Mangafodipir trisodium: review of its use as an injectable contrast medium for magnetic resonance imaging

Daniele Regge,¹ Stefano Cirillo,¹ Annalisa Macera,¹ Giovanni Galatola²

¹Radiology Unit, ²Gastroenterology Unit, Institute for Cancer Research and Treatment, Candiolo, Turin, Italy

Abstract: Mangafodipir trisodium is a hepatobiliary contrast agent, taken up by the hepatocytes and largely excreted via the bile ducts. The agent increases the signal intensity of the normal liver, and to a lesser extent of the pancreas, adrenal glands, kidneys and myocardium, on T1-weighted imaging. The increase of the signal intensity on the T1 images allows better visualization of focal lesions, especially of those that are of non-hepatocitary origin such as metastases. For this reason the most important indication for the use of mangafodipir trisodium is in detecting liver metastases, especially when the information may influence therapeutic planning, which in many cases is surgical resection. New data show that this liver-specific contrast agent is accurate in detecting small lesions and in assessing the liver status following neoadjuvant chemotherapy, where other imaging techniques, such as CT and PET, fail. Other lesser indications for studies with mangafodipir trisodium are: in characterizing liver and pancreatic lesions; in identifying biliary leakage following bile duct and/or liver surgery; and possibly in the future in the assessment of the extent of myocardial damage.

Keywords: mangafodipir trisodium, magnetic resonance imaging, contrast agent