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.

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.

(MRI-CA, MRCA) The noninvasive imaging of the coronary arteries using magnetic resonance imaging of the heart.
For cardiac MRI-CA, high performance machines are necessary with minimum 40mT/m and 300μsec slew rate.
2D and 3D acquisition are used for fast gradient echo sequences with techniques for minimizing cardiac and respiratory motion and suppressing the high signal of pericardial fat. The optimal sequences seem to be trueFISP, Balanced FFE or FIESTA with SMASH and SENSE techniques. Respiratory motion is minimized for 3D acquisitions by using respiratory gating, especially using navigator echoes (Navigator Technique) to track diaphragmatic and cardiac movement. Optimization of MR technique can provide mapping of long segments of the coronary arteries.
Blood pool agents are being applied to improve the reliability of coronary MR angiography. The major current clinical indication is the identification of coronary artery anomalies because the diagnostic accuracy's for identifying haemodynamically significant stenoses are variable depending of the image quality.

See also Magnetic Resonance Angiography, and Cardiac MRI.

The contrast agents are either renal or hepatically excreted media, which stay in the intravascular/extracellular tissue compartment. The enhancement in the blood continues for as long as the contrast agent remains in the blood stream.
E.g. Dotarem®, Magnevist®, Omniscan®, ProHance®.

See Contrast Medium, Contrast Agents and Blood Pool Agents.

Ferumoxytol is a product candidate for iron replacement therapy in the development pipeline of AMAG Pharmaceuticals Inc, formerly known as Code 7228.
Ferumoxytol has a long blood half-life and may be useful as a blood pool agent in a wide range of applications in MRI. Ferumoxytol is a true intravascular contrast agent that remains in the blood stream for an extended period of time.