Trends in Contrast Media PDF
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MEDICAL RADIOLOGY Diagnostic Imaging and Radiation Oncology Editorial Board Founding Editors 1.W . Brady, M. W. Donner(t), H.-P. Heilmann, EH.W. Heuck Current Editors Diagnostic Imaging A.1. Baert, Leuven E H. W. Heuck, Stuttgart J.E. Youker, Milwaukee Radiation Oncology 1.W . Brady, Philadelphia H.-P. Heilmann, Hamburg Springer Berlin Heidelberg New York Barcelona Hong Kong London Milan Paris Singapore Tokyo H. S. Thomsen· R. N. Muller· R. F. Mattrey (Eds.) Trends in Contrast Media With Contributions by R. Agati . T. Albrecht· T. Almen . I. Berry· M. D. Blaufox . M. J. K. Blomley H. Bosmans . A. A. Brayman· W. H. Bush, Jr. . C. Catalano· P. P. Chang· C. Church M. Clanet . R. H. Cohan· B. Coley· B. Cotter· D. O. Coscrove . B. Cotter· A. N. DeMaria J.F. Desreux . R. J. Eckersley· J. H. Ellis· A. K. Fahlvik . S. L. Fossheim . B. Frennby D. Gilsoul· M.S. Girard· K. Golman· A. Greco· R.W. Katzberg· A. Kornerup Hansen E. P. Krenning· G.-P. Krestin· D. J. Kwekkeboom· A. L'Abbate· A. Laghi· P. Leander M. Leonardi· M. Lombardi· G. Manelfe . G. Marchal· R. F. Mattrey . M. T. McNamara J. K. Moran· A. Nrevestad . H.-Y. Oei . R. A. Older· P. Pavone· T. Pelura . H. M. Pollack J. P. Ranjeva . P. A. Rinck· K.K. Shung . C. B. Sirlin . F. Stacul· G. C. Steinbach G. Sterner· I. M. Stilbo· O. Svendsen· H. S. Thomsen· G. Torheim· R. Towart E. C. Unger· H. J. Weinmann· E. R. Wisner· G. L. Wolf Foreword by A. 1. Baert With 224 Figures in 409 Separate Illustrations, 22 in Color Springer HENRIK S. THOMSEN, MD Department of Diagnostic Radiology 54E2 Copenhagen University Hospital at Herlev Herlev Ringvei 75 DK-2730 Herlev Denmark ROBERT N. MULLER, MD ProfesSor, Faculte de Medecine Departement de Chimie Organique & Laboratoire RMN Universite de Mons-Hainaut 24, Aveneu du Champ de Mars B-7000 Mons Belgium ROBERT F. MATTREY, MD UCSD Medical Center Department of Radiology 200 W. Arbor Drive San Diego, CA 92109-8756 USA MEDICAL RADIOLOGY· Diagnostic Imaging and Radiation Oncology Continuation of Handbuch der medizinischen Radiologie Encyclopedia of Medical Radiology ISBN-13:978-3-642-64136-7 e-ISBN-13:978-3-642-59814-2 DOl: 10.1007/978-3-642-59814-2 Library of Congress Cataloging-in-Publication Data. Trends in contrast media I H. S. Thomsen, R. N. Muller, R. F. Mattrey (eds.) ; with contributions by T. Albrecht ... [etal.] ; foreword by A. 1. Baert. p. cm. --(Medical radiology) Includes bibliographical references and index.ISBN-13:978-3-642-64136-7 (alk. paper) 1. Contrast media. I. Thomsen, Henrik S. II. Muller, Robert N. III. Mattrey, Robert F. IV. Albrecht, T. (Thomas) V. Series [DNLM: 1. Contrast Media. WN 160T792 1998] RC78.7.C65T74 1998 616.07'54--dc21 DNLM/DLC for Library of Congress 98-28592 CIP This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. © Springer-Verlag Berlin Heidelberg 1999 Sof tcover reprint of the hardcover 1s t edition 1999 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application con tained in this book. In every individual case the user must check such information by consulting the relevant literature. Typesetting: Best-set Typesetter Ltd., Hong Kong SPIN: 10526090 21/3135 - 5 4 3 2 1 0 - Printed on acid-free paper Foreword 0\ The use contrast media within diagnostic radiology has been firmly established for many years now. Radiologic contrast media render immense services in daily clinical practice to innumerable patients all over the world. When the new cross sectional modalities such as computed tomography and magnetic resonance ima ging were introduced into clinical practice it rapidly became evident that the judi cious use of contrast media allows the optimal exploitation of the great diagnostic potential of these revolutionary methods. More recently, efforts to create specific contrast media for ultrasound imaging have been successful, and the first benefi cial results of their application in daily practice are now evident. The aim of this book is to bring together the results of the tremendous research that has been performed during recent years in order to develop specific contrast media for magnetic resonance imaging and ultrasonography and also to develop safer contrast media for the classical radiologic techniques as well as computed tomography. Moreover, the book provides a comprehensive overview of the indica tions for and applications of these new contrast media in clinical radiology. Finally, risks, side-effects, and complications which may occur with the use of these drugs are covered appropriately. The three editors are leading and well-known experts in their specific field. They have been very successful in ensuring the collaboration of so many intern~tionally known specialists to cover the different