Contrast media may be administered in medical imaging procedures, for example X-ray, magnetic resonance and ultrasound imaging, to enhance the image contrast in images of a subject, generally a human or non-human animal body. The resulting enhanced contrast enables different organs, tissue types or body compartments to be more clearly observed or identified.

In X-ray imaging, the contrast media function by modifying the X-ray absorption characteristics of the body sites into which they distribute.

Clearly however the utility of a material as a contrast medium is governed largely by its toxicity, by its diagnostic efficacy, by other adverse effects it may have on the subject to which it is administered, and by its ease of storage and ease of administration.

Since such media are conventionally used for diagnostic purposes rather than to achieve a direct therapeutic effect, when developing new contrast media there is a general desire to develop media having as little as possible an effect on the various biological mechanisms of the cells or the body as this will generally lead to lower animal toxicity and lower adverse clinical effects.

The toxicity and adverse biological effects of a contrast medium are contributed to by the components of the medium, e. g. the solvent or carrier as well as the contrast agent and its components (e. g. ions where it is ionic) and metabolites.

The following major contributing factors to contrast media toxicity and adverse effects have been

identified: -the chemotoxicity of the contrast agent, -the osmolality of the contrast medium, and -the ionic composition (or lack thereof) of the contrast medium.

In coronary angiography, for example, injection into the circulatory system of contrast media has been associated with several serious effects on cardiac function. These effects are sufficiently severe as to place limitations on the use in angiography of certain contrast media.

In this procedure, for a short period of time a bolus of contrast medium rather than blood flows through the circulatory system and differences in the chemical and physicochemical nature of the contrast medium and the blood that it temporarily replaces can give rise to undesirable effects, e. g. arrhythmias, QT-prolongation, and, especially, reduction in cardiac contractile force and occurrence of ventricular fibrillation. There have been many investigations into these negative effects on cardiac function of infusion of contrast media into the circulatory system, e. g. during angiography, and means for reducing or eliminating these effects have been widely sought.

Early injectable ionic X-ray contrast agents, based on triiodophenylcarboxylate salts, were particularly associated with osmotoxic effects deriving from the hypertonicity of the contrast media injected.

This hypertonicity causes osmotic effects such as the draining out of water from red-blood cells, endothelial cells, and heart and blood vessel muscle cells. Loss of water makes red blood cells stiff and hypertonicity, chemotoxicity and non-optimal ionic make- up separately or together reduce the contractile force of the muscle cells and cause dilation of small blood vessels and a resultant decrease in blood pressure.

The osmotoxicity problem was addressed by the

development of the non-ionic triiodophenyl monomers, such as iohexol, which allowed the same contrast effective iodine concentrations to be attained with greatly reduced attendant osmotoxicity effects.

The drive towards reduced osmotoxicity led in due course to the development of the non-ionic bis (triiodophenyl) dimers, such as iodixanol, which reduce osmotoxicity associated problems still further allowing contrast effective iodine concentrations to be achieved with hypotonic solutions.

This ability to achieve contrast effective iodine concentrations without taking solution osmolality up to isotonic levels (about 300mOsm/kg H2O) further enabled the contribution to toxicity of ionic imbalance to be addressed by the inclusion of various plasma cations, as discussed for example in WO-90/01194 and WO-91/13636 of Nycomed Imaging AS.

Further iodinated contrast agents were described in US 4,314,055 of Mallinckrodt, Inc. However, these compounds are not sufficiently water soluble to be effective as contrast agents. For instance, the compound of Example VII has a solubility in water of 1.86% (w/v) whereas a solubility in water of at least 5%, preferably at least 20%, ideally at least 50% is preferred to meet the high standards of today's contrast media.

However X-ray contrast media, at commercial high iodine concentrations of about 300 mgI/mL have relatively high viscosities, ranging from about 15 to about 60 mPas at ambient temperature with the dimeric media generally being more viscous than the monomeric media. Such viscosities pose problems to the administrator of the contrast medium, requiring relatively large bore needles or high applied pressure, and are particularly pronounced in paediatric radiography and in radiographic techniques which require rapid, bolus administration, e. g. in angiography.

In practice, viscosities in excess of 30 mPas at body temperature (37°C) are unacceptably high for routine X-ray investigations, and especially for paediatric investigations. Accordingly, the maximum practical iodine concentration achievable with available non-ionic iodinated X-ray contrast agents is generally about 300-350 mgI/mL. Higher iodine concentrations, if accessible at acceptable viscosities, would increase the diagnostic efficacy of contrast enhanced images.

Alternatively viewed, lower contrast medium viscosities for any given, iodine concentration would increase ease of administration and the range of investigations and patients for which the contrast media could be used.

Further iodinated contrast agents were described in WO 96/09282, also of Nycomed Imaging A/S. These compounds show generally improved levels of viscosity over comparable non-ionic contrast agents. However, it has now been discovered that, surprisingly, a small sub- set of the compounds disclosed by a generic formula in WO 96/09282 have very low viscosity, while also exhibiting other advantageous properties, particularly low toxicity and osmolality.

A low viscosity is desirable but not at the expense of an increased toxicity. The best contrast media will have low toxicity, osmolarity and viscosity but it is not possible to predict which compounds or contrast media will have this advantageous combination of properties.

The present invention addresses the viscosity problem encountered with the prior art materials while maintaining high iodine concentrations and attempting, at the same time, to reduce toxicity and osmolality and thus viewed from one aspect the invention provides iodinated aryl compounds, useful as X-ray contrast agents, of formula I

wherein n is 0 or 1; X is an amide group linked to the phenyl ring either by the nitrogen atom or by the carbon of the carbonyl group; R is H or a C14 alkyl group substituted by two or more-OH groups; R'is a Ci-4 alkyl group optionally substituted by one or more-OH groups; R"is a C24 alkyl group which may be straight chained or branched and is substituted by two or more- OH groups and isomers thereof.

In general, the R group is preferably H or a C3 alkyl group substituted by 2 or more-OH groups.

Advantageously R'is a hydroxylated Cl-3 alkyl group and n is preferably 0.

The practical advantages of this small group of compounds according to the invention can be seen by considering a number of important properties of iodinated contrast agents, e. g. viscosity, osmolality and acute toxicity. For each of these parameters, an acceptable or desirable limit may be set for a candidate contrast agent compound. An upper limit for viscosity (at a given iodine concentration) may be set, low viscosity being generally desirable and of particular importance in paediatric radiography. As shown in Figure 1, this limit may exclude some but not all known iodinated contrast agents. A low viscosity by itself will not guarantee a safe and effective contrast agent,

a further important parameter is osmolality. Figure 2 gives the osmolality in mOsm/kg for all compounds which had acceptable viscosities according to Figure 1.

Again, all compounds according to the invention which were tested have lower osmolalities than the predetermined acceptable limit.

Perhaps the most important overall parameter is the maximum tolerable dose which can be administered to a subject. The compounds according to the invention can be administered safely at high doses, i. e. all demonstrate exceptionally low acute toxicity compared to other"low viscosity"contrast agents. Figure 3 shows that the only compound not according to the invention which had acceptable viscosity and osmolality levels has a maximum tolerated dose which is much lower than for the compounds according to the invention. Thus, a high maximum tolerated dose is an especially important beneficial property of the compounds according to the invention.

Consideration of these three parameters indicates how overall, the compounds according to the invention offer significant benefits and improvements over prior art iodinated contrast agents. These compounds also have good water solubility.

Thus, according to a further aspect, the present invention provides tri-iodinated aromatic compounds for use as contrast agents, incorporating further non-ionic substitutions and having a viscosity of less than 13, preferably less than 11 mPas in aqueous solution at 20°C and a concentration of 350 mgI/ml and having a maximum tolerated dose in mice of greater than 6, preferably greater than 8, more preferably greater than 10 gI/kg.

The viscosity and maximum tolerated dose of a candidate compound may be determined as described in the Examples herein. The single values for maximum tolerated dose cited above refer to the dose at which all animals survive, i. e. the lower end of the ranges given in Example 6 herein.

Particularly preferred compounds of the present invention include

The compounds according to the inventions will advantageously have a viscosity of less than 8, preferably less than 7 mPas in aqueous solution at 20°C and a concentration of 300mgI/ml. These compounds will advantageously have a viscosity of less than 13, preferably less than 11 mPas in aqueous solution at 20°C and a concentration of 350mgI/ml. In addition, the compounds will advantageously have an osmolality of less than about 700, preferably less than 600 mOsm/kg at 20°C and a concentration of 350mgI/ml. Also, these compounds will have approximate LD50 values in mice of more than 13, preferably more than 14, ideally more than 15 gI/kg (see Example 6).

The compounds according to the invention will advantageously have a solubility in water of at least 5%, preferably at least 20%, ideally at least 50%.

