Compositions for increasing the image contrast in imaging of the digestive tract of patients

Abstract: Suspensions of magnetic particles in aqueous bioadhesive carriers effectively improve MRI of the digestive tract. Affinity of the compositions for the gastric mucosa can be adapted to the needs by appropriately selecting the carrier in function to inherent bioadhesive capacity : this technique leads to improved visualization of selected portions of the lumen.

Description: The present invention concerns innocuous ingestible or enterally administrable compositions which are used as contrast enhancer media in nuclear magnetic resonance imaging (MRI) of the gastro-intestinal tract of animal and human patients. It is well known that MRI enables the direct electronic visualization of internal organs in living beings and is therefore of powerful help and guide in prognosis, medical treatment and surgery. This technique can often advantageously supplement or replace X-ray tomography as well as the use of radio-active tracer compounds which may have obvious undesirable side-effects. It is also known that MRI techniques comprise subjecting a patient to a main static magnetic field combined with a linear gradient magnetic field, both being directed to some parts of the body to be investigated. The magnetic fields act on the nuclei of atoms with fractional spin quantum numbers and encode them into various degrees of statistical alignment with different resonant frequencies in a selected direction of orientation; the nuclei of concern here are mainly that of hydrogen atoms, i.e. protons, these being predominantly that of molecules present in relatively high concentration in or around the organs to be investigated, viz, the protons of water and lipids. For doing the measurements, one will apply to the parts of the body under investigation pulses of radio-frequency that matches with the resonance energy of the protons involved in the tissues or fluids of said parts of the body. When the protons under consideration are excited by a pulse of resonant energy, they are raised to a higher energy state which causes them to flip from the average orientation direction controlled by the magnetic field. Thereafter, the protons will return to their original state by relaxation in an exponential time dependent fashion, the corresponding energy then reemitted (spin-echo) forming a response signal typical of the protons under consideration, i.e. depending on their immediate environment. MRI techniques are actually based on the detecting, acquiring and electronically processing of this signal (according to Fourier transforms) and thereafter displaying it spatially on a screen, thus forming an image whose various patterns correspond to areas having protons in different environments, i.e. to protons belonging to organ tissues or body fluids being subjected to investigation. Among the critical factors pertaining to MRI, one usually distinguishes two mutually perpendicular components of the proton-distinctive relaxation time parameter, namely the spin-lattice component along the axis of magnetization (called T₁), which corresponds to the release of energy to the nuclear environment, and the perpendicular or transverse (spin-spin) relaxation component (called T₂), that corresponds to the returning of the nucleus to the initial statistical energy level. Either T₁ or T₂ can contribute to the definition of the NMR images depending on the kind of organ selected and the measurement conditions. It should be noted that when the measurements are carried out in the absence of agents added for increasing image contrasts, the differences in relaxation time constants between protons in various parts of the organs are small and the image is of poor to bad quality. The contrast effect can however be enhanced by the presence, in the environment of the hydrated molecules under excitation, of a variety of magnetic species, e.g. paramagnetic (which mainly affect T₁) and ferromagnetic or superparamagnetic (which mainly affect the T₂ response). The paramagnetic substances include some metals in the ionic or organometallic state (e.g. Fe⁺³, Mn⁺², Gd⁺³ and the like, particularly in the form of chelates to decrease the intrinsic toxicity of the free metal ions). Ferromagnetic contrast substances preferably include magnetic aggregate particles of micronic or submicronic size, i.e. not smaller than about 100-200 nm, for instance particles of magnetite (Fe₃O₄), γ-Fe₂O₃, ferrites and other magnetic mineral compounds of transition elements. Superparamagnetic materials are usually very small magnetic particles (below about 100-150 nm) which, because their size is under a critical value, do not behave any longer as small autonomous magnets, i.e they will align in a preferential direction only when subjected to an external magnetic field. The