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de Winne K, Vanderkerken S, Hoste K, Dubruel P, Schacht E, Jelinkova M, Rihova B. Dendritic Poly-[N-(2-Hydroxyethyl)-L-Glutamine] as Potential Drug Carrier. J BIOACT COMPAT POL 2016. [DOI: 10.1177/0883911504046680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dendritic poly-[ N-(2-hydroxyethyl)-L-glutamine] (PHEG) with different molecular weights were synthesized by aminolysis of dendritic poly-(γ-benzyl-L-glutamate) (PBG), which was obtained by polymerization of the corresponding N-carboxyanhydride (NCA) with poly(amido amine) (PAMAM, starburst®) of the fourth generation as initiator. Dynamic light scattering (DLS) was used to determine the size of the polymeric carriers and to compare the dendritic polymer to the linear analogue. The body distribution and blood clearance of 125 I-radiolabelled linear and dendritic PHEG with similar molecular weight were investigated in female BALB/c mice.
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Affiliation(s)
| | | | | | - Peter Dubruel
- Polymer Materials Research Group, Ghent University, Krijgslaan 281 S4-bis, 9000 Ghent, Belgium
| | - Etienne Schacht
- Polymer Materials Research Group, Ghent University, Krijgslaan 281 S4-bis, 9000 Ghent, Belgium
| | | | - Blanka Rihova
- Institute of Microbiology, Academy of Sciences of the Czech Republic, Videnska 1083, 142 20 Prague 4, Czech Republic
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2
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Huang CH, Tsourkas A. Gd-based macromolecules and nanoparticles as magnetic resonance contrast agents for molecular imaging. Curr Top Med Chem 2014; 13:411-21. [PMID: 23432004 DOI: 10.2174/1568026611313040002] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 11/21/2012] [Accepted: 11/26/2012] [Indexed: 11/22/2022]
Abstract
As we move towards an era of personalized medicine, molecular imaging contrast agents are likely to see an increasing presence in routine clinical practice. Magnetic resonance (MR) imaging has garnered particular interest as a platform for molecular imaging applications due its ability to monitor anatomical changes concomitant with physiologic and molecular changes. One promising new direction in the development of MR contrast agents involves the labeling and/or loading of nanoparticles with gadolinium (Gd). These nanoplatforms are capable of carrying large payloads of Gd, thus providing the requisite sensitivity to detect molecular signatures within disease pathologies. In this review, we discuss some of the progress that has recently been made in the development of Gd-based macromolecules and nanoparticles and outline some of the physical and chemical properties that will be important to incorporate into the next generation of contrast agents, including high Gd chelate stability, high "relaxivity per particle" and "relaxivity density", and biodegradability.
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Affiliation(s)
- Ching-Hui Huang
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
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3
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Besheer A, Caysa H, Metz H, Mueller T, Kressler J, Mäder K. Benchtop-MRI for in vivo imaging using a macromolecular contrast agent based on hydroxyethyl starch (HES). Int J Pharm 2011; 417:196-203. [DOI: 10.1016/j.ijpharm.2010.10.051] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 10/17/2010] [Accepted: 10/19/2010] [Indexed: 10/18/2022]
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4
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Frullano L, Caravan P. Strategies for the preparation of bifunctional gadolinium(III) chelators. Curr Org Synth 2011; 8:535-565. [PMID: 22375102 DOI: 10.2174/157017911796117250] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The development of gadolinium chelators that can be easily and readily linked to various substrates is of primary importance for the development high relaxation efficiency and/or targeted magnetic resonance imaging (MRI) contrast agents. Over the last 25 years a large number of bifunctional chelators have been prepared. For the most part, these compounds are based on ligands that are already used in clinically approved contrast agents. More recently, new bifunctional chelators have been reported based on complexes that show a more potent relaxation effect, faster complexation kinetics and in some cases simpler synthetic procedures. This review provides an overview of the synthetic strategies used for the preparation of bifunctional chelators for MRI applications.
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Affiliation(s)
- Luca Frullano
- Case Western Reserve University. 11100 Euclid Ave Cleveland, OH 44106
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5
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Hatakeyama W, Sanchez TJ, Rowe MD, Serkova NJ, Liberatore MW, Boyes SG. Synthesis of gadolinium nanoscale metal-organic framework with hydrotropes: manipulation of particle size and magnetic resonance imaging capability. ACS APPLIED MATERIALS & INTERFACES 2011; 3:1502-10. [PMID: 21456529 DOI: 10.1021/am200075q] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Gadolinium metal-organic framework (Gd MOF) nanoparticles are an interesting and novel class of nanomaterials that are being studied as a potential replacement for small molecule positive contrast agents in magnetic resonance imaging (MRI). Despite the tremendous interest in these nanoscale imaging constructs, there are limitations, particularly with respect to controlling the particle size, which need to be overcome before these nanoparticles can be integrated into in vivo applications. In an effort to control the size, shape, and size distribution of Gd MOF nanoparticles, hydrotropes were incorporated into the reverse microemulsion synthesis used to produce these nanoparticles. A study of how hydrotropes influenced the mechanism of formation of reverse micelles offered a great deal of information with respect to the physical properties of the Gd MOF nanoparticles formed. Specifically, this study incorporated the hydrotropes, sodium salicylate (NaSal), 5-methyl salicylic acid, and salicylic acid into the reverse microemulsion. Results demonstrated that addition of each of the hydrotropes into the synthesis of Gd MOFs provided a simple route to control the nanoparticle size as a function of hydrotrope concentration. Specifically, Gd MOF nanoparticles synthesized with NaSal showed the best reduction in size distributions in both length and width with percent relative standard deviations being nearly 50% less than nanoparticles produced via the standard route from the literature. Finally, the effect of the size of the Gd MOF nanoparticles with respect to their MRI relaxation properties was evaluated. Initial results indicated a positive correlation between the surface areas of the Gd MOF nanoparticles with the longitudinal relaxivity in MRI. In particular, Gd MOF nanoparticles with an average size of 82 nm with the addition of NaSal, yielded a longitudinal relaxivity value of 83.9 mM⁻¹ [Gd³⁺] sec⁻¹, one of the highest reported values compared to other Gd-based nanoparticles in the literature to date.
