Tumor specific MRI contrast agents are in development to provide better delineation and progression information for various tumors. Clinical oncology has a need for contrast agents that can identify tumors and metastases at a size of 100,000 cells rather than 1,000,000,000 cells. This level of sensitivity requires excellent tumor targeting of imaging agents and a high MRI signal.
Tumor specific agents accumulate at pathological tissues by passive or active targeting mechanisms. Passive targeting agents use e.g., the natural defense mechanisms in which phagocytic cells remove foreign particles from the body. Active targeting is based on a ligand-directed, site-specific accumulation of contrast agents. The availability of macromolecular contrast agents such as feruglose and ultrasmall superparamagnetic iron oxide (USPIO), which permit the assessment of tissue permeability, may also improve the detection of tumor grade, tumor type, and response to drugs that target angiogenesis.

See also Monoclonal Antibodies, Metalloporphyrins, Nitroxides and Ferrioxamine.

The company changed its name from Advanced Magnetics, Inc. to AMAG Pharmaceuticals, Inc. in July 2007.
AMAG Pharmaceuticals, Inc., a biopharmaceutical company, developed and manufactured organ-specific diagnostic contrast agents that provide clearer images during magnetic resonance imaging (MRI) tests used to detect tumors and other abnormalities.
The company had two MRI related products on the market: Feridex I.V. (for the diagnosis of liver lesions) and GastroMARK (used for bowel and abdominal MR imaging). In November 2008, AMAG Pharmaceuticals, Inc. decided to discontinue the manufacturing of Feridex. The development of Combidex as a contrast agent for lymph disease has also been stopped.
The Company has now two commercial products: Feraheme® and GastroMARK®. Feraheme® is the trade name of Ferumoxytol (formerly Code 7228) and is indicated for the treatment of iron deficiency anemia. Feraheme® is also being developed as a diagnostic agent for vascular-enhanced magnetic resonance imaging (MRI) to assess peripheral arterial disease.

MRI Contrast Agents:

(Cr(III)-labeled RBC's) Chromium labeled red blood cells have paramagnetic properties and potential as an intravascular MRI contrast agent. The labeling with chromium decreases the relaxation times of packed red blood cells (RBCs). The use of RBCs in nuclear medicine suggests a low toxicity.

See also Contrast Agents, Intravascular Contrast Agents, Blood Pool Agents.

Short name: Code 7228, generic name: Ferumoxytol, central moiety: Fe
Code 7228 is the code name for a substance in the development pipeline (AMAG Pharmaceuticals, Inc.) for use as a contrast agent in magnetic resonance angiography (MRA). Ferumoxytol, as a true blood pool agent, resides in the vascular space for an extended period of time and does not leak out into adjacent tissues like currently used gadolinium-based contrast agents. The product is being evaluated in MRA applications for the detection of blood flow in the heart muscle, in exploratory studies for the diagnosis of vulnerable plaque and as a next generation lymph node agent.
Code 7228 is currently in approval phase for use as an iron replacement therapeutic in chronic kidney disease patients receiving erythropoetin.
It is presently contemplated that Ferumoxytol will compete with the contrast agents Vasovist™ from EPIX Pharmaceuticals, Inc. and NC100150 Injection from Nycomed Amersham.

(CE MRA) Contrast enhanced MR angiography is based on the T1 values of blood, the surrounding tissue, and paramagnetic contrast agent.
T1-shortening contrast agents reduces the T1 value of the blood (approximately to 50 msec, shorter than that of the surrounding tissues) and allow the visualization of blood vessels, as the images are no longer dependent primarily on the inflow effect of the blood. Contrast enhanced MRA is performed with a short TR to have low signal (due to the longer T1) from the stationary tissue, short scan time to facilitate breath hold imaging, short TE to minimize T2* effects and a bolus injection of a sufficient dose of a gadolinium chelate.
Images of the region of interest are performed with 3D spoiled gradient echo pulse sequences. The enhancement is maximized by timing the contrast agent injection such that the period of maximum arterial concentration corresponds to the k-space acquisition. Different techniques are used to ensure optimal contrast of the arteries e.g., bolus timing, automatic bolus detection, bolus tracking, care bolus. A high resolution with near isotropic voxels and minimal pulsatility and misregistration artifacts should be striven for. The postprocessing with the maximum intensity projection (MIP) enables different views of the 3D data set.
Unlike conventional MRA techniques based on velocity dependent inflow or phase shift techniques, contrast enhanced MRA exploits the gadolinium induced T1-shortening effects. CE MRA reduces or eliminates most of the artifacts of time of flight angiography or phase contrast angiography. Advantages are the possibility of in plane imaging of the blood vessels, which allows to examine large parts in a short time and high resolution scans in one breath hold. CE MRA has found a wide acceptance in the clinical routine, caused by the advantages: