Use of intravascular contrast agents in MRI

Nanomedicine: tiny particles and machines give huge gains

Nanomedicine is an emerging field that integrates nanotechnology, biomolecular engineering, life sciences and medicine; it is expected to produce major breakthroughs in medical diagnostics and therapeutics. Nano-scale structures and devices are compatible in size with proteins and nucleic acids in living cells. Therefore, the design, characterization and application of nano-scale probes, carriers and machines may provide unprecedented opportunities for achieving a better control of biological processes, and drastic improvements in disease detection, therapy, and prevention. Recent advances in nanomedicine include the development of nanoparticle (NP)-based probes for molecular imaging, nano-carriers for drug/gene delivery, multifunctional NPs for theranostics, and molecular machines for biological and medical studies. This article provides an overview of the nanomedicine field, with an emphasis on NPs for imaging and therapy, as well as engineered nucleases for genome editing. The challenges in translating nanomedicine approaches to clinical applications are discussed.

Application of nanoparticles on diagnosis and therapy in gliomas

Glioblastoma multiforme (GBM) is one of the most deadly diseases that affect humans, and it is characterized by high resistance to chemotherapy and radiotherapy. Its median survival is only fourteen months, and this dramatic prognosis has stilled without changes during the last two decades; consequently GBM remains as an unsolved clinical problem. Therefore, alternative diagnostic and therapeutic approaches are needed for gliomas. Nanoparticles represent an innovative tool in research and therapies in GBM due to their capacity of self-assembly, small size, increased stability, biocompatibility, tumor-specific targeting using antibodies or ligands, encapsulation and delivery of antineoplastic drugs, and increasing the contact surface between cells and nanomaterials. The active targeting of nanoparticles through conjugation with cell surface markers could enhance the efficacy of nanoparticles for delivering several agents into the tumoral area while significantly reducing toxicity in living systems. Nanoparticles can exploit some biological pathways to achieve specific delivery to cellular and intracellular targets, including transport across the blood-brain barrier, which many anticancer drugs cannot bypass. This review addresses the advancements of nanoparticles in drug delivery, imaging, diagnosis, and therapy in gliomas. The mechanisms of action, potential effects, and therapeutic results of these systems and their future applications in GBM are discussed.

Coating optimization of superparamagnetic iron oxide nanoparticles for high T2 relaxivity

We describe a new method for coating superparamagnetic iron oxide nanoparticles (SPIOs) and demonstrate that, by fine-tuning the core size and PEG coating of SPIOs, the T2 relaxivity per particle can be increased by >200-fold. With 14 nm core and PEG1000 coating, SPIOs can have T2 relaxivity of 385 s-1 mM-1, which is among the highest per-Fe atom relaxivities. In vivo tumor imaging results demonstrated the potential of the SPIOs for clinical applications.

The utility of superparamagnetic contrast agents in MRI: theoretical consideration and applications in the cardiovascular system

This review will discuss the in vivo physical chemical relaxation properties of superparamagnetic iron oxide particles. Various parameters such as size, magnetization, compartmentalization and water exchange effects and how these alter the behavior of the iron oxide particles in an in vitro vs an in vivo situation with special reference to the cardiovascular system will be exemplified. Furthermore, applications using iron oxide particles for vascular, perfusion and viability imaging as well as assessment of the inflammatory status of a given tissue will be discussed.

Evaluation of a new ultrasmall superparamagnetic iron oxide contrast agent Clariscan, (NC100150) for MRI of renal perfusion: experimental study in an animal model

PURPOSE

To determine the diagnostic value of a new ultrasmall superparamagnetic iron oxide Clariscan, (NC100150) for the evaluation of renal perfusion in an animal model using a 3D-FFE-EPI sequence.

MATERIALS AND METHODS

Four groups of four rabbits each were imaged after bolus injection of NC100150, using a 1.5 T MR system (Gyroscan ACS-NT). T2*w MR images in the coronal plane were acquired over 60 seconds with an echo-shifted 3D-FFE-EPI sequence (TR/TE/alpha = 18/25 msec/8 degrees ). Data were transferred to a workstation and converted into concentration curves. Based on the fitted concentration time curves, parameter maps were calculated pixelwise: bolus arrival time (T0), time-to-peak (TTP), mean transit time (MTT), and relative bolus volume (rBV). Maximum signal decrease was determined with respect to the baseline value.

RESULTS

Mean MTT increased from 4.2 seconds at a dose of 0.25 mg to 5.9 seconds at 1.0 mg (P < .0001). The maximum signal decrease was observed at 0.75 mg, corresponding to 85% of the baseline value. Transit times of the contrast bolus were accurately calculated for the cortex and the outer medulla, but at the level of the inner medulla no arterial flow profile was identified. No significant difference between the cortex and the outer medulla was found for either T0 or rBV, but medullar TTP and MTT were prolonged with regard to cortical TTP and MTT (6.3 seconds vs. 5.7 seconds, P < .001; 5.7 seconds vs. 4.2 seconds, P < .0001).

CONCLUSION

The employed intravascular contrast agent is well suited to assess renal perfusion. By the use of a T2*w3D perfusion sequence, cortical and medullar transit times can be quantified and physiologic information on regional perfusion differences can be obtained.