advantage of the superparamagnetic materials (also defined sometimes as superparamagnetic fluids) over the ferromagnetic particles is mainly of efficiency density, i.e. being smaller, the number of available magnetic particles for a given weight of metal is greater in the case of superparamagnetic particles than with ferromagnetic particles and the magnetic efficiency on the neighboring protons is further enhanced. For the MRI imaging of the digestive tract, the particulate contrast agents, in the form of particles of ferromagnetic, superparamagnetic, or paramagnetic materials, are usually administered orally or rectally, either neat or preferably with a carrier. For instance, EP-A-0 275 215 (Amersham) discloses NMRI contrast enhancers for the investigation of the digestive tract comprising complexes of paramagnetic metal species like gadolinium, iron, manganese and the like associated with mineral particulate carriers such as alkaline-earth polyphosphates and apatite. EP-A-0 083 760 (Amersham) discloses EDTA, DTPA and NTA chelates of paramagnetic metals chemically bonded to organic polymer carriers such as sepharose, dextran, dextrin, starch and the like. Also in EP-A-0 299 920 (Schering), there are disclosed complexes between paramagnetic metals such as Cr, Mn, Fe, Ni, Co, Gd, etc. and polysulfated oligosaccharides like sucrose or maltose, these complexes being used for NMRI of the digestive tract. It has been indicated above that paramagnetic contrast agents in which the metals are in the ionic state or in the form of metal-organic compounds are often metabolizable and toxic and, although this toxicity can be controlled to some extent by using very strong chelatants and non-metabolizable polymer carriers, it is desirable to further minimize possible hazards by using less toxic materials, e.g. non-metabolizable magnetic particles of sufficient size not to diffuse through the intestinal membrane; the micronic ferromagnetic and nanometric superparamagnetic aggregate particles typically fulfill such requirements. For instance, in US-A-4,770,183 (Advanced Magnetics), there is recommended to use biodegradable sub-micron sized superparamagnetic metal oxide particles (1-50 nm) which may be used uncoated or coated with a polysaccharide (like dextran) or serum albumin. Coating is effected by precipitating the particles with alkali, starting with water solutions of metal salts in the presence of the polymer. These products are suitable for intravenous applications as well as for gastro-intestinal applications, in which case they are administrable by intubation or enema, presumably because otherwise biodegradation by the stomach fluids would be too fast and toxicity might become a problem. In WO-A-85/04330 (Nycomed), there is disclosed the use of ferromagnetic particles as contrast agents for MRI. As mentioned before, ferromagnetic particles are bigger than superparamagnetic particles and behave as small permanent magnets which also achieve a significant reduction of T₂. For direct administration into the digestive tract, the ferromagnetic particles are preferably embedded in a cellulose matrix or coated with this matrix. Cellulose derivatives can also be added as viscosants but the reference indicates that contrast enhancement is not readily achieved beyond the stomach, presumably because the embedding cellulose matrix does not protect sufficiently the particles from attack by the stomach fluids. Non-biodegradable embedding or coating matrices are therefore recommended to minimize absorption of toxic materials by the body. EP-A-0 186 616 (Schering) discloses the use of complexes of particles of magnetite (Fe₃O₄), γ-iron oxide (Fe₂O₃) and metal ferrites as contrast agents for MRI. The cited complexants include oligo- and polysaccharides, proteins, polycarboxylic acids, protective colloids and other compounds. Examples of such compounds comprise polyvinyl-alcohol (PVA), polysilanes, polyethylene-imine, dextran, dextrin, oleic acid, gelatin, globulin, albumin, insulin, peptides and antibodies. The particles can also be encapsulated in liposomes. For enteral administration, the contrast agents are suspended in a water medium which may contain further ingredients such as salt or excipients like methylcellulose, viscosants, lactose, mannitol and surfactants like lecithin, Tween®, Myrj® and the like. For enteral use, this document particularly mentions compositions containing dextrin or dextran-magnetite complexes, the manufacturing of which is disclosed in US-A-4,101,435 (Meito Sangyo). WO-A-91/01148 (Nycomed), see the preamble of claim 1, discloses compositions for use as MRI contrast media for imaging of the gastrointestinal tract and other body cavities comprising magnetite particles and an incompletely hydrated viscosity enhancing agent. After full hydration, within the gastrointestinal