Blood pool agent

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Blood pool agents (BPAs) are a class of magnetic resonance angiography contrast agents. [1] [2] Blood pool agents (also known as intravascular contrast agents) are differentiated from other contrast agents due to their high molecular weight and higher relaxivities. [3] Their large size prevents diffusion through the vascular epithelium and leakage into the interstitial space, and because of this they stay in the vascular system for a longer time period. Most contrast agents, leave the vascular system within a few minutes, however blood pool agents remain in the circulation for up to an hour, extending the window available for imaging. Longer image acquisition times allow better signal-to-noise ratio and improved image resolution.

Contents

Roles of blood pool agents

Due to their extended time in the circulatory system, blood pool agents can be used for delayed steady-state imaging, and additionally these results can be combined with first pass arterial imaging. [2] [3]

Classes of blood pool agents

Albumin-binding gadolinium complexes

This class of BPAs is based on the noncovalent binding of low molecular weight Gd3+-based complexes to human serum albumin. The first commercial agent to be approved in this class is gadofosveset trisodium [4] (also known as Vasovist [5] or Ablavar, [6] and previously known as MS-325 [7] ). Many clinical and case studies documenting the use of this BPA have been published, [8] [9] [10] [11] [12] [13] [14] and its efficacy in enhancing blood vessels visibility has been demonstrated. [15] The manufacturer (Lantheus Medical) discontinued production in 2017 though, due to poor sales. [16]

Gadocoletic acid (Bracco SpA), also known as B-22956 and B22956/1, is a Gd-DTPA derivative that is currently in development, but has not yet been approved for clinical use. [17]

Gadobenic acid (MultiHance [18] ) is sometimes categorized as a BPA; however, as it only binds weakly to albumin and because hepatobiliary uptake of this compound occurs, this contrast agent should not be classified as a BPA.

Polymeric gadolinium complexes

Polymeric Gd3+ chelates are large in size, which prevents leakage into the interstitial space, and provides long imaging windows. Several polymeric gadolinium-based BPAs are currently in development but have not yet been approved for clinical use: Gadomelitol (Guerbet, France), also known as Vistarem and P792 [19] Gadomer-17 (Schering AG, Berlin, Germany) also known as Gd-DTPA-17, SH L 643 A. [20]