The compounds of the invention may in general be prepared in two stages: (a) iodination of phenyl groups and (b) substitution of phenyl groups by solubilizing moieties.

While, in theory, stages (a) and (b) can be performed in any order, for reasons of economy, it will be preferred to perform the iodination step at as late a stage in the synthesis as is feasible so as to reduce iodine wastage. Thus, especially those where ring substitution is asymmetric, iodine loading will generally be effected before or after partial substitution of the phenyl ring with alkyl groups.

In all cases, conventional synthetic routes well known in the literature (eg methods analogous to those used and described for the production of the compounds referred to in WO-94/14478) may be used.

The compounds of the invention may be used as X-ray contrast agents and to this end they may be formulated with conventional carriers and excipients to produce diagnostic contrast media.

Thus viewed from a further aspect the invention

provides a diagnostic composition comprising a compound according to the invention (as defined above) together with at least one physiologically tolerable carrier or excipient, e. g. in aqueous solution in water for injections optionally together with added plasma ions or dissolved oxygen.

The contrast agent compositions of the invention may be at ready-to-use concentrations or may be formulated in concentrate form for dilution prior to administration. Generally compositions in ready-to-use form will have iodine concentrations of at least 100mgI/ml, preferably at least 150 mgI/ml, with concentrations of at least 300mgI/ml, e. g. 320 to 600 mgI/ml being generally preferred. The higher the iodine concentration the higher the diagnostic value but equally the higher the solution's viscosity and osmolality. Normally the maximum iodine concentration for a given compound will be determined by its solubility, and by the upper tolerable limits for viscosity and osmolality.

For contrast media which are administered by injection, the desirable upper limit for solution viscosity at ambient temperature (20°C) is 30mPas; however viscosities of up to 50 or even up to 60mPas can be tolerated although their use in paediatric radiography will then generally be contraindicated. It is a particular advantage of the compounds of the present invention that diagnostically effective amounts of iodine can be administered with much lower viscosities, e. g. less than 20mPas, even less than 10 or 8mPas. For contrast media which are to be given by bolus injection, e. g. in angiographic procedures, osmotoxic effects must be considered and preferably osmolality should be below 1 Osm/kg H20, especially below 850 mOsm/kg H2O.

With the compounds of the invention, such viscosity, osmolality and iodine concentration targets

can readily be met. It may however be desirable to include plasma cations for their cardioprotective effect. Such cations will desirably be included in the ranges suggested in WO-90/01194 and WO-91/13636.

Preferred plasma cation contents for the contrast media of the invention, especially contrast media for angiography, are as follows: sodium 2 to 100, especially 15 to 75, particularly 20 to 70, more particularly 25 to 35 mM calcium up to 3.0, preferably 0.05 to 1.6, especially 0.1 to 1.2, particularly 0.15 to 0.7mM potassium up to 2, preferably 0.2 to 1.5, especially 0.3 to 1.2, particularly 0.4 to 0.9 mM magnesium up to 0.8, preferably 0.05 to 0.6, especially 0.1 to 0.5, particularly 0.1 to 0.25 mM The plasma cations may be presented, in whole or in part, as counterions in ionic contrast agents.

Otherwise they will generally be provided in the form of salts with physiologically tolerable counteranions, e. g. chloride, sulphate, phosphate, hydrogen carbonate, etc., with plasma anions especially preferably being used.

Besides plasma cations, the contrast media may contain other counterions and such counterions will of course preferably be physiologically tolerable.

Examples of such ions include alkali and alkaline earth metal ions, ammonium, meglumine, ethanolamine, diethanolamine, chloride, phosphate, and hydrogen carbonate. Other counterions conventional in pharmaceutical formulation may also be used. The'

compositions moreover may contain further components conventional in X-ray contrast media, e. g. buffers, etc.

Publications referred to herein are incorporated herein by reference.

The invention will now be described further with reference to the following non-limiting Examples and to the figures in which: Figure 1 is a graphical representation of the viscosity in mPas of certain prior art iodinated contrast agents and compounds according to the invention at various concentrations of mgI/ml. In this and all subsequent figures, WO* stands for WO 96/09282; Figure 2 is a graphical representation of the osmolality in mOsm/kg at 37°C of various compounds proposed for use as contrast agents at certain concentrations of iodine; Figure 3 is a graphical representation of the maximum tolerated dose in gI/kg of various compounds proposed for use as contrast agents. The doses are given as a range, the lower end of which being a dose where all mice injected survived and the upper end a dose where at least one animal died.