tract, the viscosities imparted can reach 200 to 150,000 cP, thus securing an even distribution of the magnetic particles and even slowing the passage of the contrast media through the bowels. The viscosity enhancing agents disclosed include water soluble food thickening agents such as guar gum, tragacanth, methyl cellulose, hydroxypropyl cellulose, carboxymethyl cellulose, xanthan gum and alginates. Alternatively the viscosity enhancing agents may include insoluble materials which swell in aqueous media to produce viscous dispersions. The materials mentioned are kaolin, bentonite, magnesium aluminium silicate, etc. According to the document, the compositions may also include wetting agents, binders, fillers, osmoactive and flavouring agents etc. For improving contact of the particles with the bowel walls the compositions may further contain mucoadhesives such as polyacrylic acid or a derivative thereof, xanthan gum etc. The document contains no disclosure relative to the nature or type of polyacrylic acid suitable for the inteded use. There is also reported by J. Klaveness et al, in Diagnostic Imaging International, November 1988, p. 70, the use as contrast agents for the gastro-intestinal system of microspheres (3.5 µm) of sulfonated ionexchange styrene-divinylbenzene resin coated with magnetite Fe₃O₄. The matrix is non-biodegradable and the particles with an iron content of about 20% are stable in the gastro-intestinal tract. After testing the compositions of the cited prior art consisting of coated or uncoated magnetic particles in admixtures with polymer carriers, the present inventors noted that the contrast effect in NMR imaging is generally unstable and rapidly vanishes, presumably because despite the presence of the carrier phase the magnetic particles tend to coalesce or coacervate together under the influence of the external magnetic field which strongly reduces their controlling effect on the spin-relaxation of the neighbouring protons. The present inventors found that for efficient and selective imaging of portions of the digestive tract, it is advantageous to select carrier phases that have essential particular selective affinity for the gastric mucosa, e.g. carrier phases which can form intestinal linings or coatings on all or selected portions of the internal lumen surfaces. Hence when the carrier phase has special affinity for the gastric and intestinal mucosa, it will tend to stay in immobilized layer form thereon, thus further reducing particle mobility and preventing coalescence. The foregoing findings form the basis of the present invention, see claim 1, which mainly concerns compositions to be used as contrast enhancing agents in the NMR imaging of portions of the digestive tract of humans and animals, said compositions comprising magnetically responsive particles, in admixture with, or chemically bonded to, at least one physiologically acceptable substantially water insoluble carrier phase. The carrier phase which is swellable by hydration and gel forming, and, when hydrated, has differential affinity for the gastro-intestinal mucosa, i.e. the carrier phase which adheres preferably to some areas thereof forming luminal linings or coatings having specific magnetic contrast response patterns which enable improved visualization of specific portions of the oeso-gastro-duodenal tract. The carrier phase of the present composition comprises at least one bioadhesive polymer or copolymer of acrylic acid containing a proportion of other monomers (generally di- or polyfunctional allyl ethers or acrylates) to impart a degree of water-insolubility and swelling capacity to form gels. Suitable polymers of this type are available on the market under the names of Carbopol® (polyacrylic acid cross-linked with allylsucrose) or Polycarbophil® (Ca salt of polyacrylic acid cross-linked with divinyl glycol), for instance from the Goodrich Company. Other suitable polymers of comparable type are disclosed in EP-A-0 309 404 and comprise copolymers of acrylic acid with allyl ethers of glycols or sugars. Upon addition of water these polymers will form viscous dispersions of microgels which have strong affinity for internal mucous membranes. Furthermore, the gelling and swelling properties of such polymers are pH dependent; hence the volume, bulk and adhesive properties of the carrier can be controlled by adjusting the pH to a desired value. Other additional carriers may comprise materials having affinity for the membrane mucosa of the digestive tract and can include most luminal coating materials in use for treatment, protection of medication of gastro-intestinal regions, including for instance, adhesives containing bismuth oxide, aluminum oxide and montmorillonite and attapulgite designed for luminal applications. These materials also include cross-linked polymers such as polysiloxanes (Dimethicone®), magnesium and other metals alginates, bioadhesive pectins and carbohydrates polysubstituted with groups such as sulfate, phosphate, sulfonate and phosphonate. One convenient polysulfated carbohydrate is sucrose octasulfate (also named Sucralfate). It is already known that montmorillonite of the Beidel type alone can function as useful contrast agents in the MRI of the digestive tract of humans and animals, this being possibly due to some inherent magnetic properties of the montmorillonite. The contrast effect of Beidel montmorillonite is further enhanced when used as an additional carrier of magnetite particles according to the invention. Although the exact reason of these findings is not definitely explained, it can be postulated that using these polyacrylic acid carrier matrices which form nearly insoluble gels upon admixing with water (thixotropic or pseudo-plastic solutions) will locally raise the viscosity at the particle/carrier interface to such extent that the particle mobility is impeded and agglomeration is prevented. The composition of the invention may further comprise dispersions of magnetite particles in aqueous solution of one or more water soluble polymers. These can be selected from water-soluble polymers which can form homogeneous solutions in aqueous media, in which case the proportion of signal generating particles therein preferably not exceeds 10% by weight of solution, more preferable 5%, for optimalized stability against coalescence when subjected to a steady magnetic field. The polymers which are convenient are for instance dextran, polyvinyl-pyrrolidone (PVP) and the like. It is quite surprising that, contrary to products of the prior art with a high particle/carrier weight ratio, homogeneous dispersion of magnetic particles in relatively low concentrations in the carrier polymer remain stable in a magnetic field with virtually no or very little agglomeration of the magnetic particles, and hence no substantial weakening of the imaging response under the conditions of NMR imaging. Although the compositions with water-soluble polymers have no recognized specific affinity for the internal mucosa membrane of the digestive tract, they are useful for controlling the transit therethrough of the magnetic particles, either alone or when used in association with the bioadhesive carrier phases. The water insoluble carriers have the general property of getting hydrated with water and forming substantially insoluble gels which strongly adhere to the membrane mucosa. Depending on the selected carrier phase and the possible addition of water soluble polymers, the compositions of the invention can be made to have controllable transit time through the gastro-intestinal tract and particular adhesion to selected portions thereof, thus enabling efficient MRI of selected organs. Normally, the compositions using polymers carriers having little bioadhesion will permit faster transit than the compositions using carriers with strong bioadhesive character, hence controlled transit can be achieved with compositions in which non-bioadhesive and bioadhesive carriers are admixed in suitable proportions. It has also been surprisingly found that the particular selection of carriers used in the compositions of the invention, i.e. the carriers with enhanced affinity for mucosa membranes at low pH and/or soluble carriers with high dispersive capacity for magnetic particles provide generally excellent transverse and longitudinal luminal imaging homogeneity. The present inventors however also found that such undesirable coalescence of the magnetic particles and vanishing of the T₂ relaxing effect can be prevented by selecting as the carrier phase substantially water-insoluble hydrophilic water-swelling substrates which tend to form gels with water and when or, when additionally using water-soluble polymer carriers, raising the pH of the aqueous medium containing the magnetic particles to at least 13 when admixing with the polymer solution, and keeping the dry weight ratio of said polymers to magnetic particles not below 5:1 and, preferably, in the range of 100:1 - 10:1. The present ingestible MRI contrast compositions are stable even at pH 1 and this is another advantage over similar products of the prior art as they are not attacked by stomach fluids which normally dissolve magnetite particles into Fe⁺² and Fe⁺³ ions. This is obviously undesirable for both toxicity and imaging efficiency reasons. Bioadhesivity is particularly effective under acid or near neutral conditions; at high pH the bioadhesivity is decreased and may become negligible. Hence control of bioadhesivity by pH control is another asset of the present invention. For manufacturing the contrast compositions according to the invention one usually admixes the signal generating particles with the carrier phase. In