ProHance® consists of a nonionic gadolinium complex (Gadoteridol) used as a paramagnetic MR contrast agent.
ProHance® provides contrast enhancement of the brain, spine and surrounding tissues resulting in improved visualization (compared with unenhanced MRI) of lesions with abnormal vascularity or those thought to cause a disruption of the normal blood brain barrier. ProHance® can also be used for whole body contrast enhanced MRI including the head, neck, liver, breast, musculoskeletal system and soft tissue pathologies.

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.

See Gadoteridol.

Resovist® is an organ-specific MRI contrast agent, used for the detection and characterization of especially small focal liver lesions.
Resovist® consists of superparamagnetic iron oxide (SPIO) nanoparticles coated with carboxydextran, which are accumulated by phagocytosis in cells of the reticuloendothelial system (RES) of the liver. The uptake of Resovist® Injection in the reticuloendothelial cells results in a decrease of the signal intensity of normal liver parenchyma on both T2- and T1 weighted images.
Most malignant liver tumors do not contain RES cells and therefore do not uptake the iron particles. The resulting imaging effect is an improved contrast between the tumor (bright) and the surrounding tissue (dark).
Resovist® can be injected as an intravenous bolus, which allows immediate imaging of the liver and reduces the overall examination time. A dynamic imaging strategy after bolus injection supports to characterize lesions. In comprehensive clinical trials, it demonstrated an excellent safety profile.
In 2001, Resovist® was approved for the European market.

See also Superparamagnetic Iron Oxide.

Resovist® competed with Primovist™, the other liver imaging agent of Bayer Schering Pharma AG. Due to this reason, the production of Resovist® has been abandoned in 2009.

Sinerem® is the brand name (same as Combidex®) for an ultrasmall superparamagnetic iron oxide (USPIO) to detect metastatic disease in lymph nodes. Metastatic nodes show less uptake of this MRI contrast agent, which results in less signal decrease and allows the differentiation of normal lymph nodes from normal-sized, metastatic nodes.
Lymph node imaging with Sinerem® is performed 24 to 36 hours after slow infusion. Normal lymph nodes turn black post contrast, namely on T2* weighted images. Metastatic lymph nodes remain unchanged in signal intensity.
Indication and Diseases: Cancer, Imaging for diagnosis, Lymphatic disorders.
See Ferumoxtran, and Classifications, Characteristics, etc.

Guerbet decided in 2007 to withdraw its Marketing Authorisation Application (MAA) for Sinerem.

(Mn-DPDP) This agent, mangafodipir trisodium, is a hepatocyte specific MRI contrast agent. Manganese is very toxic, so it has to be chelated and put in the form of a vitamin B6 analog, which is taken up by normal hepatocytes to some extent.
Teslascan® was developed in the early 1980's, went through clinical trials in the early 1990's, and was approved in 1997. One problem with assessing the efficacy of this agent is the fact that the phase III trials finished in the early 1990's, and the techniques used for MR today are very different from the techniques used almost a decade ago.
This contrast agent shortens the T1 relaxation time. On T1 weighted pictures it makes a normal liver look brighter. Since metastases, for example, do not generally take up this agent, the contrast between the enhancing liver and the non-enhancing lesions will increase on T1 weighted pictures. It does not have much effect on T2 weighted images.

(VSOP = very small superparamagnetic iron oxide particles) This new class of contrast agents with smaller particle size than SPIO offers advantages for MR angiography. SPIO particles are usually coated with an organic polymer such as dextran, carboxydextran or polyethylene glycol, which limits the minimal overall particle size that can be obtained. VSOP-C184 consists of an aqueous solution of superparamagnetic iron oxide particles with a citrate coating and the overall particle size of 4-8 nm.
Short name: VSOP-C184, central moiety: Fe, concentration: 29 g Fe/l, relaxivity: R1=20.1, R2=37.1, B0=0.94 T.