When should we use contrast material in cardiac MRI?

Paiman, Elisabeth H.M.; Lamb, Hildo J.

doi:10.1002/jmri.25754

Cited by 10 publications

(7 citation statements)

References 151 publications

(161 reference statements)

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“…With adjustment of infusion time measurements of K i and possibly of ECV, the latter a hallmark of Gd-based MRI [ 1 , 80 – 82 ], may become exquisite tools in clinical physiology. It is also attractive to assess myocardial L-type Ca 2+ channel activity [ 35 ], with contribution by other Ca 2+ transporters [ 36 , 37 ] in disease.…”

Section: Memri In Humansmentioning

confidence: 99%

“…Present MRI techniques to describe the complex pathophysiology of cardiac remodeling [ 85 – 87 ] are based on signs of edema and fibrosis by delayed contrast enhancement with EC Gd agents or by native T 1 mapping and detection of deficient contractile function by cine-MRI [ 1 , 5 , 80 – 82 ]. In 2007 Skjold et al [ 19 ] applied MnDPDP to measure sector-wise myocardial viability by R 1 and systolic wall thickening (SWT) in patients 3–12 weeks after AMI treated with primary Percutaneous Coronary Intervention (pPCI).…”

Section: Memri In Humansmentioning

confidence: 99%

“…These findings, as also presented in a T 1 –SWT diagram ( Figure 11(b) ), illustrate in a quantitative manner parallel but supplementary aspects of myocardial injury and remodeling. While native T 1 maps present overall tissue conditions rather evenly [ 1 , 81 , 82 ] with main emphasis on EC events, T 1 maps after Mn 2+ enhancement encompass conditions in the major IC compartment. Accordingly, native MRI reflects edema plus fibrosis whereas MEMRI mainly reveals energy state and Ca 2+ control in cardiomyocytes.…”

Section: Memri In Humansmentioning

confidence: 99%

“…Against a future breakthrough speak a renewed position of Gd based MRI and the greater T 1 shortening capacity of Gd agents compared to MnDPDP. In addition, recent improvements in native MRI may question the need for contrast agents [ 1 , 51 , 52 , 82 ]. Notwithstanding, the IC approach with direct access to cardiomyocytes, multifunctional properties, and a potential to replace isotope scanning support a future role of cardiac MEMRI with MnDPDP.…”

Section: Back To the Futurementioning

confidence: 99%

“…MRI is an imaging modality which in its native form produces important diagnostic information with purely instrument-based techniques [ 1 ]. Diagnostic routine on the other hand commonly relies upon the use of intravenous (i.v.…”

Section: Introductionmentioning

confidence: 99%

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MnDPDP: Contrast Agent for Imaging and Protection of Viable Tissue

Jynge¹,

Skjold

Falkmer

et al. 2020

Contrast Media & Molecular Imaging

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The semistable chelate manganese (Mn) dipyridoxyl diphosphate (MnDPDP, mangafodipir), previously used as an intravenous (i.v.) contrast agent (Teslascan™, GE Healthcare) for Mn-ion-enhanced MRI (MEMRI), should be reappraised for clinical use but now as a diagnostic drug with cytoprotective properties. Approved for imaging of the liver and pancreas, MnDPDP enhances contrast also in other targets such as the heart, kidney, glandular tissue, and potentially retina and brain. Transmetallation releases paramagnetic Mn2+ for cellular uptake in competition with calcium (Ca2+), and intracellular (IC) macromolecular Mn2+ adducts lower myocardial T1 to midway between native values and values obtained with gadolinium (Gd3+). What is essential is that T1 mapping and, to a lesser degree, T1 weighted imaging enable quantification of viability at a cellular or even molecular level. IC Mn2+ retention for hours provides delayed imaging as another advantage. Examples in humans include quantitative imaging of cardiomyocyte remodeling and of Ca2+ channel activity, capabilities beyond the scope of Gd3+ based or native MRI. In addition, MnDPDP and the metabolite Mn dipyridoxyl diethyl-diamine (MnPLED) act as catalytic antioxidants enabling prevention and treatment of oxidative stress caused by tissue injury and inflammation. Tested applications in humans include protection of normal cells during chemotherapy of cancer and, potentially, of ischemic tissues during reperfusion. Theragnostic use combining therapy with delayed imaging remains to be explored. This review updates MnDPDP and its clinical potential with emphasis on the working mode of an exquisite chelate in the diagnosis of heart disease and in the treatment of oxidative stress.

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