About Imaging Agents or Tracers [DOC]

 Other common names:       Contrast Agent

                                                Radioactive Agent
                                                Radioactive Dye

Many imaging studies such as MRI, PET, CT and x-ray, involve the use of imaging agents. Imaging agents are designed to provide more information about internal organs, cellular processes and tumors, as well as normal tissue. They can be used to diagnose disease as well as monitor treatment effects.


Imaging agents may be administered by mouth, enema, or injection into a vein, artery, or body cavity. The agents are typically absorbed by the body or passed out of the body in the urine or bowel movement. Even though some agents are referred to as a “dye”, they will not permanently discolor any part of your body.


If your exam includes an imaging agent, a technologist or a physician should carefully explain its use and answer your questions before your exam. Some imaging agents carry a small risk of allergic reaction, so it is very important to tell the technologist or physician if you have any allergies or if you notice any uncomfortable or unusual symptoms during or after the exam.

MRI Imaging Agents:

Gadolinium: Gadolinium is a contrast agent that may be given during MRI scans; it highlights areas of tumor or inflammation. Sometimes the gadolinium is given midway through the MRI scan by injection into a vein.



PET and Nuclear Medicine Imaging Agents: Nuclear imaging (or scintigraphy) requires use of radioactive contrast agents (called radiopharmaceuticals) to obtain images.  Some agents used for PET imaging provide information about tissue metabolism or some other specific molecular activity.  Following are commonly used agents, as well as agents that are under evaluation in ACRIN trials.


64Cu-ATSM: 64Cu diacetyl-bis(N4-methylthiosemicarbazone), also called ATSM or Copper 64,is an imaging agent used in PET or PET/CT for its ability to identify hypoxic tissue (tissue with low oxygen).


FDG: 18F-fluorodeoxyglucose (FDG) is a radioactive sugar molecule, that, when used with PET imaging, produces images that show the metabolic activity of tissues. In FDG-PET scanning, the high consumption of the sugar by tumor cells, as compared to the lower consumption by normal surrounding tissues, identifies these cells as cancer cells. FDG is also used to study tumor response to treatment.


18F-fluoride: 18F-fluoride is an imaging agent for PET imaging of new bone formation. It can assess changes both in normal bone as well as bone tumors. As a result, it can be used to measure response to treatment. 


FLT: 3'-deoxy-3'-[18F]fluorothymidine (FLT) is a radiolabeled imaging agent that is being investigated in PET imaging for its ability to detect growth in a primary tumor. Studies may also measure the ability of FLT with PET to detect tumor response to treatment. 


FMISO: 18F-fluoromisonidazole is an imaging agent used with PET imaging that can identify hypoxia (low oxygen) in tissues. Tumors with low oxygen have been shown to be resistant to radiation and chemotherapy.


Gallium: Gallium attaches to areas of inflammation, such as infection. It also attaches to areas of rapid cell division, such as cancer cells. It can take gallium a few days to accumulate in the affected tissue, so the scan may be done 2-3 days after the gallium is administered.


Technetium-99m: Technetium-99m is used to radiolabel many different common radiopharmaceuticals. It is used most often in bone and heart scans.


Thallium: Thallium is a radioactive tracer typically used to examine heart blood flow. The thallium scan is often combined with an exercise test to determine how well the heart functions under stress. A thallium scan may also be used to measure tumor response.



X-ray Imaging Agents: X-ray imaging agents (contrast agents) work with x-ray and CT imaging by increasing the density of tissues (and thus blocking x-ray transmission). They can be administered by mouth, enema, or injection.


Barium: Barium is the most common oral contrast agent used in CT. It enhances images of the abdomen and pelvis, by filling of the stomach and intestines. Barium contrast looks like, and has a similar consistency to a milk shake. It may be offered in different flavors.


Gastrografin: Gastrografin contrast contains iodine and is a water-based drink with a tinted yellow color. When given orally, gastrografin may taste bitter. It is used in the same way as barium.


Iodine Contrast Agents: Several different agents containing iodine are used as imaging agents for x-ray and CT. Once injected into the blood stream these agents highlight blood vessels as well as the tissues of various organs. Iodine contrast agents are often classified as being ionic and nonionic. They both work similarly, but nonionic agents have less frequent side effects than ionic agents.

For more information:
  • www.radiologyinfo.org 

    This information, as well as additional imaging descriptions, can be found in the “Patients” section of the ACRIN Web site:  www.acrin.org.

    The development of lay imaging descriptions is a project of the
    American College of Radiology Imaging Network
    Patient Advocacy Committee.