The future of magnetic resonance-based techniques in neurology

Magnetic resonance techniques have become increasingly important in neurology for defining: 1. brain, spinal cord and peripheral nerve or muscle structure; 2. pathological changes in tissue structures and properties; and 3. dynamic patterns of functional activation of the brain. New applications have been driven in part by advances in hardware, particularly improvements in magnet and gradient coil design. New imaging strategies allow novel approaches to contrast with, for example, diffusion imaging, magnetization transfer imaging, perfusion imaging and functional magnetic resonance imaging. In parallel with developments in hardware and image acquisition have been new approaches to image analysis. These have allowed quantitative descriptions of the image changes to be used for a precise, non-invasive definition of pathology. With the increasing capabilities and specificity of magnetic resonance techniques it is becoming more important that the neurologist is intimately involved in both the selection of magnetic resonance studies for patients and their interpretation. There is a need for considerably improved access to magnetic resonance technology, particularly in the acute or intensive care ward and in the neurosurgical theatre. This report illustrates several key developments. The task force concludes that magnetic resonance imaging is a major clinical tool of growing significance and offers recommendations for maximizing the potential future for magnetic resonance techniques in neurology.

Contrast-enhanced coronary MRA

Coronary angiography with magnetic resonance imaging (MRI) has long been a goal for bringing cardiac MRI into clinical use for diagnosis of coronary artery disease. In this paper, the fundamental problems of respiratory and cardiac motion, signal-to-noise ratio, and contrast-to-noise ratio are discussed in reference to implications for coronary imaging strategies. Various methods that have been proposed to improve signal-to-noise and contrast-to-noise ratios in MR coronary imaging are presented with an emphasis on the role of T1-shortening contrast agents, both extracellular and intravascular. Although much progress has been made in recent years in techniques for imaging the coronary arteries, ultimate clinical success remains unproved. Success will depend on synergistic developments in MR acquisition techniques, respiratory compensation methods, post-processing techniques, and contrast agents to develop a workable solution for reliable coronary imaging across a wide range of patients. J. Magn. Reson. Imaging 1999;10:703-708.

Pulmonary MR angiography with ultrasmall superparamagnetic iron oxide particles as a blood pool agent and a navigator echo for respiratory gating: pilot study

In nine healthy adult volunteers, pulmonary magnetic resonance angiography was performed with the blood pool agent NC100150 injection combined with respiratory gating with a navigator echo. With increasing doses of the contrast agent, higher signal intensities and vessel branch order visualization were achieved. No motion artifacts were seen. The blood pool agent NC100150 injection in combination with respiratory navigator gating permitted acquisition of high-quality MR angiograms of the pulmonary vasculature during continuous breathing.

Abdominal vessel enhancement with an ultrasmall, superparamagnetic iron oxide blood pool agent: evaluation of dose and echo time dependence at different field strengths

RATIONALE AND OBJECTIVES

The purpose of the study was to determine the dose and echo time dependence of abdominal vessel enhancement at magnetic resonance (MR) imaging after injection of a blood pool contrast agent at two field strengths.

MATERIALS AND METHODS

Sixteen healthy volunteers received NC100150 Injection at three dose levels (1.0 mg, 2.5 mg, and 4.0 mg of iron per kilogram of body weight). Images of the aorta and inferior vena cava (IVC) were obtained at 0.5 or 1.5 T. Four sequences with varying echo times were used with each subject. Signal intensities were recorded from the aorta, IVC, vessel vicinity, air, and a marker outside the patient. Contrast-to-noise ratios (CNRs) were calculated for the vessels. Aortic delineation was subjectively evaluated.

RESULTS

Images with the highest mean vessel signal intensities, subjectively assessed as satisfactory for aortic delineation, were obtained with 2.5-4.0 mg of iron per kilogram of body weight at both field strengths. The highest CNR was found with 4.0 mg of iron per kilogram of body weight at 1.5 T. An increase in echo time caused larger signal intensity loss at larger dose levels. The signal intensity from the IVC was higher than that of the aorta at all dose levels, echo times, and field strengths.

CONCLUSION

NC100150 Injection is an efficient T1-reducing agent at both 0.5 and 1.5 T. A positive dose response for CNR of the aorta and IVC was seen at 1.5 T.

Benefit of T1 reduction for magnetic resonance coronary angiography: a numerical simulation and phantom study

Contrast agents have dramatically improved magnetic resonance angiography (MRA) of the abdominal and peripheral arteries. The imaging technique for these applications is usually a steady-state acquisition, for which the relationship between T1 in blood and the MR signal is well known. However, in electrocardiography-triggered angiography with limited acquisition windows, this relationship is more complex. Therefore the purpose of this work is to define the relationship between the T1 in blood and the MR signal amplitude in three-dimensional magnetic resonance coronary angiography (3D-MRCA). Simulations were performed using equations describing the MR signal in both steady-state and triggered acquisition schemes. Triggered acquisition schemes use flip-angle sweeps to maintain a constant signal during the acquisition. In this study, the effect of the flip angle sweep was calculated as a function of T1. The results show that the effect of T1 shortening in contrast-enhanced 3D-MRCA differs substantially from that in conventional contrast-enhanced MRA. The triggered acquisition allows unsaturated blood to enter the volume between the acquisitions and thereby gives a much higher signal at long T1s than does steady-state acquisition. Therefore, to gain a benefit in signal amplitude with contrast agents for 3D-MRCA using gradient-echo sequences, the T1 in blood may have to be as low as 50 msec. In addition, when using a prepulse to null myocardium, the results indicate the need for a large difference in T1 between blood and myocardium to avoid signal loss in blood.