the preparation, one may use magnetic particles which can be ferromagnetic or superparamagnetic. The nature of both and the distinction between them has been stressed before in this specification. Hence, one prefers superparamagnetic particles for optimalized density efficiency, i.e. magnetic particles of size not exceeding about 150 nm and preferably in the 1-100 nm range (10-1000 A). The preparation of such magnetic particles is well known and disclosed in many references, e.g. the aforementioned references and further references, e.g. US-A-4,554,088; EP-A-0 125 995 (Advanced Magnetics); US-A-4,267,234; US-A-4,157,323 (California Institute); WO-A-78/00005 (Mosbach); WO-A-83/01738; WO-A-83/03426; WO-A-84/00294 (Schröder). They are also available commercially, e.g. from Ferrofluidics Corp., Burlington, Mass. They normally result from the alkalinization of an aqueous solution containing Fe⁺² and Fe⁺³ salts in correct proportions. In one embodiment of a method for preparing the compositions according to the present invention, an aqueous suspension of the magnetic particles is treated with alkali to raise the pH to 13 or more, then the obtained alkaline suspension is admixed with an aqueous solution or dispersion of the carrier phase at the same pH and finally a water-compatible organic solvent in which the carrier phase is insoluble is added, whereby a precipitate of the desired composition is formed. The composition can thereafter be separated, for instance by filtration, and washed free from alkali, then it can be stored dry. When used for internal MRI investigation, the composition can be rehydrated with water or an aqueous solution of innocuous excipients, this being for oral or enteral administration. In the foregoing embodiment, the magnetic particles are not covalently linked to the carrier phase, the latter being water-soluble, but still they are immobilized therein presumably due to the existence of electrostatic or Van der Waals forces between the carrier phase constituents and the magnetic particles or, if the carrier is insoluble in water but in hydrated gel form, to immobilization of the hydrated magnetic particles within the carrier gelled structure. In another embodiment for preparing the compositions of the invention, the magnetic particles are chemically bonded to the carrier phase by the use of either reactive functions of the carrier itself or of a coupler grafted to the particles, said coupler possessing also functions which will bind to the carrier. For instance, the coupler can be a silane which will bind to the particles by silanation (see EP-A-0 125 995) and which bears a function which may subsequently react with the carrier phase. For example, a useful function of the silane coupler can be an amine group which can further react with negative groups on the carrier material, e.g. COOH or S-OH, sulfate or sulfonate groups, to form ammonium salts. Preferably, if the carrier is an organic polymer obtained by polymerization of one or more monomers, the silane coupler can comprise functions that will copolymerize with said one or more monomers. Thus for instance, in the case the carrier phase comprises a polymer or copolymer of acrylic acid, this can be prepared by copolymerizing a mixture of acrylic acid (and optionally other olefinic monomers) and magnetic particles carrying grafted thereon silanes with substituents bearing functions copolymerizable with acrylic acid. An appropriate silane for achieving this is trimethoxy-hydroxypropyl acrylate or methacrylate which possesses a double bond copolymerizable with other acrylates. The grafting technique is disclosed for instance in EP-A-0 113 367 and EP-A-0 125 995. For using the present compositions in the study of the digestive tract, the compositions (when stored dry) are admixed with an aqueous phase suitable for oral administration in order to provide a gel which will adhere to a predetermined extent to the mucous membrane of the digestive tract and therefore will carry the particles through said tract to the portion thereof to be visualized. The rate of transfer and the transit time can be adapted by properly selecting the nature and degree of bioadhesion of the carrier phase. For this, variable proportions of contrast compositions including a water-soluble carrier polymer can be admixed with the bioadhesive carrier, these proportions being selected to reach up to 99% by weight or more in the case where little restricted transit, unrestricted transit or accelerated transit is desired. For instance, for NMR investigations, using mainly dextran as the carrier phase in rats gave a transit rate similar to that observed with no carrier, while using mainly CMC as carrier gave accelerated transit. Using Carbopol® (polyacrylic acid cross-linked with allylsucrose) as the carrier phase gave strongly retarded