Imaging Liver Metastases with a New Oral Manganese-Based Contrast Agent

Abstract

The purpose of the study was a preliminary evaluation of a new oral, manganese-based, liver-specific contrast medium (CMC-001; CMC Contrast AB, Malmoe, Sweden) for magnetic resonance imaging (MRI) in patients with liver metastases. The study included 10 consecutive patients with known liver metastases. Patients underwent abdominal MRI as a supplement to routine diagnostics. Patients fasted for at least 10 hours before ingesting CMC-001 (1.6 g manganese chloride tetrahydrate, 1 g alanine, and 1,600 IU vitamin D3 were dissolved in water). MRI took place before and 2 hours after drinking CMC-001. The 1.5-T MRI protocol included two-dimensional T1w sequences to visualize metastases. T2w and diffusion weighted imaging (DWI) sequences were used to identify cysts and blood vessels correspondingly. The intake of CMC-001 caused an increase in the signal intensity of the "healthy" liver tissue, making the internal structure of the liver significantly better visualized. Compared with our routine examinations, MRI showed more metastases in four patients and allowed determining a more precise outline of metastases. CMC-001 improves imaging of liver metastases in comparison with computed tomography and with MRI without CMC-001.