PARTICULATE IMAGING CONTRAST AGENTS
This invention relates to the formulation and administration of imaging contrast agents to the lungs, especially contrast agents for magnetic resonance imaging (MRI) or X-ray imaging.
It is known to enhance the contrast of images obtained by techniques such as MRI or X-ray imaging, by the prior administration of suitable contrast agents. In the case of X-ray imaging such agents are typically highly radio-opaque materials, while for MRI imaging they are typically paramagnetic species that affect the relaxation times of the medium into which they are introduced.
It is also known to administer contrast agents to a patient's lungs by inhalation. Such administration has conventionally been carried out by means of a nebulised solution or gas phase administration.
There have now been devised improvements to contrast agents for administration by inhalation.
According to a first aspect of the invention, there is provided an imaging contrast agent formulation for administration to the lung, the formulation comprising solid particles of an imaging contrast agent.
For administration to the lung such particles are preferably fine enough to penetrate deep into the lung. Suitable particles will generally have a mass median diameter of less than 10μm, more preferably less than 5μm.
As the formulation according to the first aspect of the invention is intended for administration by inhalation, it will normally be dispensed from an inhaler device. Thus, according to another aspect of the invention there is provided an inhaler
charged with one or more doses of an imaging contrast agent in the form of solid particles.
The inhaler may be a pressurized metered dose inhaler (MDI), in which case the solid particles will be suspended in a propellant medium such as a hydrofluorocarbon propellant. Examples of such propellants are those known as 1 ,1 ,1 ,2-tetrafluoroethane and 1 ,1 ,1 ,2,3,3,3-heptafluoropropane. MDI formulations may also comprise other constituents conventional in such formulations such as surfactants or suspending aids etc.
Alternatively, the inhaler may be a dry powder inhaler (DPI) device, in which case the contrast agent is entrained in an airflow through the device, most commonly caused by inhalation by the patient. DPI formulations may comprise the particles of contrast agent in admixture with larger particles of other carrier materials (eg lactose) in order to facilitate filling of the formulation into the device and dispensing of the formulation from the device. The carrier particles preferably have a mass median diameter greater than 50μm and less than 200μm.
According to a third aspect of the invention, there is provided a method of enhancing the contrast of images of a patient's lungs, which method comprises administering an imaging contrast agent in the form of solid particles by inhalation to the lungs prior to generation of the image.
The solid particles of contrast agent are preferably formed by a spray drying technique. Such a method provides a simple one-step process by which commercially available liquid X-ray and MRI contrast agents can be converted into dry powder formulations, for delivery via the pulmonary route.
It may also be possible to form mixed particles comprising not only the contrast agent, but also other materials, eg a medicament. Such particles may be used, for
instance, as a means of monitoring the deposition of the other materials (eg medicament) in the lung.
The formulation according to the invention may also be advantageous in that it may permit a high degree of control over the deposition of the contrast agent in the lung. For example, the particle size distribution of the formulation may be chosen in such a way as to control the depth to which the particles can penetrate into the lungs. The formulation may also offer advantages in comparison to solution or gas phase formulations in terms of stability and shelf life.
X-ray imaging contrast agents that may be used in the invention include a variety of iodine-containing compounds that have suitable properties for such use. Such compounds are generally soluble and may be ionic or non-ionic. One particular example of such an X-ray contrast agent is that known as iopamidol.
MRI contrast agents that may be used include a variety of compounds comprising paramagnetic metal ions. Suitable such ions include iron, manganese and, particularly, gadolinium. Suitable compounds are commonly used in the form of chelates, and a particular example of a suitable MRI contrast agent is gadolinium chelate.
The invention will now be described in greater detail, by way of illustration only, with reference to the following Examples and accompanying Figures, in which
Figure 1 shows size distributions of two batches of X-ray contrast agent prepared in Example a1);
Figure 2 is an electron micrograph of X-ray contrast agent prepared in Example a1);
Figure 3 shows CT images of rat lungs (a) before and (b) after administration of X- ray contrast agent prepared by the method of Example a1);
Figure 4 shows the size distribution of MRI contrast agent prepared by the method of Example b1);
Figure 5 is an electron micrograph of MRI contrast agent particles prepared by the method of Example b1); and
Figure 6 shows magnetic resonance images of excised rat lungs (a) before and (b) after administration of MRI contrast agent prepared by the method of Example b1).
A) X-rav contrast agents
a1) Making solid particles : X-ray contrast agents
Spray drying parameters were optimised and those which gave the optimal particle size were determined.
Two batches of particles were produced for further characterisation. The following conditions were used to produce the particles. The only variable that was changed was the atomisation pressure
Working at room temperature (24°C), the following solution was prepared:
• 20g iopamidol (Niopam 300, Lot No. 0572, 61.2%), corresponding to 32.68ml of Niopam
• 100ml absolute ethanol
• 267.32ml pyrogen free purified water (PFPW)
The prepared solution was noted to be clear and colourless, and corresponded to 5% iopamidol in 25% ethanol.