transit, particularly in the duodenum portion of the intestinal tract. The present contrast compositions may also advantageously comprise isoosmolarity agents which minimize loss or gain of water during intestinal transit, i.e. diffusion by osmosis; such agents may comprise carbohydrates such as sorbitol, mannitol, xylitol and the like. During transit time, the patient having received a dose of the present compositions is subjected to periodical or continuous investigations using conventional MRI equipment, whereby the obtained processed images can thereafter be used for diagnostic or other medical applications. In the drawings: Fig. 1 to 5 illustrate by graph obtained from radioactive tracer measurements the rate of transit (expressed at % radioactivity in function to time) of contrast compositions through the digestive tract of experimental animals. Fig. 1 refers to the stomach. Fig. 2 to 5 refer to successive parts of the intestine. The invention is now illustrated by the following practical examples. Example 1 A water solution (30 ml) of FeCl₃.6H₂O (185.3 mg; 0.685 mmol) and FeCl₂.4H₂O (80.5 mg; 0.405 mmol) labeled with 59Fe was brought slowly to pH 13.4 by the dropwise addition of 3% aqueous NH₄ solution; then it was heated to 75°C for about 10 min. This resulted in the formation of a dark brown suspension of magnetite in large and coarse particles. To this was added under agitation a solution of 5 g of Dextran in 200 ml of water and the pH was reajusted to 13.4 by adding some more NaOH solution. After 15 min more stirring, alcohol was added, whereby a very fine precipitate of Dextran-magnetite was formed. This precipitate was drained under succion, washed with alcohol and dried at 50°C in air. Radioactive measurements showed that the yield was 94% by comparison with the radioactivity of the initial mixture. The proton magnetic resonance transverse relaxivity, expressed as R₂, i.e. R₂ = 1/T₂/mmol Fe) was measured on aqueous dispersions of the aforementioned precipitate by means of a 60 MHz RMN spectrometer. The measurements were effected at mid-height of the absorption peaks. Values of R₂ in the range of 500-550 (mM.s)⁻¹ were obtained which did not substantially change with time, thus showing that reagglomeration of the particles did not occur. Comparative tests A comparative test was performed as disclosed in Example 2 of EP-A-0 186 616. To a solution of Dextrin (80 g) in 180 ml of H₂O at 70°C were added a solution of 19 g of FeCl₃.6H₂O (70 mmol) and 7.01 g FeCl₂.4H₂O (35 mmol) in 105 ml of water. A tracer quantity of ⁵⁹FeCl₃ was also added. The pH was raised to 2.4 by first adding 20% aqueous Na₂CO₃, then it was brought to pH 11 with 10N NaOH added dropwise, whereby the color of iron oxides developed. The mixture was refluxed for 30 min, then it was cooled to room temperature and the pH was brought to 6.2 with 6N HCl. Then 0.8 liter of ethanol was added which caused the formation of a precipitate. This was collected, resuspended in water and the suspension was dialyzed for 24 hrs in running water (membrane cut-off = 10'000). Then the suspension was freeze-dried which gave a blackish powder. Measurements of R₂ as described above gave none or useless responses. Analogous results were obtained by replacing Dextrin by a comparable amount of Dextran. Obviously, the ratio of metal to polymer in this formulation is much too high to prevent reagglomeration of the particles subjected to a magnetic field. It was also found that when the experiment of Example 1 was repeated, but the magnetite precipitation was effected with the polymer already present in the solution, no useful R₂ measurements were obtained. Example 2 To a solution of 13.56 g FeCl₃.6H₂O (50 mmol) and 5.3 g FeCl₂.4H₂O (27 mmol) in 60 ml of water labeled with ⁵⁹Fe (about 10⁶ cpm) were added dropwise 60 ml of 5M aqueous NaOH until the pH was above 13. The solution was left to stand until a blackish sediment accumulated at the bottom of the container. This was washed carefully by decantation ten times with portions of 300 ml H₂O. After the last portions, the pH of the water had dropped to 9.3. The suspension was acidified to pH 3.2 with glacial CH₃COOH and sonicated for 2 min (Branson Sonifier, output mark 40). Then 10 ml of trimethoxy-3-hydroxypropylsilane methacrylate were added and sonication was resumed for 2 min. Sixty ml of glycerol were added and the mixture was heated under reduced pressure in a rotavapor until a black viscous residue has formed. This residue was diluted with 240 ml of water, agitated for 20 min and allowed to rest whereby it separated into two phases. This was dialyzed for 24 hrs against a citrate buffer (10 mM, pH 8.3 with ammonia) in order to remove low molecular material (glycerol, unreacted silane and acrylate oligomers). A suspension was made containing 20 ml of acrylic acid 10 ml H₂O and 10 ml