Iron-Based Contrast for the Heart: Clinical Promise of Ferumoxytol-Enhanced CMR.
5 affiliations
- 1Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA USA.
- 2Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA USA.
- 3Department of Bioengineering, University of California, Los Angeles, CA USA.
- 4Department of Radiological Sciences, University of California at Los Angeles, Peter V. Ueberroth Building Suite 3371, 10945 Le Conte Ave., Los Angeles, CA 90095-7206 USA.
- 5David Geffen School of Medicine at UCLA, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA 90073 USA.
Abstract
Ferumoxytol is an ultrasmall superparamagnetic iron oxide (USPIO) nanoparticle that was originally approved by the U.S. FDA for treating iron deficiency anemia in patients with chronic kidney disease. It has since emerged as an off-label, versatile intravascular contrast agent for cardiovascular magnetic resonance (CMR) imaging, and in 2025, received FDA approval for brain imaging. This review provides an overview of ferumoxytol-enhanced CMR applications primarily focused on the heart, outlines its key imaging and pharmacokinetic properties, and summarizes its diagnostic safety profile. Unlike gadolinium-based contrast agents (GBCAs), which rapidly wash out from the circulation, ferumoxytol has high r1 and r2 relaxivities and remains confined to the intravascular compartment for prolonged periods. Once metabolized by the reticuloendothelial system, its iron core is incorporated into the body's hematopoietic pathways. These unique properties enable steady-state and delayed-phase imaging, simplify complex imaging workflows, and facilitate accelerated multidimensional cardiac imaging methods. Emerging applications for ferumoxytol-enhanced CMR include myocardial perfusion assessment, multidimensional imaging, vascular and hemodynamic evaluation, and comprehensive structural heart disease imaging. Ferumoxytol expands the clinical applications of CMR by enabling imaging techniques that are not feasible with conventional GBCAs and broadening imaging options for patients in whom GBCA administration may be less desirable based on individualized clinical risk-benefit assessment, including selected patients with renal insufficiency, very young children, and pregnant women.
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BibTeX
@article{pogosyan2026ironbased,
title = {{Iron-Based Contrast for the Heart: Clinical Promise of Ferumoxytol-Enhanced CMR.}},
author = {Arutyun Pogosyan and Yuehong Liu and Jasmine A Patel and Mostafa Mahmoudi and Hang Xu and J Paul Finn and Kim-Lien Nguyen},
journal = {Current cardiovascular imaging reports},
year = {2026},
month = oct,
doi = {10.1007/s12410-026-09618-5},
url = {https://europepmc.org/article/MED/42953276},
note = {CC BY},
}
RIS
TY - JOUR
TI - Iron-Based Contrast for the Heart: Clinical Promise of Ferumoxytol-Enhanced CMR.
AU - Arutyun Pogosyan
AU - Yuehong Liu
AU - Jasmine A Patel
AU - Mostafa Mahmoudi
AU - Hang Xu
AU - J Paul Finn
AU - Kim-Lien Nguyen
PY - 2026
DA - 2026/10/27
JO - Current cardiovascular imaging reports
DO - 10.1007/s12410-026-09618-5
UR - https://europepmc.org/article/MED/42953276
AB - Ferumoxytol is an ultrasmall superparamagnetic iron oxide (USPIO) nanoparticle that was originally approved by the U.S. FDA for treating iron deficiency anemia in patients with chronic kidney disease. It has since emerged as an off-label, versatile intravascular contrast agent for cardiovascular magnetic resonance (CMR) imaging, and in 2025, received FDA approval for brain imaging. This review provides an overview of ferumoxytol-enhanced CMR applications primarily focused on the heart, outlines its key imaging and pharmacokinetic properties, and summarizes its diagnostic safety profile. Unlike gadolinium-based contrast agents (GBCAs), which rapidly wash out from the circulation, ferumoxytol has high r1 and r2 relaxivities and remains confined to the intravascular compartment for prolonged periods. Once metabolized by the reticuloendothelial system, its iron core is incorporated into the body's hematopoietic pathways. These unique properties enable steady-state and delayed-phase imaging, simplify complex imaging workflows, and facilitate accelerated multidimensional cardiac imaging methods. Emerging applications for ferumoxytol-enhanced CMR include myocardial perfusion assessment, multidimensional imaging, vascular and hemodynamic evaluation, and comprehensive structural heart disease imaging. Ferumoxytol expands the clinical applications of CMR by enabling imaging techniques that are not feasible with conventional GBCAs and broadening imaging options for patients in whom GBCA administration may be less desirable based on individualized clinical risk-benefit assessment, including selected patients with renal insufficiency, very young children, and pregnant women.
SN - 1941-9066
SN - 1941-9074
ER -