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References

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  2. 1 2 "Blood Pool Agents". Archived from the original on March 13, 2018.
  3. 1 2 Geraldes, Carlos F. G. C.; Laurent, Sophie (2009). "Classification and basic properties of contrast agents for magnetic resonance imaging". Contrast Media & Molecular Imaging. 4 (1). Wiley: 1–23. doi:10.1002/cmmi.265. ISSN   1555-4309. PMID   19156706.
  4. ↑ "Ablavar (gadofosveset trisodium) injection". Food and Drug Administration . Archived from the original on 2017-02-22. Retrieved 2019-12-16.
  5. ↑ "DailyMed". dailymed.nlm.nih.gov. Archived from the original on 2018-10-03. Retrieved 2024-07-26.
  6. ↑ "Ablavar.com is for sale | HugeDomains". Archived from the original on 2012-01-27. Retrieved 2012-03-08.
  7. ↑ "MRI Database : MS-325". www.mr-tip.com. Archived from the original on 2018-08-29. Retrieved 2024-07-26.
  8. ↑ Wolf, Florian; Plank, Christina; Beitzke, Dietrich; Popovic, Martin; Domenig, Christoph M.; Weber, Michael; Loewe, Christian (2011). "Prospective Evaluation of High-Resolution MRI Using Gadofosveset for Stent-Graft Planning: Comparison With CT Angiography in 30 Patients". American Journal of Roentgenology. 197 (5). American Roentgen Ray Society: 1251–1257. doi:10.2214/ajr.10.6268. ISSN   0361-803X. PMID   22021522.
  9. ↑ Partovi; Aschwanden; Staub; Rasmus; Zipp; Rengier; Jacobi; Hügli; Bilecen (2011-07-01). "Gadofosveset enhanced MR phlebography for detecting pelvic and deep vein leg thrombosis". Vasa. 40 (4). Hogrefe Publishing Group: 315–319. doi:10.1024/0301-1526/a000121. ISSN   0301-1526. PMID   21780056.
  10. ↑ Haneder, Stefan; Attenberger, Ulrike I.; Biffar, Andreas; Dietrich, Olaf; Fink, Christian; Schoenberg, Stefan O.; Michaely, Henrik J. (2011). "Gadofosveset". Investigative Radiology. 46 (11). Ovid Technologies (Wolters Kluwer Health): 678–685. doi:10.1097/rli.0b013e31822428ad. ISSN   0020-9996. PMID   21709565.
  11. ↑ Pfeil, Alexander; Betge, Stefan; Poehlmann, Guenther; Boettcher, Joachim; Drescher, Robert; Malich, Ansgar; Wolf, Gunter; Mentzel, Hans-Joachim; Hansch, Andreas (2012). "Magnetic resonance VIBE venography using the blood pool contrast agent gadofosveset trisodium—An interrater reliability study". European Journal of Radiology. 81 (3). Elsevier BV: 547–552. doi:10.1016/j.ejrad.2011.01.102. ISSN   0720-048X. PMID   21349675.
  12. ↑ Pedersen, Steen F; Thrysøe, Samuel A; Paaske, William P; Thim, Troels; Falk, Erling; Ringgaard, Steffen; Kim, Won Y (2011). "CMR Assessment of endothelial damage and angiogenesis in porcine coronary arteries using gadofosveset". Journal of Cardiovascular Magnetic Resonance. 13 (1). Elsevier BV: 10. doi: 10.1186/1532-429x-13-10 . ISSN   1097-6647. PMC   3036628 . PMID   21269470.
  13. ↑ Yamashita, Tomohiro; Takahara, Taro; Kwee, Thomas C.; Kawada, Shuichi; Horie, Tomohiko; Inomoto, Chie; Hashida, Kazunobu; Yamamuro, Hiroshi; Myojin, Kazunori; Luijten, Peter R.; Imai, Yutaka (2011). "Diffusion magnetic resonance imaging with gadofosveset trisodium as a negative contrast agent for lymph node metastases assessment". Japanese Journal of Radiology. 29 (1). Springer Science and Business Media LLC: 25–32. doi:10.1007/s11604-010-0513-2. ISSN   1867-1071. PMID   21264658.
  14. ↑ Lambregts, Doenja M.J.; Beets, Geerard L.; Maas, Monique; Kessels, Alfons G.H.; Bakers, Frans C.H.; Cappendijk, Vincent C.; Engelen, Sanne M.E.; Lahaye, Max J.; de Bruïne, Adriaan P.; Lammering, Guido; Leiner, Tim; Verwoerd, Jan L.; Wildberger, Joachim E.; Beets-Tan, Regina G.H. (2011). "Accuracy of Gadofosveset-enhanced MRI for Nodal Staging and Restaging in Rectal Cancer". Annals of Surgery. 253 (3). Ovid Technologies (Wolters Kluwer Health): 539–545. doi:10.1097/sla.0b013e31820b01f1. ISSN   0003-4932. PMID   21239980.
  15. ↑ McGregor, Robert; Vymazal, Josef; Martinez-Lopez, Manuel; Neuwirth, Jiri; Salgado, Perla; Beregi, Jean-Paul; Peduto, Anthony; de la Pena-Almaguer, Erasmo; Slater, Greg J.; Shamsi, Kohkan; Parsons, Edward C. (2008). "A multi-center, comparative, phase 3 study to determine the efficacy of gadofosveset-enhanced magnetic resonance angiography for evaluation of renal artery disease". European Journal of Radiology. 65 (2). Elsevier BV: 316–325. doi:10.1016/j.ejrad.2007.03.018. ISSN   0720-048X. PMID   17499952.
  16. ↑ Bell, Daniel; Morgan, Matt. "Gadofosveset trisodium". Radiopaedia. radiopaedia.org. Archived from the original on 2018-08-29. Retrieved 2018-08-28.
  17. ↑ "Gadocoletic acid". bloodpoolagents.us. Archived from the original on January 28, 2012.
  18. ↑ "MultiHance" (PDF). Food and Drug Administration . Archived (PDF) from the original on 2017-05-09. Retrieved 2019-12-16.
  19. ↑ "Gadomelitol". bloodpoolagents.us. Archived from the original on January 28, 2012.
  20. ↑ "Gadomer 17". bloodpoolagents.us. Archived from the original on January 28, 2012.
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