Clinical and Technical Feasibility of a Ultrasuperparamagnetic Nanoparticle Iron Oxide (USPIO)-Enhanced Magnetic Resonance Lymph Node Imaging

Study Participation:

If you are found to be eligible, during the following MRI scans, you will pass into a long,
narrow tube scanner, which is open at both ends. You will have a total of 3 MRI scans.

You will have an MRI scan before you receive ferumoxytole as needed. This is the
standard-of-care MRI scan. You will then receive ferumoxytole by vein. If you are scheduled
to have an MRI scan of your abdomen, or if you have visible lymph nodes in the abdomen, you
will stay in the MRI scanner an extra 30 minutes for liver imaging right after you receive
your dose of ferumoxytole. This is a part of an investigational scan (Visit 1--Day 1)

You will then return for an MRI scan 2 days later (Visit 2--Day 2) and then again the
following day (Visit 3--Day 3) to scan your lymph nodes. These are the investigational scans.
The timing of the second and third scans may be changed based on the study doctor's decision.

Length of Study:

Your participation on this study will be over after the third MRI scan.

Additional Information:

The images collected as part of this study will not be included as part of your medical
record. If any of the images and/or information from this study are used for publication, all
identifiable information will be removed. The data will be stored for 5 years after the study
data has been published.

This is an investigational study. Ferumoxytole is FDA approved and commercially available for
the treatment of iron-deficiency anemia in patients with chronic kidney disease. Its use to
help researchers "see" cancerous lymph nodes from an MRI scan is considered investigational.

Up to 18 participants will be enrolled in this study. All will take part at MD Anderson.

Inclusion Criteria:

1. Enrolled at MDACC, Written consent

2. Measurable nodes on the recent cross sectional imaging (CT, MRI. US) or suspicious
lymph nodes for metastasis

3. Requiring tissue diagnosis (FNA, core biopsy, surgical biopsy, surgical resection), or
clinical follow-ups for at least 6 months.

4. Any and all primary disease sites in the abdomen and pelvis will be allowed

Exclusion Criteria:

1. Primary or secondary iron overload

2. Lactation or pregnant - women of child bearing potential will be excluded

3. Contraindications for MRI

4. Contraindication or allergy to Feraheme® (based on insert)

5. Clinically documented or risk of primary or secondary iron overloading (e.g. History
of thalassemia, sickle cell anemia, hereditary hemochromatosis, multiple transfusions
with any reason), anemia not caused by iron deficiency

6. Age under 18