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      Toxicity Evaluation of a Novel Magnetic Resonance Imaging Marker, CoCl2-N-Acetylcysteine, in Rats

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          Abstract

          C4 (cobalt dichloride-N-acetylcysteine [1% CoCl 2:2% NAC]) is a novel magnetic resonance imaging contrast marker that facilitates visualization of implanted radioactive seeds in cancer brachytherapy. We evaluated the toxicity of C4. Rats were assigned to control (0% CoCl 2:NAC), low-dose (0.1% CoCl 2:2% NAC), reference-dose (C4), and high-dose (10% CoCl 2:2% NAC) groups. Agent was injected into the left quadriceps femoris muscle of the rats. Endpoints were organ and body weights, hematology, and serum chemistry and histopathologic changes of tissues at 48 hours and 28 and 63 days after dosing. Student's t tests were used. No abnormalities in clinical signs, terminal body and organ weights, or hematologic and serum chemistry were noted, and no gross or histopathologic lesions of systemic tissue toxicity were found in any treatment group at any time point studied. At the site of injection, concentration-dependent acute responses were observed in all treatment groups at 48 hours after dosing and were recovered by 28 days. No myofiber degeneration or necrosis was observed at 28 or 63 days in any group. In conclusion, a single intramuscular dose of C4 produced no acute or chronic systemic toxicity or inflammation in rats, suggesting that C4 may be toxicologically safe for clinical use in cancer brachytherapy.

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          Most cited references22

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          Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging.

          Nephrogenic systemic fibrosis is a new, rare disease of unknown cause that affects patients with renal failure. Single cases led to the suspicion of a causative role of gadodiamide that is used for magnetic resonance imaging. This study therefore reviewed all of the authors' confirmed cases of nephrogenic systemic fibrosis (n = 13) with respect to clinical characteristics, gadodiamide exposure, and subsequent clinical course. It was found that all had been exposed to gadodiamide before the development of nephrogenic systemic fibrosis. The delay from exposure to first sign of the disease was 2 to 75 d (median 25 d). Odds ratio for acquiring the disease when gadodiamide exposed was 32.5 (95% confidence interval 1.9 to 549.2; P < 0.0001). Seven (54%) patients became severely disabled, and one died 21 mo after exposure. No other exposure/event than gadodiamide that was common to more than a minority of the patients could be identified. These findings indicate that gadodiamide plays a causative role in nephrogenic systemic fibrosis.
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            Dynamic contrast-enhanced magnetic resonance imaging as an imaging biomarker.

            Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is being used in oncology as a noninvasive method for measuring properties of the tumor microvasculature. There is potential for DCE-MRI to be used as an imaging biomarker to measure antiangiogenic effects of cancer treatments. This article reviews the general methodology for performing DCE-MRI and discusses existing data and challenges to applying DCE-MRI for treatment response assessment in clinical trials.
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              Toxicity of MRI and CT contrast agents.

              Anatomical and physiological imaging using CT and MRI are playing a critical role in patients' diagnosis, disease characterization and treatment planning. CT- and MRI-based protocols increasingly require an injection of iodinated CT and gadolinium (Gd)-based MRI contrast media. Although routinely used in clinical practice, iodinated and to a less extent Gd-based contrast media possess side effects: life-threatening contrast-induced nephropathy (CIN) is associated with CT and nephrogenic systemic fibrosis (NSF) with MRI contrast agents. CIN is defined as an acute decline in renal functions (serum creatinine increase > 0.5 mg/dl) after administration of iodinated contrast media. Patients with moderate-to-severe chronic kidney disease are considered the highest risk group for development of CIN. CIN is more common with ionic high-osmolar contrast CT media. NSF is a rare condition characterized by the formation of connective tissue in the skin and systemically in the lung, liver, heart and kidney. Patients with end stage kidney disease, acute kidney injury and stage 4-5 chronic kidney disease are at a high risk for NSF. The nonionic linear Gd-chelates are associated with the highest risk of NSF. This review summarizes the incidence, symptoms, safety profile of various CT and MRI contrast agents based on their physiochemical properties.
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                Author and article information

                Contributors
                Journal
                J Toxicol
                J Toxicol
                JT
                Journal of Toxicology
                Hindawi
                1687-8191
                1687-8205
                2018
                2 December 2018
                : 2018
                : 9173452
                Affiliations
                1Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
                2Departments of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, USA
                3Department of Physics, University of Texas Rio Grande Valley, USA
                4Strategia Therapeutics, Inc., USA
                5InPharma, LLC., USA
                6Department of Pathology, The University of Texas MD Anderson Cancer Center, USA
                7Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, USA
                8Merck & Co., Inc., Kenilworth, NJ, USA
                9Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USA
                Author notes

                Academic Editor: Orish Ebere Orisakwe

                Author information
                http://orcid.org/0000-0001-6517-7884
                Article
                10.1155/2018/9173452
                6304599
                4d029871-91c8-4ef1-a6b7-78d8b173e62b
                Copyright © 2018 Li Wang et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 February 2018
                : 31 August 2018
                : 16 October 2018
                Funding
                Funded by: Cancer Center Support
                Award ID: CA016672
                Funded by: National Cancer Institute to MD Anderson Cancer Center
                Funded by: Prostate Cancer Foundation
                Funded by: University Cancer Foundation via the Sister Institution Network Fund
                Funded by: Institutional Research Grant program
                Funded by: University of Texas MD Anderson Cancer Center
                Categories
                Research Article

                Toxicology
                Toxicology

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