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.

Paramagnetic substances, for example Gd-DTPA solutions, are used as MRI oral contrast agents in gastrointestinal imaging to depict the lumen of the digestive organs. Different Gd-DTPA solutions or zeolites containing gadolinium can be used e.g., for diagnosis of delayed gastric emptying, diagnosis of Crohn's disease etc.
Low concentrations of gastrointestinal paramagnetic contrast agents cause a reduction in T1 relaxation time; consequently, these agents act on T1 weighted images by increasing the signal intensity of the bowel lumen. High concentrations cause T2 shortening by decreasing the signal, similar to superparamagnetic iron oxide. Gd-DTPA chelates are unstable at the low pH in the stomach, therefore buffering is necessary for oral use.

See also Gadopentetate Gastrointestinal, Gadolinium Zeolite, Negative Oral Contrast Agents, Gastrointestinal Superparamagnetic Contrast Agents, and Ferric ammonium citrate.

Rectal staging is necessary for the preoperative assessment of intra- and extramural tumor infiltration or the decision for adjuvant radio-chemotherapy. One indication of MRI with luminal contrast enhancement is small bowel enteroclysis after duodenal intubation for visualization of inflammatory bowel wall thickening and other complications.
"Double contrast" enhancement of the bowel lumen is the administration of plain water or water with methylcellulose along with heavily T2 weighted sequences or contrast enhanced T1 weighted sequences.
Several oral contrast agents have been used for small bowel MRI: Mannitol, metamucil, locust bean gum, and PEG. All provide sufficient bowel distension and homogeneity, but suffer from side effects such as diarrhea. The volume of PEG or mannitol administered must be not too large in order to achieve the best compromise between distension and acceptance by the patient.
MR colonography with positive bowel lumen enhancement requires higher concentrations of paramagnetic agents compared to the available dedicated enteral contrast agents, IV compounds are used to dope water enemas for this purpose.
Some investigators advocate negative bowel enhancement with Contrast Agents to suppress high signal bowel content in MRCP ( Magnetic resonance cholangiopancreaticography ). The use of a mixture of metamucil and 20 ml of gadolinium chelate provides good homogeneity and good tolerance without diarrhea.

The use of gas as a contrast medium has significant potential to avoid limitations of conventional contrast agents. Gases can transit smaller vascular conduits and can be injected through smaller and less traumatic access systems than liquids. Highly soluble gases (such as CO2) can be imaged as a bolus. Blood is displaced by the gas, with the result of negative image contrast.
Because gases are compressible, standard liquid injectors cannot be used. The design for a gasinjector should have the option for individual adaptation of blood flow rate, vessel diameter, pulse pressure, and heart rate.

This superparamagnetic oral contrast agent consists of large iron oxide particles, coated with insoluble material. Abdoscan® particles have a mean diameter no less than 300 nm. Gastrointestinal superparamagnetic contrast agents are used for negative bowel enhancement.

Abdoscan® was approved in Europe but was taken off the market in 2000, and all sales stopped by the end of 2002.