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Affiliation(s)
- Wilasinee Hatakeyama
- Department of Chemistry and Geochemistry, Colorado School of Mines, Golden, Colorado 80401, USA
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6
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Atkins KM, Martínez FM, Nazemi A, Scholl TJ, Gillies ER. Poly(para-phenylene ethynylene)s functionalized with Gd(III) chelates as potential MRI contrast agents. CAN J CHEM 2011. [DOI: 10.1139/v10-156] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A poly(para-phenylene ethynylene) with water-solubilizing groups and Gd(III) chelates conjugated to the polymer backbone was designed and synthesized. Pre- and post-polymerization functionalization approaches were explored and the pre-polymerization approach for the introduction of the Gd(III) chelate was found to be more successful. The UV–vis absorption and fluorescence emission properties of the protected polymers were characterized and were found to be consistent with the results expected for this class of polymers. Removal of the protecting groups followed by chelation of Gd(III) led to a water-dispersible polymer. Relaxivity measurements were performed on this polymer with the aim of evaluating its potential as a new MRI contrast agent, and an r1 of 1.37 L mmol–1 s–1 at 310 K and 20 MHz was determined. These results, along with dynamic light scattering analyses, suggested that the polymers formed micrometre-sized assemblies in aqueous solution. Although the relaxivity was relatively modest, these results provide important insights into the assembly properties of this new class of polymers and into the design criteria for future agents.
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Affiliation(s)
- Katelyn M. Atkins
- Department of Chemistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5B7, Canada
- Department of Medical Biophysics, The Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5C1, Canada
| | - Francisco M. Martínez
- Department of Chemistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5B7, Canada
- Department of Medical Biophysics, The Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5C1, Canada
| | - Ali Nazemi
- Department of Chemistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5B7, Canada
- Department of Medical Biophysics, The Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5C1, Canada
| | - Timothy J. Scholl
- Department of Chemistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5B7, Canada
- Department of Medical Biophysics, The Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5C1, Canada
| | - Elizabeth R. Gillies
- Department of Chemistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5B7, Canada
- Department of Medical Biophysics, The Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond Street, London, ON N6A 5C1, Canada
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7
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Serŝa G, Beravs K, Ĉemazˆar M, Miklavĉiĉ D, Demsar F. Contrast Enhanced MRI Assessment of Tumor Blood Volume After Application of Electric Pulses. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/15368379809022574] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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8
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Becker A, Riefke B, Ebert B, Sukowski U, Rinneberg H, Semmler W, Licha K. Macromolecular Contrast Agents for Optical Imaging of Tumors: Comparison of Indotricarbocyanine-labeled Human Serum Albumin and Transferrin¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2000)0720234mcafoi2.0.co2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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9
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Langereis S, Dirksen A, Hackeng TM, van Genderen MHP, Meijer EW. Dendrimers and magnetic resonance imaging. NEW J CHEM 2007. [DOI: 10.1039/b616960k] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Perkins AC. Polymer conjugates for imaging. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2003; 519:195-205. [PMID: 12675216 DOI: 10.1007/0-306-47932-x_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alan C Perkins
- Academic Medical Physics, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
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11
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Bryant LH, Jordan EK, Bulte JWM, Herynek V, Frank JA. Pharmacokinetics of a high-generation dendrimer-Gd-DOTA. Acad Radiol 2002; 9 Suppl 1:S29-33. [PMID: 12019888 DOI: 10.1016/s1076-6332(03)80390-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- L Henry Bryant
- Laboratory of Diagnostic Radiology Research, Warren Grant Maguson Clinical Center, National Institutes of Health, Bethesda, MD 20892-1074, USA
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12
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Magnetic resonance imaging contrast agents: Theory and the role of dendrimers. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s1874-5229(02)80006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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13
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Bulte JW, Douglas T, Witwer B, Zhang SC, Strable E, Lewis BK, Zywicke H, Miller B, van Gelderen P, Moskowitz BM, Duncan ID, Frank JA. Magnetodendrimers allow endosomal magnetic labeling and in vivo tracking of stem cells. Nat Biotechnol 2001; 19:1141-7. [PMID: 11731783 DOI: 10.1038/nbt1201-1141] [Citation(s) in RCA: 704] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Magnetic resonance (MR) tracking of magnetically labeled stem and progenitor cells is an emerging technology, leading to an urgent need for magnetic probes that can make cells highly magnetic during their normal expansion in culture. We have developed magnetodendrimers as a versatile class of magnetic tags that can efficiently label mammalian cells, including human neural stem cells (NSCs) and mesenchymal stem cells (MSCs), through a nonspecific membrane adsorption process with subsequent intracellular (non-nuclear) localization in endosomes. The superparamagnetic iron oxide nanocomposites have been optimized to exhibit superior magnetic properties and to induce sufficient MR cell contrast at incubated doses as low as 1 microg iron/ml culture medium. When containing between 9 and 14 pg iron/cell, labeled cells exhibit an ex vivo nuclear magnetic resonance (NMR) relaxation rate (1/T2) as high as 24-39 s-1/mM iron. Labeled cells are unaffected in their viability and proliferating capacity, and labeled human NSCs differentiate normally into neurons. Furthermore, we show here that NSC-derived (and LacZ-transfected), magnetically labeled oligodendroglial progenitors can be readily detected in vivo at least as long as six weeks after transplantation, with an excellent correlation between the obtained MR contrast and staining for beta-galactosidase expression. The availability of magnetodendrimers opens up the possibility of MR tracking of a wide variety of (stem) cell transplants.
