Review Article

Contrast-Enhanced MicroCT for Virtual 3D Anatomical Pathology of Biological Tissues: A Literature Review

Table 1

Reported CE-CT contrast agents used for musculoskeletal tissues.

TissueCAs and referencesRemarks and added value of CE-CT

Cartilage(i) Anionic iodinated CA
 (1) Ioxaglate/Hexabrix® [1925]
 (2) Iothalamate/Cysto-Conray® II [23, 26]
 (3) Gadopentetate/Magnevist [24]
(ii) Cationic iodinated CA
 (1) CA4+ [3, 23, 24, 2735]
 (2) CA1+ [23]
 (3) CA2+ [23]
(iii) Nonionic iodinated CA
 (1) Iopromide/Ultravist® [36]
 (2) Iodixanol/Visipaque® [37]
(iv) PTA [3841]
(v) Gadopentetate dimeglumine/Magnevist® [24, 42, 43]
(vi) Gd3+ [42]
(vii) Gadoteridol [35, 42]
(viii) Hf-WD POM [18] (Figure 1(a))
Electrostatic interactions between anionic or cationic CAs and the GAGs in the cartilage enable quantification of GAG content
POM CAs bind to collagen, enabling structural analysis of the cartilage tissue and, in case of sufficiently high spatial resolution, imaging of individual chondrocytes

Bone marrow compartmentHf-WD POM [18]Enables simultaneous visualization and structural quantification of adipocytes, vasculature, and mineralized tissues

MusclePTA [13, 15, 17]
I2KI [13, 44, 45]
Hf-WD POM [18]
PMA [17]
HgCl2 [17]
Na2WO4 [17]
(NH4)2MoO4 [17]
PTA, PMA, I2KI, HgCl2, Na2WO4, and (NH4)2MoO4 have high osmolality compared to biological tissues, thus inducing tissue shrinkage

Bone marrow adiposityOsO4 [46, 47]OsO4 is highly toxic and requires a two-step scanning protocol

Tendons and ligamentsPTA [13, 17, 48, 49]
I2KI [49]
Imeron300 [50]
PMA [17, 48]
(NH4)2MoO4
Ba(ClO3)2 [17]
HgCl2 [17]
Na2WO4 [17]
BaCl2 [17]
Same remarks as for muscle tissue for PTA, I2KI, PMA, HgCl2, Na2WO4, (NH4)2MoO4, BaCl2, and Ba(ClO3)2