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.

Inert hyperpolarized gases are under development for imaging air spaces, including those in the lungs. Because they mostly contain air and water, lungs are difficult organs to image.
These ventilation agents (gases) have potential in lung imaging and are currently used in studies of the pulmonary ventilation:
Specific isotopes of inert gases can be hyperpolarized. Hyperpolarized is a state in which almost all of the atoms nuclei are spinning in the same direction. Once the nuclei in the isotope 3He have been hyperpolarized using a laser, they remain in this state for several days. The inert, hyperpolarized gas can then be used in a lung imaging study, where the high concentration of polarized nuclei provides a sharp contrast in MRI. The technique is already being developed with a view to commercialization by Magnetic Imaging Technologies in Durham, North Carolina. According to the company, existing MRI equipment can be used with a few minor modifications, along with a gas polarizer. The technique could provide early detection and monitoring of pulmonary disease.
Hyperpolarized 129Xe can also be used as a magnetic resonance tracer because of its MR-enhanced sensitivity combined with its high solubility. This isotope differs from 3He in that it can dissolve in the blood. Strong enhancement of the nuclear spin polarization of xenon in the gas phase can be achieved by optical pumping of rubidium and subsequent spin-exchange with the xenon nuclei. This technique can increase the magnetic resonance signal of xenon by five orders of magnitude, thus allowing NMR detection of xenon in very low concentration. MR spectroscopy and imaging of optically polarized xenon shows considerable potential for medical applications (see also back projection imaging).
Nycomed Amersham anticipated the market for inert gases in pulmonary imaging. The company obtained an exclusive license for the use of helium (He) and xenon (Xe) as MRI contrast agents. Currently, the US FDA has not yet approved the commercial distribution of inert gas imaging equipment, because the technique is still undergoing trials.

Short name: P792, generic name: Gadomeritol
A macromolecular Gd-DOTA derivate under development (phase II, Guerbet SA) as a positive enhancing blood pool agent (MRI contrast agent) for, e.g. myocard perfusion and tumor characterization.

See also Blood Pool Agents.