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Affiliation(s)
- J W Bulte
- Laboratory of Diagnostic Radiology Research (CC), National Institutes of Health, Bethesda, MD 20892, USA.
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15
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Takahashi M, Hara Y, Aoshima K, Kurihara H, Oshikawa T, Yamashita* M. Utilization of dendritic framework as a multivalent ligand: a functionalized gadolinium(III) carrier with glycoside cluster periphery. Tetrahedron Lett 2000. [DOI: 10.1016/s0040-4039(00)01488-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Becker A, Riefke B, Ebert B, Sukowski U, Rinneberg H, Semmler W, Licha K. Macromolecular contrast agents for optical imaging of tumors: comparison of indotricarbocyanine-labeled human serum albumin and transferrin. Photochem Photobiol 2000; 72:234-41. [PMID: 10946578 DOI: 10.1562/0031-8655(2000)072<0234:mcafoi>2.0.co;2] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Macromolecules accumulate in solid tumors and can thus be used as carriers for the delivery of attached contrast agents to tumors. We report the synthesis and use of serum protein-dye conjugates consisting of transferrin (Tf) or human serum albumin (HSA) and an indotricarbocyanine (ITCC) derivative as contrast agents for the optical imaging of tumors. The compounds were characterized with respect to their photophysical properties and tested in vitro for their ability to bind to tumor cells and in vivo for their potential to delineate experimental tumors. In contrast to HAS-ITTC, Tf-ITCC showed receptor-mediated uptake by HT29 human colon cancer cells in vitro. After intravenous injection into HT29 tumor-bearing nude mice both compounds induced increased fluorescence contrast of tumors in vivo. After 24 h the contrast between tumor and normal tissue was significantly higher for Tf-ITCC than for HAS-ITCC. Dye-induced fluorescence was found to be predominantly located in perinecrotic areas of the tumor. Furthermore, Tf-ITCC produced fluorescence of viable tumor cells, whereas HAS-ITCC fluorescence was recorded along connective tissue. We conclude that ITCC-labeled Tf and HSA can serve as macromolecular contrast agents for the optical imaging of tumors, with Tf-ITCC showing higher efficiency.
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Affiliation(s)
- A Becker
- Institut für Diagnostikforschung GmbH, Freien Universität Berlin, Germany
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17
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Helbich TH, Gossman A, Mareski PA, Radüchel B, Roberts TP, Shames DM, Mühler M, Turetschek K, Brasch RC. A new polysaccharide macromolecular contrast agent for MR imaging: biodistribution and imaging characteristics. J Magn Reson Imaging 2000; 11:694-701. [PMID: 10862070 DOI: 10.1002/1522-2586(200006)11:6<694::aid-jmri17>3.0.co;2-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aims of this study were to characterize certain physicochemical, pharmacokinetic, and enhancement properties of a new macromolecular contrast agent, carboxymethyl hydroxyethyl starch-(Gd-DO3A)(35) [CMHES-(Gd-DO3A)(35)], consisting of a polysaccharide backbone covalently derivatized with multiple macrocyclic chelating groups for gadolinium. CMHES-(Gd-DO3A)(35) has an average molecular weight of 72 kD and a plasma half-time of 8.4 hours. T1 and T2 relaxivities are 14.1 +/- 0.1 L mmol(-1) * sec(-1) and 17.8 +/- 0.9 L mmol(-1) * sec(-1), respectively, for each gadolinium ion measured at 39 degrees C and 20 Mhz; this T1 relaxivity is more than 4 times that of gadopentetate. Seven days after intravenous administration only relatively small amounts of gadolinium could be detected in blood or other tissues of rats. The compound was well tolerated in diagnostic dosages by all experimental animals. Magnetic resonance angiography performed within 1 hour of CMHES-(Gd-DO3A)(35) administration showed a near-constant and strong enhancement of blood in arteries and veins. Analysis of dynamic enhancement patterns of experimental tumors (MAT-LyLu prostate cancer implanted in rats) following intravenous CMHES-(Gd-DO3A)(35) administration yielded quantitative estimates of tumor plasma volume and microvessel permeability; the demonstrated hyperpermeability of tumor microvessels was easily distinguished from the absence of measurable microvascular permeability in non-neoplastic soft tissues.