of the silanized magnetite prepared as described above. This suspension was heated to 50°C and a 10% aqueous ammonium persulfate solution was added dropwise. After the polymerization was complete, the polymer was ground in 500 ml of water and dialyzed against running water. Then it was freeze-dried to give 20.1 g of silvery powder. A suspension of 1 g of this powder in 100 ml of water was prepared and 1 ml of this suspension was mixed with 9 ml of a 1% aqueous solution of Carbopol® (polyacrylic acid cross-linked with allylsucrose) at pH 7-8. The relaxation time T₂ was measured as described in Example 1, the value found being R₂ = 160 (s.mM)⁻¹. Example 3 The procedure of Example 1, i.e. the preparation of dispersions of magnetite (1.1 mmol) in aqueous solutions of 5 g of polymer in 200 ml of H₂O, was repeated using different polymers according to the Table below. The Table provides the names of the polymers, the yield of the preparation (calculated on the basis of the iron converted to magnetite) and the relaxivity R₂ in terms of s⁻¹ mmol Fe⁻¹/1. Example 4 In the experiments reported below, magnetite suspensions were prepared as disclosed in Examples 1 and 3, using a tracer amount of 59 FeCl₃ as label. The quantities of iron salts were selected so that the final concentration was about 1.46 mmol of Fe/l. After precipitation with alkali the suspensions were further homogenized by adding a drop of surfactant Tween-80® (polyoxyethylenesorbitan monooleate) and sonication for a few minutes with a Branson sonifier (30 Watt output). Samples of the suspensions (0.1 ml) were diluted with 9.9 ml (dilution 1:100) of 1% by weight aqueous polymer solutions also containing 0.3 mol/l of mannitol to preserve isotonicity. The polymers used were: a) Carboxymethylcellulose (CMC) Na salt (0.1 g/9.9 ml of water). b) sodium salt of polyacrylic acid cross-linked with allylsucrose ("Carbosal"); this was the code name given to Carbopol® (from the Goodrich Company) when in the form of sodium salt. c) "SA" polymer; this polymer is disclosed in EP-A-0 309 404 and is based on acrylic acid copolymerized with a mixture of sucrose mono- and di- allyl ethers with minor quantities of sucrose polyfunctional allyl ether. d) Dextran. e) Control; this was made as above by diluting the magnetite preparation to 1/100 but using only water without polymer. Five ml of samples a) to e) were administered to Sprague-Dawly rats (about 180 g) which were kept fast except for water 24 hrs before administration. The samples were introduced intragastrically with a ball-point syringe. The tracer amount in each sample accounted for about 10⁶ cpm. At time intervals of 0.5, 1, 1.5, 2, 3 and 6 hrs, animals were sacrificed and stomach, small intestine, caecum and large intestine removed for examination. The small intestine was divided into four segments about equal in length and these were examined separately. The tests consisted in measuring the radioactive response of the various parts of the digestive tract and correlate the results with time. The global results were that sample (d) (Dextran) behaved about like the control, i.e there was no visible influence of the polymer on the intestinal transit time while (a) accelerated it and (b) and (c) retarded it significantly, thus allowing prolonged examination when visualized under MRI. The results are recorded on the graphs of fig. 1-5 which refer, respectively, to the stomach and to the four successive portions of the small intestine. In the figures, the curves representing control (e) or Dextran (d) (they are practically similar) are marked with full dots; the curves for CMC (a) are marked with empty squares and the curves for the bioadhesive polymers (b) and (c) are marked with shaded squares. These results clearly support the foregoing findings. If in the experiments reported in this Example the carrier phases were replaced by mixtures of the component carriers, intermediate transit and retention rates were observed. Hence, the compositions of the invention enable to control the length of the periods during which NMR imaging of the digestive tract portions can be performed. Example 5 Montmorillonite clay of the Beidel type (BEDELIX®) available from Laboratoires Beaufour, 28100 Dreux (France) was tested for NMR contrast response under the following conditions: three g of Montmorillonite were stirred in 100 ml of a 0.5% solution of Carbopol® (polyacrylic acid cross-linked with allylsucrose). The 1/T₂ value of this preparation was measured as usual with a Perkin-Elmer/Hitachi NMR apparatus at 60 MHz and found to be 435.5 s⁻¹ without the addition of magnetite. This value was stable (due to the presence of the acrylic polymer) and the preparation could be used as such for the NMR Imaging of the digestive tract of animals. However the contrast performances were further enhanced by the