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.

Short name: SHU 555 A, generic name: Ferucarbotran
A RES-directed MRI contrast agent (SPIO) made-up of a colloidal sol of iron oxide nanoparticles coated with carboxydextran (Resovist®, Cliavist™).
It is used for the detection and characterization of especially small focal liver lesions and offers the opportunity to make a reliable diagnosis at a very early stage of patients with suspected liver tumors.
Bayer Schering Pharma AG announced that it has received marketing approval for the liver-specific contrast agent Resovist® in Japan. See Contrast Agents and Superparamagnetic Contrast Agents.

Short name: AMI-25, generic name: Ferumoxide (SPIO)
Ferumoxides are superparamagnetic (T2*) MRI contrast agents, so the largest signal change is on T2 and T2* weighted images.
The agent distributes relatively rapidly to organs with reticuloendothelial cells primarily the liver, spleen and bone marrow. The liver shows decreased signal intensity, as does the spleen and marrow. The agent is taken up by the normal liver, resulting in increased CNR between tumor and normal liver. Hepatocellular lesions, such as adenoma or focal nodular hyperplasia, contain reticuloendothelial cells, so they will behave similar to the liver, with decreased signal on T2 weighted images. On T1 images, there is typically some circulating contrast agent, and blood vessels show increased signal intensity.
Current MRI protocols involve T1 weighted breath-hold gradient echo images of the liver, and fast spin echo T2 weighted pictures. This requires about 15 minutes. The patient is then removed from the scanner, and the contrast agent administered. After contrast administration, the same pulse sequences are again repeated.

Lumirem® belongs to the negative oral contrast agents (same as GastroMARK®, another brand name for ferumoxsil). Lumirem® is used to distinguish the loops of the bowel from other abdominal structures and physiology. When Lumirem® is ingested, it flows through and darkens the stomach and the small intestine in 30 to 45 minutes. By more clearly identifying the intestinal loops, Lumirem® improves visualization of adjacent abdominal tissues such as the pancreas.
Additionally, in Europe Lumirem® is approved for rectal administration to delineate the lower intestinal system.

Categories of negative oral contrast agents:
Negative oral contrast media are usually based on superparamagnetic particles and act by inducing local field inhomogeneities, which results in shortening of both T1 and T2 relaxation times. Superparamagnetic contrast agents have predominant T2 weighted effects. Biphasic contrast media are agents that have different signal intensities on different sequences, depending on the concentration at which they are used.
Suitable materials for oral contrast agents should have little or no absorption by the stomach or intestines, complete excretion, no motion or susceptibility artifacts, affordability, and uniform marking of the gastrointestinal tract. Benefits of negative oral contrast agents are the reduction of ghosting artifacts caused by the lack of signal. Superparamagnetic iron oxides produce also in low concentrations a noticeable signal loss; but can generate susceptibility artifacts especially in gradient echo sequences. Perfluorochemicals do not dilute in the bowel because they are not miscible with water.
High cost, poor availability, and limited evaluations of side effects are possible disadvantages.
Negative oral contrast agents are used e.g., in MRCP, where the ingestion of 600-900 ml of SPIO cancels out the signal intensity of the lumen (in addition after the injection of a gadolinium-based contrast medium, the enhancement of the inflammatory tissues is clearer seen), and in MR abdominal imaging of Crohn's disease in combination with mannitol.

Blueberry or pineapple juices are useable for examinations of the pancreas (MRCP, upper abdominal imaging) as cheep contrast agents, because of the content of magnetic substances (e.g. manganese).

See also Ferristene, Ferumoxsil, Oral Magnetic Particles, Gastrointestinal Imaging.