The importance of computed tomography (CT) as one of the leading radiology technologies applied in the field of biomedical imaging escalated the development of nanoparticles as the next generation CT contrast agents. Nanoparticles are expected to play a major role in the future of medical diagnostics due to their many advantages over the conventional contrast agents, such as prolonged blood circulation time, controlled biological clearance pathways and specific molecular targeting capabilities. This paper will describe the basic design principles of nanoparticle-based CT contrast agents and review the state-of-the-art developments and clinical applications of blood pool, passive and active targeting CT contrast agents.

In recent years, advances in molecular biology and cancer research have led to the identification of sensitive and specific biomarkers that associate with various types of cancer. However, in vivo cancer detection methods with computed tomography, based on tracing and detection of these molecular cancer markers, are unavailable today. This paper demonstrates in vivo the feasibility of cancer diagnosis based on molecular markers rather than on anatomical structures, using clinical computed tomography. Anti-epidermal growth factor receptor conjugated gold nanoparticles (30 nm) were intravenously injected into nude mice implanted with human squamous cell carcinoma head and neck cancer. The results clearly demonstrate that a small tumor, which is currently undetectable through anatomical computed tomography, is enhanced and becomes clearly visible by the molecularly-targeted gold nanoparticles. It is further shown that active tumor targeting is more efficient and specific than passive targeting. This noninvasive and nonionizing molecular cancer imaging tool can facilitate early cancer detection and can provide researchers with a new technique to investigate in vivo the expression and activity of cancer-related biomarkers and molecular processes.