topics dealt with in this book. It is my pleasure to congratulate the editors and all the authors for their excellent contributions. I am convinced that this volume includes the latest, up-to-date infor mation that radiologists and other clinicians are looking for in order to alow them to provide the best possible care to their patients and to maintain their standards of excellent clinical practice. I sincerely hope that this book will meet the expectations of all those interested in updating their knowledge about radiologic contrast media and I wish this volume the same success as the previous volumes published in our series "Medical Radiology". I would appreciate every constructive criticism that might be offered. Leuven ALBERT 1. BAERT Preface During the past two decades more has happened in diagnostic imaging than during the first 8 decades following the birth of the specialty in 1895. A variety of new modalities - computed tomography, magnetic resonance imaging, ultrasono graphy, gamma camera imaging, and positron emission tomography - have been introduced and all have shown their importance in the workup of patients with symptoms/signs of disease. Initially it was claimed that neither magnetic resonan ce imaging nor ultrasonography required the use of contrast media. Today we know that this was incorrect. With all modalities, use of contrast media increases the information acquired, and accordingly there has also been enormous development with regard to contrast media during the past two decades. High-osmolar contrast media have been available since the early 1950s, but their role has now almost com pletely been taken over by the low- and iso-osmolar contrast media. Ultra sonography has got its bubbles. Magnetic resonance imaging uses agents distribu ted in the extracellular phase and organ-specific agents. Nuclear medicine has access to several pharmaceuticals attached to an isotope. More contrast media are on their way in order to improve imaging with the various modalities to the bene fit of the patient. The technological development is now rapid, and sometimes it bypasses the much slower pharmaceutical projects. Therefore it is difficult to pre dict the future for the various old and new contrast media for diagnostic imaging. Nevertheless, diagnostic imaging has moved from being a specialty using one class of contrast media to a multipharmaceutical business. Radiologists now have many drugs on their shelves: it has not become easier to be a radiologist! During recent years I have gained the impression that there is a strong wish among many radiologists to have an overview on the current state of the art regar ding contrast media and some recommendations for daily work. Therefore this project was undertaken, with strong encouragement from Professor Albert L. Baert and Springer-Verlag. This book is devoted to the general radiologist, being desi gned to serve as a reference in his/her daily practice and to provide an update of current knowledge. The reader will find chapters ranging from the history of con trast media to what is going on in the laboratory, together with recommendations on doses, use, and treatment of adverse effects. The book covers iodinated contrast media used for x-ray examinations, radiopharmaceuticals employed for nuclear medicine, agents usable with magnetic resonance and echo-increasing agents for ultrasonography. It is my sincere hope that general radiologists will find it useful. There would not have been a single word in this book without the assistance of my co-editors Prof. Mattrey and Prof. Muller as well as the authors of the chapters. VIII I sincerely thank them all for their excellent contributions. I am fully aware of the fact, that the project has taken the authors away from their families, clinical work, and the research laboratory, and that at some institutions it is not as rewarding to write a book chapter as it is to write an original paper published in a peer-reviewed journal. Nevertheless, the chapters were written, and I am sure that the readers will appreciate the end result. The staff at Springer-Verlag did a tremendous job bringing the book together. Many thanks to them. Finally my wife and three boys often did not see me owing to this project; they did not complain. The book is devoted to Pia, Jannick, Michael, and Ulrik Between Bangkok and Singapore on SK 973 HENRIK S. THOMSEN Contents I Iodinated Contrast Media ................................................ 1 1 History of Iodinated Contrast Media H. M. POLLACK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 Design of X-ray Contrast Agents G. L. WOLF ............................................................ 21 3 Biological Variation, Reproducibility, and Predictability of Experimental Research in Animals O. SVENDSEN and A. KORNERUP HANSEN ................................... 