The solution was spray dried using a Buchi Mini Spray Dryer model B-191 , fitted with a Schlick 2-fluid atomisation nozzle (model 970/0) using the following parameters:
Inlet temperature 125°C
Starting outlet temperature 80 - 88°C Liquid feed rate 3ml/min
Atomisation pressure 3.0barg (batch 1) or
O.δbarg (batch 2) Drying air setting 100%
The particles were recovered from the cyclone collection jar.
a2) Characterising the solid particles : X-ray contrast agent
Size Analysis
A Malvern Aerosizer was used to produce size data on the 2 batches of particles. The results confirmed that the particles produced at the higher pressure (3.0barg) were smaller and had a narrower size distribution than particles produced at lower pressure (O.δbarg). The size distributions of the two batches are shown in Figure 1.
Physical Properties
The particles produced at higher pressure (3.0barg) were very cohesive and relatively more difficult to handle. The particles produced at lower pressure
(O.δbarg) were easier to handle, with less cohesion and better flow properties. This is consistent with the size data.
Aerodynamic Properties
The deposition of the X-ray contrast microparticles was also assessed using an in vitro lung model, in the form of a Multi Stage Liquid Impactor (MSLI). For each run of the MSLI, 1 gelatin capsule (Capsugel Coni-Snap #3, Belgium) was filled with 50mg of formulation, and placed in a dry powder inhaler.
The capsule was fired into the MSLI under a flow rate of 60L/min (Copley pump, Nottingham UK), with 3 actuations (10 seconds each) being used per capsule. A minimum of 3 seconds was left between each actuation. The MSLI, inhaler and capsule were subsequently washed with water.
Each of the recovered washings were diluted 1/40, and read on a spectrophotometer (Shimadzu UV-160), set at 242nm. A calibration curve was used to calculate the concentration of iopamidol present in each washing.
The results generated confirmed that the "larger" particles tended to deposit more in the upper stages (equivalent to the upper airways) whilst the "smaller" particles tended to deposit in the lower stages (equivalent to deep lung).
The results for the "small" microparticles are shown below in Table 1. Stages 3 and 4 are generally accepted to represent deposition in the deep lung of humans.
Table 1
Deposition of "small" microparticles (Batch 1) in MLSI. Data calculated ex-device
Electron Microscopy
Images generated confirmed the microparticles were generally spherical and had δ smooth surfaces. The sizes appeared consistent with the size data generated by the Aerosizer (see Figure 2).
Imaging with Ex-vivo Rat Lung
0 The imaging properties of the smaller particles were assessed in an ex-vivo rat lung.
The lungs of 3 adult male Sheffield strain Wistar rats were removed surgically. The lungs were inflated at 1δcm H20 with air through the cannulated trachea, and δ maintained by a continuous stream of air (from a cylinder) over a column of water.
The lungs were administered with 3 doses of the X-ray contrast particles (see Table 2) by suspending them in chloroform and spraying into the lung using a Microsprayer™ (Series IA-1 B Intratracheal Aerosoliser, Penn-Century Inc., 0 Pennsylvania USA).
Table 2
CT images of the rat lungs were obtained BEFORE and AFTER contrast agent 5 was administered. The CT imaging was performed with a General Electric (GE
Medical Systems) HiSpeed CT/I, operating with a volume acquisition of 1 mm, a pitch of 1.0, and reconstructions of 0.8 mm slices.
The ex vivo lungs were kept inflated throughout, and kept damp whilst positioned δ on the tray. An initial scout view was performed to localise the lungs, followed by pre-contrast (control) CT scans.
The lungs were subsequently instilled with formulation, and a new scout view performed for localisation, followed by post-contrast CT scans. 0
Results confirmed that all doses showed contrast enhancement in all of the regions through the lungs. The images of the rat lungs after administration of the lowest dose are shown in Figure 3.
δ B) MRI contrast agents
b1) Making the particles : MRI contrast agent
Working at room temperature (24°C), the following solution was prepared: 0
• Gadolinium chelate* 8ml
• absolute ethanol 25ml
• pyrogen free purified water 67ml
5 * Gadolinium chelate was a commercially available MR contrast imaging agent
The prepared solution was noted to be clear and colourless.
The solution was spray dried using a Buchi Mini Spray Dryer model B-191 , fitted 0 with a Schlick 2-fluid atomisation nozzle (model 970/0) using the following parameters:
Inlet temperature 60°C
Starting outlet temperature 40°C
Liquid feed rate 1ml/min Atomisation pressure 2.0barg
Drying air setting 100%
The particles were recovered from the cyclone collection jar.
b2) Characterising the particles : MRI contrast agent
Size Analysis
A Malvern Aerosizer was used to produce size data on the batch of particles. The results confirmed that the particles produced were of the desired size distribution (see Figure 4).
Electron Microscopy
Images generated confirmed the microparticles were generally spherical and had smooth surfaces. The sizes appeared consistent with the size data generated by the Aerosizer (See Figure 5).
Imaging with Ex-vivo Rat lung
The imaging properties of the MRI particles were assessed in an ex-vivo rat lung.
The lungs of 2 adult male Sheffield strain Wistar rats were removed surgically. The lungs were inflated at 1δcm H20 with air through the cannulated trachea, and maintained by a continuous stream of air (from a cylinder) over a column of water.
The lungs were administered with 2 doses of the MRI contrast particles (see Table 3) by suspending them in chloroform and spraying into the lung using a Microsprayer™ (Series IA-1 B Intratracheal Aerosoliser, Penn-Century Inc., Pennsylvania USA).
Table 3
Contrast enhancement was observed with both doses. Figure 6 shows MR scans of the rat lungs pre- and post-administration of 5.0mg of gadolinium chelate.