incorporation of magnetite as follows: A suspension of magnetite was prepared as disclosed in Example 1, first paragraph. A 0.2 ml portion of this suspension was added to 99.8 ml of a 0.5% by weight solution of Carbopol® (polyacrylic acid cross-linked with allylsucrose). The iron concentration in this preparation was 0.178 mmol/ml; the 1/T₂ value was 144.5 s⁻¹, i.e. R₂ = 812 (s.mM)⁻¹. Aliquots of the magnetite preparation were taken and to each were added a different quantity of Montmorillonite. The R₂ values were measured as usual and reported below in function to the % by weight of added clay. Example 6 A composition of magnetic particles suspended in an aqueous solution of Carbopol® (polyacrylic acid cross-linked with allylsucrose) was prepared as disclosed in Example 4 (item b). The quantities were adjusted to provide a mixture containing about 0.3 µmol of iron (0.0174 mg) per ml and 10 mg/ml of the polymer. Male Sprague Dawley rats were used for the experiment after 24 hours of fasting. Eight ml of the Carbopol-magnetite solution were administrated orally to the conscious animals which were anesthetized 10 min later by 30 ml/kg of Pentotal. Transversal NMR images were then taken on an Esaote ESATOM 5000 imager equipped with a special 8 cm i.d. RF receiver coil, using a slice of 2 mm, a F.O.V. of 15.9 x 15.9 cm, and a matrix size of 128 x 256. T₂ weighted images (SE 200/70/1), were acquired as well as T₁ weighted images (SE 500/16/2), and intermediate scan images (SE 350/50/2). For the T₂ weighted and intermediate scan images gradient moment nulling techniques were used in order to minimize respiratory artifacts. The T₂ weighted and intermediate scan images show a clear delineation of the darkened and expanded bowel loops. Especially the 350/50/2 image showed very clearly the single loops of the small intestine. The wall of the loops could be clearly observed. A cross section of the colon and of a kidney were also seen as well as abdominal and dorsal muscles. The contrast media was distributed evenly over the whole GI tract.

Claims: A composition for enhancing the contrast in NMR imaging of the digestive tract of humans and animals the composition comprising magnetically responsive particles in admixture with or chemically bonded to at least one physiologically acceptable water-insoluble carrier phase, said carrier phase being mucoadhesive and water-swellable, characterized in that said mucoadhesive carrier phase is selected from polymers and copolymers of acrylic acid crosslinked with polyfunctional allyl acrylates or with polyfunctional allyl ethers of glycols or sugars and, to control the rate of transit through the digestive tract, said composition has an administrable pH of between 1 and 8. The compositions of claim 1, wherein the carrier further comprises polymers having carboxy, sulfate, sulfonate, phosphate and phosphonate groups free or in the form of alkali- or alkaline-earth metal salts. The compositions of claim 2, wherein the carrier comprises polysulfated or polyphosphonated carbohydrate polymers. The compositions of claim 1, wherein the carrier is further admixed with magnesium alginate, pectin, hydroxylated coatable polysaccharides or Attapulgite and/or Montmorillonite clays. The compositions of claim 1, further comprising dispersions of contrast enhancing particles in an aqueous solution of one or more water-soluble polymer carrier, the amount of said particles to said water-soluble polymer carrier, measured dry, not exceeding 5% wt. The compositions of claim 5, wherein the proportion of said dispersions is up to 99% of the total of the compositions and the water-soluble polymer carrier is selected from dextran, polyvinyl-pyrrolidone (PVP), carboxymethyl-cellulose (CMC), hydroxypropyl-cellulose and other water-soluble non-metabolizable polymers. The compositions of claim 1, wherein the particles are bonded to the bioadhesive carrier substrate by means of a chemical coupler. The compositions of claim 7, wherein said coupler has at least two reactive functions of which one will bind to the particles and another will bind to the carrier. The compositions of claim 8, wherein said one function of the coupler is a trialkoxy-silane function which binds to the magnetic particles through formation of a silicon-containing bond. Use of compositions of claims 1-9 as a carrier phase for magnetically responsive particles in NMR imaging of gastrointestinal tract. Use of compositions of claims 1-9 for the manufacture of orally or rectally administrable NMR contrast agents for imaging of gastrointestinal tract.

Inventors: CAVAGNA FRIEDRICH, HYACINTHE ROLAND, TOURNIER HERVE, CAVAGNA, FRIEDRICH, HYACINTHE, ROLAND, TOURNIER, HERVE, Tournier, Hervé 
Applicants: BRACCO INT BV, BRACCO INTERNATIONAL B.V.
Application year: 1992
Main classification: G01R33
IPC codes: A61K49, G01R33, A61K47