Short name: Gd-BOPTA, generic name: Gadobenate dimeglumine
A paramagnetic MRI contrast agent (small molecular weight Gd-chelate) with 0.5 and 0.25 molar concentration.
The albumin-mediated relaxation enhancement may result in advantages for Gd-BOPTA over Gd-DTPA and other gadolinium agents in poorly vascularized, small, or lesions with low enhancement and in tumors with high concentrations of albumin. The substance is excreted partly by the kidneys (75-90%), partly by the biliary system (10-25%). The uptake in the liver is about 5% in humans. It is bolus injectable.

See Contrast Agents and MultiHance®.

MultiHance® is a paramagnetic contrast agent for use in diagnostic magnetic resonance imaging (MRI) of the liver and central nervous system. MultiHance® is a small molecular weight chelate, which tightly binds the Gd atom. The substance is excreted partly by the kidneys, partly by the biliary system, which is especially unique.
MultiHance® is indicated, for the detection of focal liver lesions in patients with known or suspected primary liver cancer (e.g. hepatocellular carcinoma) or metastatic disease.
MultiHance® is also indicated in brain MRI and spine MRI where it improves the detection of lesions and provides diagnostic information additional to that obtained with unenhanced MRI.
Gd-BOPTA-enhanced MRA can provide superior vascular signal intensity and SNR, as compared with Gd-DTPA, due to its higher relaxivity, even at lower doses.
1 ml of solution MultiHance® contains: (0.5M) gadobenate dimeglumine 529 mg = gadobenic acid 334 mg + meglumine 195 mg. Viscosity at 37°C: 5.3 mPa

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.

Hepatobiliary chelates used in MRI are paramagnetic contrast agents consisting of a metal ion bound to an organic ligand. Paramagnetic metal ions such as gadolinium improve the MRI signal, but the toxicity of these uncomplexed metal ions makes the use of a chelate to bind the metal ion essential. Due to the hepatocyte uptake of this chelate complex, the different contrast between normal parenchyma and liver lesions improves the detection and characterization of specific diseases. In addition, the hepatobiliary excretion allows the assessment of the hepatobiliary system.
Chelates for hepatobiliary imaging: MultiHance® (Gadobenate Dimeglumine), Teslascan® (Mangafodipir Trisodium), Gd-HIDA, Cr-HIDA, and Fe-EHPG IronIII or other derivatives.

See also Hepatobiliary Contrast Agents, Liver Imaging.

Contrast agent with a preferential intracellular distribution.
Intracellular agents (such as manganese derivatives and ultrasmall superparamagnetic iron oxide), exhibit a flow- and metabolism-dependent uptake. These properties may allow delayed imaging, similar to isotopic methods.
Phospholipid liposomes are rapidly sequestered by the cells in the reticuloendothelial system (RES), primarily in the liver. For imaging of the liver, liposomes may be labeled with MR contrast medium, both positive (T1-shortening) paramagnetic media, and negative (T2-shortening) superparamagnetic media.
Several other nonliposome MR contrast media are also taken up by the RES, e.g.:
Other MR contrast agents accumulate selectively in the hepatocytes, e.g.:

Liver imaging with gadolinium contrast enhanced MRI is sometimes not sufficient for a reliable diagnosis of liver lesions. For this reasons, special liver Contrast agents that are targeted to the reticuloendothelial system (RES), have been developed to improve both detection and characterization of liver and spleen lesions. Reticuloendothelial Contrast Agents, as e.g. superparamagnetic iron oxides (SPIO), are taken up by healthy liver tissue but not tumors.
These RES targeted contrast agents provide a prolonged imaging window and enough time for high spatial resolution or multiple breath hold images. Reticuloendothelial contrast agents have an increased sensitivity for the detection of small liver lesions (e.g., metastases), compared with gadolinium enhanced MRI and spiral CT. At higher field strengths with an increased signal to noise ratio the susceptibility effect with iron oxide particles may be enhanced.
Other new agents (Gadobenate Dimeglumine, Gadoxetic Acid) have both an initial extracellular circulation and a delayed liver-specific uptake. Since a considerable part of these contrast agents is excreted in the bile, functional biliary imaging can diagnose biliary anomalies, postoperative bile leaks, and anastomotic strictures. Other agents, such as liposomes (with encapsulated Gd-DTPA) or DOTA complexes are in different development stages.

See also Hepatobiliary Contrast Agents, Gadolinium Oxide, Superparamagnetic Iron Oxide and Liposomes.