SPIONs has been extensively explored as the Contrast Agent for MRI. What are the current mega trends that are in this field? What are the challenges that are still to be achieved and overcome?
I think there are two big picture research directions for SPIONs currently: creation of unique functionalized particles for specific cancers and repurposing of ferumoxytol (one of the simplest SPIONs) as an alternative to Gd contrast. I think the elephant in the room that is ignored in most publications is the comparison to standard Gd contrast. For clinical application, Gd contrast works so there is no major impetus to replace it or improve it.
If a tumor would uptake a functionalized SPION, it will probably also take up Gd. And even if a functionalized SPION can provide more specificity, the imaging is often followed by biopsy anyway. So then even if you create a new awesome SPION contrast agent, the challenge is finding a use case where it is a clear and significant improvement over the standard approach. You have to convince people that the cost will not be prohibitive and that it is worth it for them to change how they are comfortable doing things.
The push for ferumoxytol, follows a similar logic: it's meant as an alternative for patients that cannot do Gd due to impaired kidney function. Ferumoxytol clears through the liver after all. Ferumoxytol is also already FDA approved for a subtype of anemia. A push-back that I have heard is that some hospitals don't want to give anything to these patients as they see it as too risky. There is also some question about how long Ferumoxytol takes to clear out of the liver. Though that may be a bigger issue when used for anemia as the dose is much larger for that indication. Both of these are probably more surmountable, so I can easily see Ferumoxytol imaging becoming more common though in a limited population.
I am not so sure that the answer to this question has changed for some time, therefore not so current. At least in the USA, there were institutions that set policies for the clinical use of ferumoxytol as an MRI contrast agent in 2015. I haven't seen much change since then.
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