Combidex® is the brand name (same as Sinerem®) for an ultrasmall superparamagnetic iron oxide (USPIO) in the development pipeline to detect metastatic disease in lymph nodes. Metastatic lymph nodes show less uptake of this MRI contrast agent, which results in less signal decrease and allows the differentiation of normal lymph nodes from normal-sized, metastatic nodes. Combidex® has also potential to be used as a functional molecular imaging agent.
In March 2005, AMAG Pharmaceuticals Inc received an approvable letter from the U.S. Food and Drug Administration with respect to Combidex subject to certain conditions.
See also Ferumoxtran, Drug Development and Approval Process USA, Molecular Imaging and Classifications, Characteristics, etc.

Biphasic oral contrast agents may produce either high or low signal intensities depending on the pulse sequence used, for example low signal intensity on T1 weighted MR images and high signal intensity on T2 weighted images. The combination of different oral contrast agents can generate a macroscopic cancellation of negative and positive magnetic susceptibility, thereby eliminating susceptibility artifacts.
Possible combinations are e.g., ferric ammonium citrate and corn oil, or ferrous sulfate emulsified with baby formula. Paramagnetic agents combined with oil emulsion may be used in MRI as positive abdominal contrast agents. The combination of diamagnetic barium sulfate and superparamagnetic iron oxide (SPIO) in one suspension may be a useful negative contrast agent.

See also Gastrointestinal Paramagnetic Contrast Agents, Gastrointestinal Superparamagnetic Contrast Agents, Gastrointestinal Diamagnetic Contrast Agents, Gastrointestinal Imaging.

Contrast enhanced MRI is a commonly used procedure in magnetic resonance imaging. The need to more accurately characterize different types of lesions and to detect all malignant lesions is the main reason for the use of intravenous contrast agents.
Some methods are available to improve the contrast of different tissues. The focus of dynamic contrast enhanced MRI (DCE-MRI) is on contrast kinetics with demands for spatial resolution dependent on the application. DCE-MR imaging is used for diagnosis of cancer (see also liver imaging, abdominal imaging, breast MRI, dynamic scanning) as well as for diagnosis of cardiac infarction (see perfusion imaging, cardiac MRI). Quantitative DCE-MRI requires special data acquisition techniques and analysis software.
Contrast enhanced magnetic resonance angiography (CE-MRA) allows the visualization of vessels and the temporal resolution provides a separation of arteries and veins. These methods share the need for acquisition methods with high temporal and spatial resolution.
Double contrast administration (combined contrast enhanced (CCE) MRI) uses two contrast agents with complementary mechanisms e.g., superparamagnetic iron oxide to darken the background liver and gadolinium to brighten the vessels. A variety of different categories of contrast agents are currently available for clinical use.
Reasons for the use of contrast agents in MRI scans are:
Common Indications:
Brain MRI : Preoperative/pretreatment evaluation and postoperative evaluation of brain tumor therapy, CNS infections, noninfectious inflammatory disease and meningeal disease.
Spine MRI : Infection/inflammatory disease, primary tumors, drop metastases, initial evaluation of syrinx, postoperative evaluation of the lumbar spine: disk vs. scar.
Breast MRI : Detection of breast cancer in case of dense breasts, implants, malignant lymph nodes, or scarring after treatment for breast cancer, diagnosis of a suspicious breast lesion in order to avoid biopsy.

For Ultrasound Imaging (USI) see Contrast Enhanced Ultrasound at Medical-Ultrasound-Imaging.com. See also Blood Pool Agents, Myocardial Late Enhancement, Cardiovascular Imaging, Contrast Enhanced MR Venography, Contrast Resolution, Dynamic Scanning, Lung Imaging, Hepatobiliary Contrast Agents, Contrast Medium and MRI Guided Biopsy.

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.

Short name: Fe O-BPA, central moiety: Fe3+/Fe2+
An ultrasmall superparamagnetic iron oxide under development (preclin.) as a vascular contrast agent for MR angiography.

See also USPIO.