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Affiliation(s)
- T H Helbich
- Contrast Media Laboratory, Department of Radiology, University of California-San Francisco, San Francisco, California 94143, USA
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18
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Abstract
The use of exogenous contrast media in magnetic resonance imaging of the brain has brought dramatic improvement in the sensitivity of detection and delineation of pathological structures, such as primary and metastatic brain tumors, inflammation and ischemia. Disruption of the blood brain barrier leads to accumulation of the intravenously injected contrast material in the extravascular space, leading to signal enhancement. Magnetic resonance angiography benefits from T(1)-shortening effects of contrast agent, improving small vessel depiction and providing vascular visualization even in situations of slow flow. High speed dynamic MRI after bolus injection of contrast media allows tracer kinetic modeling of cerebral perfusion. Progressive enhancement over serial post-contrast imaging allows modeling of vascular permeability and thus quantitative estimation of the severity of blood brain barrier disruption. With such an array of capabilities and ever improving technical abilities, it seems that the role of contrast agents in MR neuroimaging is established and the development of new agents may be superfluous. However, new agents are being developed with prolonged intravascular residence times, and with in-vivo binding of ever-increasing specificity. Intravascular, or blood pool, agents are likely to benefit magnetic resonance angiography of the carotid and cerebral vessels; future agents may allow the visualization of therapeutic drug delivery, the monitoring of, for example, gene expression, and the imaging evaluation of treatment efficacy. So while there is a substantial body of work that can be performed with currently available contrast agents, especially in conjunction with optimized image acquisition strategies, post processing, and mathematical analysis, there are still unrealized opportunities for novel contrast agent introduction, particularly those exploiting biological specificity. This article reviews the current use of contrast media in magnetic resonance neuroimaging, discusses some of the developing strategies for new applications of imaging with these agents and finally offers some views and indications for contrast agents currently under development, as well as some speculation on unsolved problems in neuroimaging, and opportunities for novel contrast agents.
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Affiliation(s)
- T P Roberts
- Department of Radiology, University of California, Box 0628, 513 Parnassus Avenue, San Francisco, CA 94143, USA.
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19
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Clarke SE, Weinmann HJ, Dai E, Lucas AR, Rutt BK. Comparison of two blood pool contrast agents for 0.5-T MR angiography: experimental study in rabbits. Radiology 2000; 214:787-94. [PMID: 10715047 DOI: 10.1148/radiology.214.3.r00mr25787] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate two experimental blood pool agents for potential use in equilibrium phase abdominal magnetic resonance (MR) angiography. MATERIALS AND METHODS MR imaging at 0.5 T was performed in 37 rabbits before and after intravenous injection of a gadolinium-based blood pool contrast agent (SH L 643 A), superparamagnetic iron oxide blood pool agent (SH U 555 C), or gadopentetate dimeglumine. T1-weighted fast spoiled gradient-echo images from the renal arteries to below the iliac bifurcation were obtained. The aorta-to-tissue signal difference-to-noise ratio (SDNR) was measured over time. RESULTS Both blood pool agents yielded excellent demonstration of the rabbit abdominal aorta. At a dose of 0.1 mmol/kg, both provided a statistically significant increase in aorta-to-tissue SDNR in comparison with that achieved with gadopentetate dimeglumine (200% increase for SH L 643 A, 95% increase for SH U 555 C; P < .05). A 0.1 mmol/kg dose of SH L 643 A provided a 24% increase in SDNR relative to the increase with a 0.37 mmol/kg dose of gadopentetate dimeglumine. Time-dependent enhancement properties of the blood pool agents differed due to differences in elimination method. CONCLUSION Both blood pool agents were found to be promising contrast agents for 0.5-T MR angiography; however, their clinical applicability warrants further investigation. The gadolinium-based agent had several advantages over the iron oxide compound, including less T2* dephasing, lack of susceptibility artifacts, and fast renal elimination.
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Affiliation(s)
- S E Clarke
- Robarts Research Institute, Imaging Research Laboratories, London, Ontario, Canada
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20
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Marchand B, Douek PC, Benderbous S, Corot C, Canet E. Pilot MR evaluation of pharmacokinetics and relaxivity of specific blood pool agents for MR angiography. Invest Radiol 2000; 35:41-9. [PMID: 10639035 DOI: 10.1097/00004424-200001000-00005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the use of two new blood pool contrast agents (P760, P775) compared with a low-molecular-weight gadolinium chelate in MR angiography. METHODS The r1 efficiency of P760 was evaluated in vitro at 1.5 T; 3D abdominal contrast-enhanced MR angiography with qualitative analysis was compared in four rabbits after injection of incremental doses of P760 and in one rabbit after Gd-DOTA. A dynamic MR study was performed using a 2D T1-weighted turbo-flash MR sequence after injection of P760, P775, and Gd-DOTA. Each compound was tested at equivalent doses in three rabbits to assess r1 efficiency. Quantitative analysis of signal intensity in the aorta, the inferior vena cava, the renal cortex, and the medulla was performed. RESULTS In vitro, the r1 efficiency of P760 was 23.3 mmol(-1) x L x sec(-1) at 1.5 T. Injection of a dose of P760 10 times less than Gd-DOTA allowed similar vessel visualization. The signal intensity peak and first-pass contrast kinetics in the aorta and the inferior vena cava were similar with the three products. Compared with P760 and Gd-DOTA, P775 allowed a greater renal cortex signal intensity at the first pass and a faster decrease on delayed images. CONCLUSIONS The superior r1 efficiency of P760 and P775 was confirmed in vitro and in vivo at 1.5 T compared with Gd-DOTA, and P775 proved to be a rapid-clearance blood pool agent.
