Dotarem® is a paramagnetic ionic MRI contrast agent. Extracellular contrast agents like Dotarem®, can be bolus injected because of the relatively low rate of side effects. This contrast medium is useable to enhance signal intensity in magnetic resonance imaging for intracranial and spinal lesions with an abnormal blood brain barrier or abnormal vascularity, and in whole body imaging.

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

EP-2104R is a molecularly targeted MRI contrast agent for high resolution blood clot imaging within half an hour of injection. This gadolinium based small peptide has high affinity and specificity for human fibrin.
The thrombus agent is a new class of contrast medium for the diagnostic of, e.g. deep venous thrombosis, carotid artery blood clots, coronary artery blood clots and pulmonary embolism. Fibrin is an excellent target for a molecular imaging contrast agent, since it is present in arterial and venous clots at high concentrations (20-100 μM), and is a target for fibrinolytic therapy.
Due to financial problems, the developer EPIX Pharmaceuticals, Inc. had to shut down all operations. As a consequence, the development of EP-2104R is discontinued.

The principal activity of this Japan-based Group, is to manufacture and sell diagnostic substances and reagents. The Group's other activities include wholesale of reagents and analysis equipment. The Group has one consolidated subsidiary located in Japan. Diagnostic substances and reagents accounted for 83% of fiscal 2002 revenues; medical equipment, 12% and blood vessel contrast mediums, 5%. Eiken Chemical Co., Ltd. distributes Feridex®.

A brand name for ferumoxide (same as Feridex®)
Endoremâ„¢ is a black to reddish-brown aqueous colloid of superparamagnetic iron oxide associated with dextran for intravenous administration as a MRI contrast medium for the detection of liver lesions that are associated with an alteration in the RES.
Endoremâ„¢ is taken up by macrophages, found only in healthy liver cells but not in most tumors. Tissues such as metastases, primary liver cancer, cysts and various benign tumors, adenomas and hyperplasia retain their native signal intensity, so the contrast between normal and abnormal tissue is increased.

See also Ferumoxide.

Eovist® (other brand name Primovist™) is a organ specific MRI contrast agent for the imaging, detection and characterization of liver conditions, including liver tumors, cysts, as well as other malignant and benign lesions. It is a water-soluble ethoxybenzyl derivative of Gd-DTPA. This compound is taken up by the hepatocytes (approximately 30% of the dose goes to the hepatocytes) and is equally excreted renal and biliary in humans. Excretion of Gd-EOB-DTPA in the bile may also permit visualization of both the gall bladder and the bile ducts.
Eovist® brightens the signal of T1 weighted MR images immediately after contrast administration. Dynamic and accumulation phase imaging can also be performed after bolus injection of Eovist®. The hepatocytes uptake will increase the signal intensity of normal liver parenchyma at 10 to 20 minutes after injection. This results in improved lesion-to-liver contrast because malignant tumors (metastases, the majority of hepatocellular carcinomas) do not contain either hepatocytes or their functioning is hampered.

WARNING: Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

See also Drug Development and Approval Process USA, Contrast Medium, Hepatobiliary Contrast Agents, Tumor Specific Agents and Molecular Imaging.