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MR contrast agents for liver imaging: what, when, how.

Sunil N Gandhi¹, Michèle A Brown, James G Wong

¹Department of Radiology, UCSD Medical Center, 200 W Arbor Dr, San Diego, CA 92103, USA.

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|November 15, 2006

Summary

Magnetic resonance (MR) imaging contrast agents for the liver vary by class, including extracellular gadolinium chelates, reticuloendothelial ferumoxides, and hepatobiliary agents like mangafodipir. Each agent has unique mechanisms, uses, and considerations for liver imaging.

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Area of Science:

Radiology
Medical Imaging
Contrast Agents

Background:

Current magnetic resonance (MR) imaging of the liver utilizes several classes of contrast agents.
These include extracellular gadolinium chelates, reticuloendothelial agents (ferumoxides), hepatobiliary agents (mangafodipir), blood pool agents, and combined agents.
Each class possesses distinct mechanisms of action, dosages, elimination pathways, toxic effects, indications, and technical considerations.

Purpose of the Study:

To review the major classes of contrast agents used in liver MR imaging.
To discuss their varying properties, applications, and developmental status.

Main Methods:

Review of existing literature and classification of liver MR contrast agents.
Analysis of mechanisms, efficacy, and safety profiles for each agent class.

Main Results:

Gadolinium chelates are the most prevalent MR contrast agents for liver imaging.
Ferumoxides offer adjunct benefits for hepatocellular carcinoma detection, especially when combined with gadolinium for enhanced contrast.
Mangafodipir, a hepatobiliary agent, is taken up by hepatocytes and useful for MR cholangiography and liver imaging, though no longer available in the US.
Newer agents, including the approved gadobenate dimeglumine, are emerging.

Conclusions:

The choice of liver MR contrast agent depends on the specific clinical application and desired imaging outcome.
Ongoing development promises new and improved agents for liver MR imaging.
Understanding the characteristics of different contrast agent classes is crucial for effective liver MR imaging.