Magnetic resonance imaging (MRI) is one of the most powerful diagnostic techniques at the disposal of the medical community. Its success in the clinic, with 75 to 90 million scans performed worldwide annually, can be attributed in part to the use of injectable contrast agents to improve signal differentiation between healthy and pathological tissue. These contrast agents primarily use Gd(III) as the paramagnetic metal ion to induce contrast. With seven unpaired electrons, Gd(III) has the most paramagnetic character of any nonradioactive element. Aqueous Gd(III), however, is highly toxic; hence contrast agents use chelators to encapsulate the Gd(III) ion, which protects the patient from from the Gd(III) ion.
While these chelators are necessary, they greatly decrease the relaxivity of the current commercial contrast agents. Commercial contrast agents are similar in that they are heteroatom chelators (N, O) and octadentate coordination, leaving only one open site for water coordination. Additionally, given their steric bulk, the water exchange mechanism with bulk solvent is a laboriously hindered dissociative mechanism. These factors contribute to the low efficiency of these Gd(III) complexes, as measured in relaxivity. Diagnostic scans typically inject 8-10 g of these complexes to achieve sufficient signal.
Hydroxypyridinone (HOPO) chelators have emerged as a superior alternative to current commercial compounds. Using a tris(2-aminoethyl)amine (TREN) capping moiety, three bidentate HOPO chelators form a hexadentate ligand. These TREN-tris-HOPO ligands leave multiple open sites for water coordination and exhibit rapid water exchange with bulk solvent, due to their reduced steric bulk and associative exchange mechanism. These ligands use all-oxygen-donor chelators, capitalizing on the oxophilicity of Gd(III) to form highly stable complexes.
From this superior family of chelators, a variety of approaches can be used to develop the next generation of MRI contrast agents. Increasing molecular weight and tumbling time has been a strategy for increasing relaxivity and efficiency of MRI contrast agents. Through macromolecular conjugation, relaxivity is readily increased; simultaneously, these macromolecules provide the potential for building multimodal and multifunctional diagnostic and therapeutic agents. The potential applications for this class of materials are further increased with the addition of targeting functionality. These agents must have the ability to be fully and rapidly excreted and have facile and uniform large-scale syntheses to be candidates for the clinic.
The esteramide (EA) dendrimer is one such macromolecular platform. With eight sites for contrast agent conjugation, the esteramide dendrimer readily loads many distinct HOPO ligands with multiple lanthanides for multimodal imaging. With close to 40 kDa of polyethylene glycol units, the Gd-HOPO-EA macromolecular architecture is highly soluble and biocompatible. Furthermore, the ester core of the dendrimer is degradable under in vivo conditions, easing renal clearance with four smaller moieties. The superior properties of this system inspired investigation into a variety of other macromolecular systems.
Porous silica mesoparticles provide a rigid architecture that is much larger than other macromolecules evaluated and can hold greater than 108 small molecule MRI contrast complexes. The surfaces of these particles are readily functionalized and suitable for conjugation with most small molecule MRI contrast agents. These structures use a nontoxic silica infrastructure and are excreted renally despite their large size, making them viable candidates for further in vitro and in vivo study.
Gold nanoparticles (AuNP) as a solid-support system have the most potential for use as multifunctional diagnostic and therapeutic compounds. AuNP have been long used for enhancing computed tomography (CT) imaging and have recently emerged as a cancer therapeutic when their structure is irradiated. These compounds are readily synthesized in large scales and have loading sites that are close together to hold multi-tethered Gadolinium-HOPO systems for multifunctional imaging.
Using a variety of macromolecules to capitalize on the structural relationship between relaxivity and size, per-Gd and per-macromolecule-Gd relaxivity have been increased dramatically at clinically and physiologically relevant conditions. These improvements show that the combination of carefully designed macromolecules with excellent HOPO chelators produces an ideal MRI contrast agent for the clinic of the future.