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22
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Helbich TH, Gossman A, Mareski PA, Rad�chel B, Roberts TP, Shames DM, M�hler M, Turetschek K, Brasch RC. A new polysaccharide macromolecular contrast agent for MR imaging: Biodistribution and imaging characteristics. J Magn Reson Imaging 2000. [DOI: 10.1002/1522-2586(200006)11:6%3c694::aid-jmri17%3e3.0.co;2-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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23
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Abstract
Dendrimers are highly branched three-dimensional macromolecules with highly controlled structures, a single molecular weight, a large number of controllable 'peripheral' functionalities and a tendency to adopt a globular shape once a certain size is reached. These features have made their application in pharmaceutical and medicinal chemistry particularly attractive. This review briefly discusses the preparation of dendrimers, their use as gene delivery agents and magnetic resonance imaging agents, and their potential for applications in drug delivery.
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Gossmann A, Okuhata Y, Shames DM, Helbich TH, Roberts TP, Wendland MF, Huber S, Brasch RC. Prostate cancer tumor grade differentiation with dynamic contrast-enhanced MR imaging in the rat: comparison of macromolecular and small-molecular contrast media--preliminary experience. Radiology 1999; 213:265-72. [PMID: 10540670 DOI: 10.1148/radiology.213.1.r99oc43265] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE To differentiate prostate cancers of different histopathologic grades with dynamic gadolinium-enhanced magnetic resonance (MR) imaging. Results with a conventional small-molecular contrast medium (CM) were compared to those with a prototypic macromolecular CM. MATERIALS AND METHODS High- and low-grade tumors, sublines of the Dunning R3327 rat prostate cancer line, were subcutaneously implanted into the flanks of 12 male Copenhagen rats. Dynamic contrast material-enhanced MR imaging was performed with small-molecular CM and macromolecular CM at an interval of 1 day. Microvascular permeability, as estimated with the endothelial transfer coefficient, and fractional plasma volume were calculated for each tumor and each CM by means of a two-compartmental, bidirectional kinetic model. RESULTS Mean endothelial transfer coefficient values for both macromolecular CM and small-molecular CM were significantly different between the two tumor sublines (P = .0004 and P = .01, respectively). For the high- and low-grade tumors, no overlap of values was seen with macromolecular CM, but a broad overlap was seen with small-molecular CM despite a significant difference in mean values. CONCLUSION Dynamic contrast-enhanced MR imaging permits differentiation of histopathologic prostatic tumor types. Quantitative microvascular permeability characteristics estimated from macromolecular CM-enhanced data were significantly superior to those derived from small-molecular CM-enhanced data.
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Affiliation(s)
- A Gossmann
- Department of Radiology, University of California, San Francisco 94143-0628, USA
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Abstract
With contrast-enhanced MR angiographic techniques, a T1-shortening contrast agent is injected into the blood stream. Imaging during the first pass of the contrast agent permits acquisition of a high-contrast MR angiogram. Scan parameters such as flip angle, repetition time, echo time, and scan duration, and injection parameters, such as dose and rate, must be carefully chosen to achieve maximum contrast between blood vessels and stationary tissues. A critical parameter affecting image quality is the timing of the acquisition relative to the injection. If the collection of the center of k-space does not coincide with peak arterial concentration, artifacts, reduced SNR, and venous enhancement may result. Several techniques have been developed to address the timing issue. Post-processing techniques such as subtracting a pre-contrast image from a post-contrast angiogram can be used to improve image quality. Intravascular contrast agents that may also lead to improved image quality are currently being developed.
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Affiliation(s)
- F R Korosec
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin.
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Reese T, Bochelen D, Sauter A, Beckmann N, Rudin M. Magnetic resonance angiography of the rat cerebrovascular system without the use of contrast agents. NMR IN BIOMEDICINE 1999; 12:189-196. [PMID: 10421910 DOI: 10.1002/(sici)1099-1492(199906)12:4<189::aid-nbm557>3.0.co;2-o] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We describe and discuss the application of three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) to visualize non-invasively the cerebral vasculature of the rat. MR angiograms of healthy spontaneously hypertensive rats were obtained without the use of contrast agents. Total imaging time ranged from 1 to 50 min for a 3D data set. The influences of the data matrix and the inflow delay on the image quality and the total imaging time are assessed and discussed. Varying the inflow delay yielded in addition semiquantitative information on hemodynamics. The method was applied to obtain angiograms in rat models of permanent and temporal middle cerebral artery occlusion. Occlusion and reopening of the vessel could easily be verified by MRA. However, after reperfusion a slight reduction in blood flow was observed.
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Affiliation(s)
- T Reese
- Core Technology, Novartis Pharma Ltd, Basel, Switzerland.
