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An overview of contrast agents today

by Gus Iversen, Editor in Chief | March 31, 2015
Molecular Imaging
DEFINITY from Lantheus
Medical Imaging
From the March 2015 issue of HealthCare Business News magazine

Over the last twelve months, several new contrast agents have been added to the radiologist’s toolbox. That means new ways to obtain clearer images in CT, MR, and ultrasound, as well as new questions and challenges in providing meaningful care safely. For ultrasound in particular, there has been a flurry of activity, like the introduction of Bracco’s Lumason contrast, which marks the company’s entrance into the ultrasound contrast market in the U.S., a segment previously dominated by Lantheus and GE exclusively.

There have also been a number of FDA approvals. With contrast, those approvals are not exclusively concerned with new fluid mediums, but often have to do with manufacturing certifications. Getting approved to manufacture a contrast agent in a given location can yield significant results in improving a company’s supply chain.

Dr. Paul Bhella is the director of cardiac imaging for the JPS Health Network in Texas. For him, any discussion of contrast agents must take into account the wide range of complexity and potential for complications uniquely associated with different agents and imaging modalities. “There are many different forms of contrast agents. Lumping them all together has some utility, but they all work very differently,” he says.
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And it isn’t simply a question of CT contrast versus MR or ultrasound contrast. Even within the different imaging modalities there are competing brands offering similar — but not identical — contrast formulas. It might not make sense for an MR imaging facility to carry two different types of gadoliniumbased contrast agents, for example, so what is that decision based on?

Also, in these times of radiation dose initiatives, what kind of impact are those initiatives having on contrast dose volume and concentration? Physicians are taking pains to ensure patients are not getting more contrast than necessary, therefore reducing the likelihood of allergic reactions and other harmful side effects and offer more benefit than harm,” says Christiane Pering, head of innovation for medical care, at Bayer. She believes, and others in the industry seem to agree, finding ways to maximize those benefits is key.

FDA approvals
For Bayer, there were breakthrough FDA approvals in the indications for using their MR contrast, Gadavist. “The first was that we completed both of our studies to demonstrate safety for breast MRI,” says Pering. “That was an important milestone because we think contrast enhanced MRI breast imaging is still undervalued and has greater clinical potential.”

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