Nitroxide radicals (or nitroxyl spin labels) are stable organic compounds with theoretical potential for use as a paramagnetic MRI contrast agent. Similar to gadolinium they have an unpaired electron, a property that provides enhancement in T1 based MRI, and a comparable pharmacokinetic. Depending on their structure and chemical bonding, different nitroxides formula may have the potential for use as cardiovascular imaging agents, to enhance the MR imaging on joints (e.g., dendrimer-linked nitroxides have a strong affinity for cartilage), to evaluate brain tumors and infarction, and as a contrast enhancement agent of body/abdominal NMR imaging. Nitroxides are rapidly enzymatically reduced in tissues to products that do not enhance the NMR signal, which can be a problem for MR imaging. In animal experiments with EPRI (electron paramagnetic resonance imaging), tissue redox studies show differences between tumors and normal tissues, which reflect their respective redox status consistent with the reduction/clearance of nitroxides.

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.