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27
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Ladd DL, Hollister R, Peng X, Wei D, Wu G, Delecki D, Snow RA, Toner JL, Kellar K, Eck J, Desai VC, Raymond G, Kinter LB, Desser TS, Rubin DL. Polymeric gadolinium chelate magnetic resonance imaging contrast agents: design, synthesis, and properties. Bioconjug Chem 1999; 10:361-70. [PMID: 10346865 DOI: 10.1021/bc980086+] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We have synthesized and evaluated five series of polymeric gadolinium chelates which are of interest as potential MRI blood pool contrast agents. The polymers were designed so that important physical properties including molecular weight, relaxivity, metal content, viscosity, and chelate stability could be varied. We have shown that, by selecting polymers of the appropriate MW, extended blood pool retention can be achieved. In addition, relaxivity can be manipulated by changing the polymer rigidity, metal content affected by monomer selection, viscosity by polymer shape, and chelate stability by chelator selection.
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Affiliation(s)
- D L Ladd
- Torsten Almén Research Center, Nycomed Amersham Imaging, 466 Devon Park Drive, Wayne, Pennsylvania 19087, USA.
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Bogdanov AA, Lewin M, Weissleder R. Approaches and agents for imaging the vascular system. Adv Drug Deliv Rev 1999; 37:279-293. [PMID: 10837740 DOI: 10.1016/s0169-409x(98)00098-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Several classes of vascular imaging agents are described: (1) liposome-based blood cell mimetics; (2) plasma protein mimetics; (3) small molecules that bind to plasma proteins in the circulation. The characteristic features of the different agents are described and critically compared, including the advantages and potential pitfalls of each individual type.
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Affiliation(s)
- AA Bogdanov
- Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Bldg. 149, 13th St., Boston, MA 02129, USA
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Bryant LH, Brechbiel MW, Wu C, Bulte JW, Herynek V, Frank JA. Synthesis and relaxometry of high-generation (G = 5, 7, 9, and 10) PAMAM dendrimer-DOTA-gadolinium chelates. J Magn Reson Imaging 1999; 9:348-52. [PMID: 10077036 DOI: 10.1002/(sici)1522-2586(199902)9:2<348::aid-jmri30>3.0.co;2-j] [Citation(s) in RCA: 207] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A series of high-generation (G) ethylenediamine-core polyamidoamine (PAMAM) dendrimers corresponding to G = 5, 7, 9, and 10 were conjugated with the bifunctional chelate 2-(4-isothiocyanatobenzyl)- 1,4,7,10-tetraazacyclododecane-N,N',N",N"'-tetraacetate (p-SCN-Bz-DOTA). Gadolinium (III) ion was added to the macromolecules, and the 1/T1 and 1/T2 NMRD profiles were measured at 3 degrees, 23 degrees, and 37 degrees C. The synthesis resulted in preparations that ranged from an average of 127 chelates and 96 Gd3+ ions per G = 5 dendrimer to an average of 3727 chelates and 1860 Gd3+ ions per G = 10 dendrimer. At 20 MHz and 23 degrees C, the 1/T1 ion relaxivity increased from 30 mM(-1) s(-1) for the G = 5 to 35 mM(-1) s(-1) for the G = 7 PAMAM dendrimer-DOTA-Gd, reaching a plateau at 36 mM(-1) s(-1) for the G = 9 and G = 10 dendrimers. A similar plateau was observed for 1/T2 with values of 36 mM(-1) s(-1) for G = 5, 42 mM(-1) s(-1) for G = 7, and 45 mM(-1) s(-1) for the G = 9 and G = 10 dendrimers. This "saturation" of ion relaxivity for high-generation dendrimers occurred over the entire frequency range studied. The 1/T1 and 1/T2 relaxivities decreased as the temperature decreased for each generation of dendrimer studied, implying that slow water exchange of bound water molecules with the bulk solvent limits the relaxivity. In such circumstances, increases in the rotational correlation time of the macromolecules associated with higher generations of dendrimer does not result in significant increases in the ion relaxivity. Although the ion relaxivity does not increase, the total molecular relaxivities increased from 2880 mM(-1) s(-1) to 66960 mM(-1) s(-1) for the G = 5 to the G = 10 dendrimer. The current findings are relevant for the design of high-generation dendrimer-based receptor agents.
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Affiliation(s)
- L H Bryant
- Laboratory of Diagnostic Radiology Research (CC), National Institutes of Health, Bethesda, Maryland 20892, USA.
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Abstract
Diagnostic imaging techniques are an essential component of modern patient management. To maximise the yield of diagnostic information from these procedures, pharmaceutical grade contrast agents can be administered which will enhance regions of the image by virtue of their presence in the patient. This concept is well established in X-ray investigations using radiographically dense materials such as intravascular iodine and oral barium. The widespread use of other imaging modalities such as nuclear medicine, magnetic resonance and ultrasound has led to the development of a broad range of pharmaceutical agents which are administered to obtain diagnostic information, rather than to result in a pharmacological effect. Synthetic polymers and polypeptides in particular offer a range of materials with properties highly suited for use as image contrast media. This article outlines the basis of the main imaging techniques and the physical attributes of materials used to obtain image contrast. The use of synthetic polymeric formulations appears to offer great potential as a range of elegant "designer contrast agents." Examples are given for each imaging modality.
