MultiHance® is a paramagnetic contrast agent for use in diagnostic magnetic resonance imaging (MRI) of the liver and central nervous system. MultiHance® is a small molecular weight chelate, which tightly binds the Gd atom. The substance is excreted partly by the kidneys, partly by the biliary system, which is especially unique.
MultiHance® is indicated, for the detection of focal liver lesions in patients with known or suspected primary liver cancer (e.g. hepatocellular carcinoma) or metastatic disease.
MultiHance® is also indicated in brain MRI and spine MRI where it improves the detection of lesions and provides diagnostic information additional to that obtained with unenhanced MRI.
Gd-BOPTA-enhanced MRA can provide superior vascular signal intensity and SNR, as compared with Gd-DTPA, due to its higher relaxivity, even at lower doses.
1 ml of solution MultiHance® contains: (0.5M) gadobenate dimeglumine 529 mg = gadobenic acid 334 mg + meglumine 195 mg. Viscosity at 37°C: 5.3 mPa

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

The company is a member of the Bracco Group, a highly innovative healthcare group and world leader in global integrated solutions for the diagnostic medical imaging field. The Bracco Group is headquartered in Milan, Italy. Its North American operations consist of Bracco Diagnostics and Bracco Research USA, both located in Princeton, New Jersey. Bracco Diagnostics is one of the fastest growing developers and marketers of diagnostic pharmaceuticals in North America, with products for various imaging applications, including Isovue® (iopamidol - X-ray contrast agent), ProHance® (gadoteridol - MRI contrast agent), SonoVue® (ultrasound contrast agent) and nuclear medicine products.
Gadoteridol has been available in Europe and the USA for several years. Holder of the Marketing Authorization: Bracco International B.V. - Strawinskylaan 3051 - 1077 ZX Amsterdam The Netherlands. (Contact: Kirk Deeter, Phone: +NL-303-838-8708)

MRI Contrast Agents:

Eisai Co., Ltd. (Tokyo, Japan, President: Haruo Naito) and Bracco-Eisai Co., Ltd. (Tokyo, Japan, President: Toshio Matsumoto) decided to withdraw the new drug application (NDA) of E7155 (gadobenate meglumine), since new indications are emerging for the product and additional clinical data was necessary to complete the targeting product competitive risk/benefit profile. The product is currently marketed in other countries, and both companies are discussing a future development plan in Japan.

MRI Contrast Agents:

Hepatobiliary chelates used in MRI are paramagnetic contrast agents consisting of a metal ion bound to an organic ligand. Paramagnetic metal ions such as gadolinium improve the MRI signal, but the toxicity of these uncomplexed metal ions makes the use of a chelate to bind the metal ion essential. Due to the hepatocyte uptake of this chelate complex, the different contrast between normal parenchyma and liver lesions improves the detection and characterization of specific diseases. In addition, the hepatobiliary excretion allows the assessment of the hepatobiliary system.
Chelates for hepatobiliary imaging: MultiHance® (Gadobenate Dimeglumine), Teslascan® (Mangafodipir Trisodium), Gd-HIDA, Cr-HIDA, and Fe-EHPG IronIII or other derivatives.

See also Hepatobiliary Contrast Agents, Liver Imaging.

Magnetic relaxation in tissues can be enhanced using contrast agents. The most commonly used for MRI are the paramagnetic contrast agents, which have their strongest effect on the T1, by increasing T1 signal intensity in tissues where they have accumulated.
MRI collects signal from the water protons, but the presence of these contrast agents enhances the relaxation of water protons in their vicinity. Paramagnetic contrast agents contain magnetic centers that create magnetic fields approximately one thousand times stronger than those corresponding to water protons. These magnetic centers interact with water protons in exactly the same way as the neighboring protons, but with much stronger magnetic fields, and therefore, have a much greater impact on relaxation rates, particularly on T1. In MRI, contrast agents are routinely injected intravenously to help identify areas of hypervascularity, as in malignant tumors.

See also Contrast Agents, Gadovist®, MultiHance®, Omniscan®, OptiMARK®.

See also the related poll result: 'The development of contrast agents in MRI is'