Any molecule used to measure organ perfusion in conjunction with imaging.
Characteristics of good perfusion agents:
Perfusion agents used in MRI are small Gd-chelates (they do not cross blood brain barrier, but extravasate quickly into extracellular space in other organs) and SPIOS.

Resovist® is an organ-specific MRI contrast agent, used for the detection and characterization of especially small focal liver lesions.
Resovist® consists of superparamagnetic iron oxide (SPIO) nanoparticles coated with carboxydextran, which are accumulated by phagocytosis in cells of the reticuloendothelial system (RES) of the liver. The uptake of Resovist® Injection in the reticuloendothelial cells results in a decrease of the signal intensity of normal liver parenchyma on both T2- and T1 weighted images.
Most malignant liver tumors do not contain RES cells and therefore do not uptake the iron particles. The resulting imaging effect is an improved contrast between the tumor (bright) and the surrounding tissue (dark).
Resovist® can be injected as an intravenous bolus, which allows immediate imaging of the liver and reduces the overall examination time. A dynamic imaging strategy after bolus injection supports to characterize lesions. In comprehensive clinical trials, it demonstrated an excellent safety profile.
In 2001, Resovist® was approved for the European market.

See also Superparamagnetic Iron Oxide.

Resovist® competed with Primovist™, the other liver imaging agent of Bayer Schering Pharma AG. Due to this reason, the production of Resovist® has been abandoned in 2009.

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.

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.