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Affiliation(s)
- A C Perkins
- Academic Division of Medical Physics, Medical School, University Hospital, Queen's Medical Centre, Nottingham, UK
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Bulte JW, Wu C, Brechbiel MW, Brooks RA, Vymazal J, Holla M, Frank JA. Dysprosium-DOTA-PAMAM dendrimers as macromolecular T2 contrast agents. Preparation and relaxometry. Invest Radiol 1998; 33:841-5. [PMID: 9818319 DOI: 10.1097/00004424-199811000-00008] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
RATIONALE AND OBJECTIVES The authors have investigated dysprosium [Dy]-DOTA-PAMAM, generation 5 (G = 5) dendrimers as a possible new class of macromolecular T2 contrast agents. The use of DOTA provides a metal complex with greater stability than can be achieved using DTPA as ligand, an important factor in the design of blood pool agents with long half-lives. METHODS Generation 5 ammonia-core PAMAM dendrimers were linked to the bifunctional ligand p-SCN-Bz-DOTA. After determination of the number of conjugated DOTA molecules by 1H nuclear magnetic resonance, Dy3+ was titrated at a 90% molar ratio. For comparison, single ionic chelates of Dy-DTPA and Dy-DOTA also were prepared. Using a variable field relaxometer, T1 and T2 relaxation times were measured at 13 different field strengths from 0.05 to 1.5 T and temperatures of 3, 10, 20 and 37 degrees C. RESULTS The synthesis resulted in a preparation with 76 DOTA and 68 Dy3+ ions per dendrimer molecule. The T1 relaxivity values for Dy-DTPA, Dy-DOTA, and the Dy-DOTA-based dendrimer all were independent of field strength, with values between 0.12 and 0.20 mM-1 sec-1. At lower fields (0.05-0.1 T), 1/T2 was identical to 1/T1. At higher fields, however, 1/T2 increased quadratically with field strength, with a strong dependence on temperature. The field-dependent component of 1/T2 was up to three times higher for the Dy-DOTA-based dendrimer compared with the single chelate molecules, with coefficients of 0.37 to 0.03 sec-1/Tesla2 for T = 3 to 37 degrees C. CONCLUSIONS The results are interpreted with the "inner sphere" theory of susceptibility effects (Curie spin relaxation). The large temperature dependence suggests that the dominant mechanism of relaxation is the contact interaction effect, with the proton residence time as the primary time constant. This largely unexplored relaxation mechanism has the potential to create a new class of T2-selective contrast agents.
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Affiliation(s)
- J W Bulte
- Laboratory of Diagnostic Radiology Research, National Institutes of Health, Bethesda, MD 20892, USA.
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Dong Q, Hurst DR, Weinmann HJ, Chenevert TL, Londy FJ, Prince MR. Magnetic resonance angiography with gadomer-17. An animal study original investigation. Invest Radiol 1998; 33:699-708. [PMID: 9766055 DOI: 10.1097/00004424-199809000-00026] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES Our purpose was to investigate a "blood pool" contrast agent for abdominal and thoracic MR angiography by comparison with standard ionic and nonionic gadolinium-based contrast agents, which redistribute into the extracellular fluid compartment. METHODS Abdominal and thoracic MR angiography was performed in three adult dogs using a three-dimensional spoiled gradient echo pulse sequence before and after intravenous administration of one of three gadolinium-based contrast agents (gadopentetate dimeglumine, gadobutrol, and gadomer-17). Each compound was tested at five different doses in all three dogs. Quantitative analysis of signal-to-noise ratio (SNR) was performed in the aorta, inferior vena cava (IVC), liver, spleen, kidney (medulla and cortex), fat, and muscle. RESULTS Gadomer-17 improved visualization of vascular anatomy at doses of 0.025, 0.05, 0.1, and 0.2 mmol/kg with three-fold greater aorta SNR during the arterial phase and more than four-fold greater aorta and IVC SNR during the equilibrium phase, in comparison with gadopentetate dimeglumine and gadobutrol at equal doses. CONCLUSIONS Gadomer-17 is a promising contrast agent for both arterial phase and equilibrium phase MR angiography.
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Affiliation(s)
- Q Dong
- Department of Radiology, University of Michigan, Ann Arbor 48109-0030, USA.
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Mühler A. The future of contrast-enhanced magnetic resonance angiography. Are blood pool agents needed? Invest Radiol 1998; 33:709-14. [PMID: 9766056 DOI: 10.1097/00004424-199809000-00027] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Su MY, Mühler A, Lao X, Nalcioglu O. Tumor characterization with dynamic contrast-enhanced MRI using MR contrast agents of various molecular weights. Magn Reson Med 1998; 39:259-69. [PMID: 9469709 DOI: 10.1002/mrm.1910390213] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Dynamic contrast-enhanced MR imaging was used to measure the kinetics of enhancement in three different animal tumor models (Walker 256, R3230 AC, MCF7) using three different Gd complexes (Gd-DTPA, Gd-DTPA-24-cascade-polymer 30 kD, and polylysine-Gd-DTPA 50 kD). The three tumor models varied in growth rate, with the most rapid growth demonstrated by Walker 256 cells and the slowest growth occurring in the MCF7 cells. For each tumor, the kinetics of enhancement using polylysine-Gd-DTPA was analyzed using a pharmacokinetic model to estimate the vascular volume of the tumor. The rate of entry of the contrast agent into the interstitial space served as the measure of vascular permeability. The smallest molecular-weight agent, Gd-DTPA, could not provide information about vascular permeability. The intermediate and the largest agents both demonstrated that the faster-growing Walker 256 tumor had greater vascular permeability than did the slower-growing R3230 AC tumor. The degree of vascular permeability in the MCF7 tumor could not be assessed fairly due to insufficient statistics. The current study provides evidence supporting the hypothesis that more rapidly growing tumors have higher vascular permeability than do tumors that grow more slowly.