31 4 Experimental Testing of Iodinated Contrast Media Before Human Testing R. TOWART and K. GOLMAN .............................................. 43 5 Phase I, II, III, and IV Studies: Good Clinical Practice I.M. STILBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 57 6 Currently Available Iodinated Contrast Media F. STACUL ............................................................. 63 7 Clinical Doses of Contrast Media R.A. OLDER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 75 8 Determination of Glomerular Filtration Rate with Contrast Media T. ALMEN, B. FRENNBY, and G. STERNER .................................... 81 9 Neurotoxicity M. LEONARDI and R. AGATI .............................................. 95 10 Nephrotoxicity H. S. THOMSEN ......................................................... 103 11 Adverse Reactions to Iodinated Radiographic Contrast Media R. H. COHAN and J. H. ELLIS .............................................. 117 12 Treatment of Adverse Reactions W. H. BUSH, Jr. . ........................................................ 133 New Agents 13 Hepatic Agents P. LEANDER ............................................................ 141 14 Lymphatic Agents E. R. WISNER AND R.W. KATZBERG ......................................... 149 x Contents II Magnetic Resonance Contrast Media ...................................... 159 Chemistry and Physics 15 Chemical Synthesis of Paramagnetic Complexes J. E DESREUX and D. GILSOUL ............................................ 161 16 Preparation and Structure-Activity Relationships of Particulate Magnetic Agents A. NlEVESTAD, S. L. FOSSHEIM, and A. K. FAHLVIK ............................ 17l 17 Magnetic Resonance Contrast Agents of Increased Specificity H.-J. WEINMANN ................................. ~ ..................... 183 Selected Applications of Magnetic Resonance Imaging Contrast Agents 18 Central Nervous System I. BERRY, J.-P. RANJEVA, M. CLANET, and C. MANELFE ......................... 195 19 Liver and Pancreas P. PAVONE,A. LAGHI, and C. CATALANO ..................................... 219 20 Heart M.LoMBARDI and A. l'A BBATE ............................................ 223 21 Kidneys and Adrenal Glands G. P. KRESTIN .......................................................... 233 22 The Musculoskeletal System P. A. RINCK, A. GRECO, and M. T. McNAMARA ............................... 253 23 Contrast-Enhanced Magnetic Resonance Angiography G. MARCHAL and H. BOSMANS ............................................ 267 24 Dynamic Contrast-Enhanced Magnetic Resonance Imaging and Image Processing G. TORHEIM and P. A. RINCK .............................................. 285 III Ultrasound Contrast Media .............................................. 297 History 25 Ultrasound Contrast Media: Past, Present, and Future R.E MATTREY .......................................................... 299 Physics 26 Interaction of Ultrasound and Contrast Agents P. P. CHANG and K. K. SHUNG ............................................. 311 27 Contrast-Specific Instrumentation and Its Potential Applications G. C. STEINBACH ........................................................ 321 28 Bubble Destruction C.B. SIRLIN, T. PELURA, and R.E MATTREY .................................. 333 29 Potential for Quantification M.J.K. BLOMLEY, R.J. ECKERSLEY, and D.O. COSGROVE ......................... 343 Contents XI Applications 30 The Vascular Space C. B. SIRLIN, B. COLEY, and R. F. MATTREY ................................... 355 31 Tumor Imaging with Ultrasound Contrast T. ALBRECHT and R. F. MATTREY .......................................... 367 32 Tissue Perfusion and Enhancement on Gray-scale R. F. MATTREY and M. S. GIRARD .......................................... 383 33 Cardiac Applications B. COTTER and A. N. DEMARIA ............................................ 393 34 Targeting and Delivery of Drugs with Ultrasound Contrast Agents E. C. UNGER ............................................................ 405 Bioeffects 35 Can the Presence of Contrast Media Promote Ultrasound Bioeffects? C. C. CHURCH and A.A. BRAYMAN ......................................... 413 IV Radiopharmaceuticals (Nuclear Medicine) .................................. 423 36 Imaging Techniques and Existing Agents H.-Y. OEI, D.J. KWEKKEBOOM, and E.P. KRENNING ............................ 425 37 New and Future Trends in Radiopharmaceuticals M. D. BLAUFOX and J. K. MORAN ........................................... 457 Subject Index ............................................................. 469 List of Contributors ........................................................ 477
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