The interaction between iodinated X-ray contrast agents and macrocyclic GBCAs provides a signal enhancement in T1 -weighted MR images: Insights into the renal excretion pathways of Gd-HPDO3A and iodixanol in healthy mice

Purpose: This work aims to investigate the supramolecular binding interactions that occur between iodinated X-ray contrast agents (CAs) and macrocyclic gadolinium (Gd)-based MRI contrast agents (GBCAs). This study provides some new insights in the renal excretion pathways of the two types of imaging probes. Methods: The water-proton relaxivities (r1 ) of clinically approved macrocyclic and linear GBCAs have been measured in the presence of different iodinated X-ray contrast agents at different magnetic field strengths in buffer and in serum. The in vivo MRI and X-ray CT of mice injected with either Gd-HPDO3A or a Gd-HPDO3A + iodixanol mixture were then acquired to assess the biodistribution of the two probes. Results: A significant increase in r1 (up to approximately 200%) was observed for macrocyclic GBCAs when measured in the presence of an excess of iodinated X-ray CAs (1:100 mol:mol) in serum. The co-administration of Gd-HPDO3A and iodixanol in vivo resulted in a marked increase in the signal intensity of the kidney regions in T1 -weighted MR images. Moreover, the co-presence of the two agents resulted in the extended persistence of the MRI signal enhancement, suggesting that the Gd-HPDO3A/iodixanol adduct was eliminated more slowly than the typical washing out of Gd-HPDO3A. Conclusions: The reported results show that it is possible to detect the co-presence of iodinated agents and macrocyclic GBCAs in contrast-enhanced MR images. The new information may be useful in the design of novel experiments toward improved diagnostic outcomes.