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Affiliation(s)
- M Y Su
- Department of Radiological Sciences, University of California, Irvine 92697-5020, USA
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36
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Roberts HC, Saeed M, Roberts TP, Mühler A, Shames DM, Mann JS, Stiskal M, Demsar F, Brasch RC. Comparison of albumin-(Gd-DTPA)30 and Gd-DTPA-24-cascade-polymer for measurements of normal and abnormal microvascular permeability. J Magn Reson Imaging 1997; 7:331-8. [PMID: 9090587 DOI: 10.1002/jmri.1880070213] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The purpose of this study was to compare a new MR macromolecular contrast medium (MMCM), gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-24-cascade-polymer, to a well-studied prototype MMCM, for the potential of distinguishing tissues of varying endothelial permeability. Three tissue models of varying capillary permeability were studied in a total of 46 rats: normal myocardium (normal capillaries), subcutaneously implanted adenocarcinoma (mild capillary leak), and reperfused infarcted myocardium (high capillary leak). TI-weighted MRI was performed before and dynamically after injection of either albumin-(Gd-DTPA)30 or the cascade polymer (each .02 mmol gadolinium [Gd] per kg). Data analysis based on a two-compartment kinetic model yielded estimates of fractional blood volume (BV) (percentage) and fractional leak rate (FLR) (1 per hour). Permeability to the cascade polymer as reflected in FLR was considerable in normal myocardium (8.24 per hour), of similar value in tumors (8.55 per hour), but significantly greater in infarcted myocardium (39.17 per hour, P < .01) versus normal myocardium. The larger albumin-(Gd-DTPA)30 demonstrated minimal extravasation in normal myocardium (FLR .33 per hour); FLR in tumors was 100% higher (.66 per hour, P < .002) and FLR in reperfused capillaries was significantly greater (7.94 per hour, P < .001). Based on capillary permeability measurements, the cascade polymer may have limited utility for detection of mildly increased microvascular permeabilities. For severe tissue injury, the cascade polymer can resolve abnormal microvascular integrity.
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Affiliation(s)
- H C Roberts
- Department of Radiology, University of California, San Francisco, USA
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Roberts TP. Physiologic measurements by contrast-enhanced MR imaging: expectations and limitations. J Magn Reson Imaging 1997; 7:82-90. [PMID: 9039597 DOI: 10.1002/jmri.1880070112] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Contrast-enhanced magnetic resonance imaging (MRI) offers the opportunity to quantitatively assess physiologic properties of tissue, such as perfusion, blood volume, and capillary permeability. Use of such quantitation potentially allows tissues to be characterized in terms of pathophysiology and to be monitored over time, during the course of therapeutic intervention. The degree to which such quantitation is applicable relies heavily on simplified model descriptions of the tissue space and assumptions relating the signal intensity observed to the contrast agent concentration. This article presents a perspective on the use of quantitative contrast-enhanced MRI, analysis of the accuracy of derived physiologic parameters, and recommendations for pulse sequence choice.
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Affiliation(s)
- T P Roberts
- Department of Radiology, University of California, San Francisco 94143, USA
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Adzamli K, Dorshow RB, Hynes MR, Li D, Nosco DL, Adams MD. Preliminary evaluation of a polyethyleneglycol-stabilized manganese-substituted hydroxylapatite as an intravascular contrast agent for MR angiography. J Magn Reson Imaging 1997; 7:204-8. [PMID: 9039616 DOI: 10.1002/jmri.1880070131] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A blood-persistent particulate paramagnetic contrast agent has been formulated via size stabilization of manganese-substituted hydroxylapatite by a polyethylene glycol (PEG) bearing a terminal diphosphonate. At high PEG surface densities (35-40 mol%), particles with mean diameter 8 +/- 2 nm were obtained. Relaxivities of autoclaved samples (at 20 MHz proton Lamor frequency) were R1 = 18.7 +/- .8 mM-1 sec-1 and R2 = 22.3 +/- .7 mM-1 sec-1. The formulation persisted in rabbit blood with a biphasic clearance profile. Half-lives (with amplitudes in parenthesis) were 4 +/- 1 minutes (55%), and 49 +/- 3 minutes (45%), respectively, for the two phases. A dose of 40 mumol Mn/kg body weight enhanced the signal from rabbit vasculature for more than 45 minutes on MR angiograms. Thus, PEG-modified MnHA particles may find use as T1 agents for MR angiography.
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Affiliation(s)
- K Adzamli
- Medical Imaging Division, Mallinckrodt, Inc., St. Louis MO, USA
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