(SPIO) Relatively new types of MRI contrast agents are superparamagnetic iron oxide-based colloids (median diameter greater than 50nm). These compounds consist of nonstoichiometric microcrystalline magnetite cores, which are coated with dextrans (in ferumoxide) or siloxanes (in ferumoxsil). After injection they accumulate in the reticuloendothelial system (RES) of the liver (Kupffer cells) and the spleen. At low doses circulating iron decreases the T1 time of blood, at higher doses predominates the T2* effect.
SPIO agents are much more effective in MR relaxation than paramagnetic agents. Since hepatic tumors either do not contain RES cells or their activity is reduced, the contrast between liver and lesion is improved. Superparamagnetic iron oxides cause noticeable shorter T2 relaxation times with signal loss in the targeted tissue (e.g., liver and spleen) with all standard pulse sequences. Magnetite, a mixture of FeO and Fe2O3, is one of the used iron oxides. FeO can be replaced by Fe3O4.
Use of these colloids as tissue specific contrast agents is now a well-established area of pharmaceutical development. Feridex®, Endorem™, GastroMARK®, Lumirem®, Sinerem®, Resovist® and more patents pending tell us that the last word in this area is not said.
Some remarkable points using SPIO:

See also Superparamagnetism, Superparamagnetic Contrast Agents and Classifications, Characteristics, etc..

(USPIO) The class of the ultrasmall superparamagnetic iron oxide includes several chemically and pharmacologically very distinct materials, which may or may not be interchangeable for a specific use. Some ultrasmall SPIO particles (median diameter less than 50nm) are used as MRI contrast agents (Sinerem®, Combidex®), e.g. to differentiate metastatic from inflammatory lymph nodes. USPIO shows also potential for providing important information about angiogenesis in cancer tumors and could possibly complement MRI helping physicians to identify dangerous arteriosclerosis plaques.
Because of the disadvantageous large T2*//T1 ratio, USPIO compounds are less suitable for arterial bolus contrast enhanced magnetic resonance angiography than gadolinium complexes. The tiny ultrasmall superparamagnetic iron oxides do not accumulate in the RES system as fast as larger particles, which results in a long plasma half-life. USPIO particles, with a small median diameter (less than 10 nm), will accumulate in lymph nodes after an intravenous injection by e.g. direct transcapillary passage through endothelial venules. Once within the nodal parenchyma, phagocytic cells of the mononuclear phagocyte system take up the particles.
As a second way, USPIOs are subsequently taken up from then interstitium by lymphatic vessels and transported to regional lymph nodes. A lymph node with normal phagocytic function takes up a considerable amount and shows a reduction of the signal intensity caused by T2 shortening effects and magnetic susceptibility. Caused by the small uptake of the USPIOs in metastatic lymph nodes, they appear with less signal reduction, and permit the differentiation of healthy lymph nodes from normal-sized, metastatic nodes.

See also Superparamagnetic Contrast Agents, Superparamagnetic Iron Oxide, Very Small Superparamagnetic Iron Oxide Particles, Blood Pool Agents, Intracellular Contrast Agents.

Contrast enhanced MRI is a commonly used procedure in magnetic resonance imaging. The need to more accurately characterize different types of lesions and to detect all malignant lesions is the main reason for the use of intravenous contrast agents.
Some methods are available to improve the contrast of different tissues. The focus of dynamic contrast enhanced MRI (DCE-MRI) is on contrast kinetics with demands for spatial resolution dependent on the application. DCE-MR imaging is used for diagnosis of cancer (see also liver imaging, abdominal imaging, breast MRI, dynamic scanning) as well as for diagnosis of cardiac infarction (see perfusion imaging, cardiac MRI). Quantitative DCE-MRI requires special data acquisition techniques and analysis software.
Contrast enhanced magnetic resonance angiography (CE-MRA) allows the visualization of vessels and the temporal resolution provides a separation of arteries and veins. These methods share the need for acquisition methods with high temporal and spatial resolution.
Double contrast administration (combined contrast enhanced (CCE) MRI) uses two contrast agents with complementary mechanisms e.g., superparamagnetic iron oxide to darken the background liver and gadolinium to brighten the vessels. A variety of different categories of contrast agents are currently available for clinical use.
Reasons for the use of contrast agents in MRI scans are:
Common Indications:
Brain MRI : Preoperative/pretreatment evaluation and postoperative evaluation of brain tumor therapy, CNS infections, noninfectious inflammatory disease and meningeal disease.
Spine MRI : Infection/inflammatory disease, primary tumors, drop metastases, initial evaluation of syrinx, postoperative evaluation of the lumbar spine: disk vs. scar.
Breast MRI : Detection of breast cancer in case of dense breasts, implants, malignant lymph nodes, or scarring after treatment for breast cancer, diagnosis of a suspicious breast lesion in order to avoid biopsy.

For Ultrasound Imaging (USI) see Contrast Enhanced Ultrasound at Medical-Ultrasound-Imaging.com. See also Blood Pool Agents, Myocardial Late Enhancement, Cardiovascular Imaging, Contrast Enhanced MR Venography, Contrast Resolution, Dynamic Scanning, Lung Imaging, Hepatobiliary Contrast Agents, Contrast Medium and MRI Guided Biopsy.

(GastroMARK®, Lumirem®) A superparamagnetic MRI contrast agent for the gastrointestinal tract.

See also Oral Contrast Agents.

(McAb) Monoclonal antibodies are used for tumor detection and localization in nuclear medicine. In MRI, monoclonal antibodies labeled with paramagnetic or superparamagnetic particles are being studied for targeting tumors, for example contrast agent containing gadolinium attached to a targeting antibody. The antibody would bind to a specific target (e.g., a metastatic melanoma cell) while the gadolinium would increase the MRI signal. Further developments are MRI contrast agents that specifically target glucose receptors on tumor cells; coupled with the high spatial resolution of high field MRI devices, these agents have potentials to detect small tumor foci.
The monoclonal antibody manufacturers produce a wide variety of ligands, which can be directed against a multiplicity of pathologic molecular targets. MRI enhanced with targeted contrast agents can be used for molecular imaging.