an acute ST-elevation or non-ST-elevation myocardial infarction (STEMI/NSTEMI) were included to this study. Following coronary angiography, a first baseline cardiovascular magnetic resonance (CMR) study (pre-SPIO) was performed within seven days after onset of cardiac symptoms. A second CMR study (postSPIO) was performed either 10min, 4h, 24h or 48h after ferucarbotran administration. The CMR studies comprised cine-CMR, T2-weighted “edema” imaging, T2*-weighted cardiac imaging and T1-weighted lategadolinium-enhancement (LGE) imaging. Results The median extent of short-axis in-plane LGE was 28% (IQR 19-31%). Following Resovist® administration the median extent of short-axis in-plane T2*-weighted hypoenhancement (suggestive of intramyocardial hemorrhage and/or SPIO accumulation) was 0% (IQR 0-9%; p=0.68 compared to pre-SPIO). A significant in-slice increase (>3%) in the extent of T2*-weighted “hypoenhancement” (post-SPIO compared to pre-SPIO) was seen in 6/16 patients (38%). However, no patient demonstrated “hypoenhancement” in T2*-weighted images following Resovist® administration that exceeded the area of LGE.