Example 1: 5-rN'-(2 3-Dihydroxypropyl)- hydroxyacetamidol-3-hydroxymethyl-N- (2 3- dihydroxypropyl)-2.4 6-triiodobenzamide a. 5-rN'- (2. 2-Dimethyl-1.3-dioxolane-4-methyl)- acetoxyacetamidol-3-acetoxymetyl-N-(2,3- diacetoxypropyl)-2 4 6-triiodobenzamide 5-Acetoxyacetamido-3-acetoxymethyl-N- (2,3-diacetoxy- propyl)-2,4,6-triiodo-benzamide (0.97 g, 1.15 mmol) was dissolved in dimethyl sulfoxide (3.0 ml) and cesium carbonate (0.38 g, 1.15 mmol) was added at room temperature. 4-Bromomethyl-2,2-dimethyl-1,3-dioxolane (0. 34 g, 1.74 mmol) was added and the mixture was heated

to 55°C with efficient stirring. After 48h the reaction mixture was cooled and poured into water (60 ml). The precipitate formed was filtered off and dissolved in ethyl acetate (60 ml). The organic phase was washed with a saturated sodium chloride solution (7x 45 ml). After drying (Na2SO4), the solvent was evaporated leaving a yellow foam of 1.0 g (91%).

MS (ESP, m/e): 958 ( [M] \ 100%), 1089 ( [M+Cs] \ 15%).

1H NMR (CDC13): 6.10-6.30 (m, lH), 5.59 (br. s, 2H), 5.17- 5.36 (m, lH), 4.02-4.60 (m, 9H), 3.28-3.94 (m, 2H), 2.08, 2.20 (2s, 12H)., 1.44 (s, 3H), 1.35 (s, 3H). b. 5-EN-(2/3-Dihyroxypropyl)-hydroxyacetamidol-3- hydroxymethyl-N-(2 3-dihydroxypropyl)-2 4.(2 3-dihydroxypropyl)-2 4. 6- triiodobenzamide <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> 5-[N-(2, 2-dimethyl-1, 3-dioxolane-4-methyl]-3-<BR> <BR> <BR> <BR> <BR> <BR> <BR> acetoxymethyl-N- (2,3-diacetoxypropyl)-2,4,6- triiodobenzamide (1.05g, 1.10 mmol) was dissolved in methanol (10 ml), and potassium carbonate (0.30 g, 2.2 mmol) was added. The mixture was stirred at room temperature for 17 h, filtered and the filtrate was then acidified with hydrochloric acid (5M) to pH=1. This solution was then stirred at room temperature for 5h, and then evaporated to dryness. The residue was purified by preparative HPLC giving 0.36 g (44%) of the product, as a white solid.

MS (ESP, m/e): 781 ( [M] \ 100%).

1H NMR (DMSO-d6): 8.16,7.83 (2t, 1H, J=6-8 Hz), 5.22 (t, 1H, J=6 Hz), 4.98 (s, 2H), 4.87 (br. s, 1H), 4.63,476 (2s, 2H), 4.55,4.47,4.44 (3s, 3H), 3.64-4.4 (m, 6H), 3.40-3.62 (m, 5H), 3.16-3.32 (m, 2H).

13C NMR (DMSO-d6): 172.6,172.4,172.0,171.7,169.9, 169.7,151.9,151.7,147.4,147.1,147.0,146.0,107.6, 106.9,100.0,99.4,98.7,74.9,74.6,69.8,68.8,64.6, 64.4,63.7,63.5,61.9,61.7,58.7,54.0,53.0,52.2, 52.0.

Example 2. 5-[N'-(2,3-Dihydroxypropyl)- hydroxyacetamido]-3-hydroxymethyl-N-(1,3,4-trihydroxybut- 2-yl)-2,4,6-triiodobenzamide a. 5-[N'-(2,2-Dimethyl-1,3-dioxolane-4-methyl)- <BR> <BR> <BR> acetoxyacetamidol-3-acetoxymethyl-N-(1 3n4-triacçtoxybut-<BR> <BR> <BR> <BR> <BR> <BR> 2-yl)-2,4, 6-triiodobenzamide Acylation of 5-amino-3-acetoxymethyl-N- (1,3,4- triacetoxybut-2-yl)-2,4,6-triiodobenzamide followed the procedure in Example 26a. Yield of crude product = 97%.

MS (ESP, m/e): 1031 ( [M] \ 100%), 1163 ([M+Cs] +, 21%).

'H NMR (CDCl3) : 6.10-6.30 (m, 1H), 5.58 (br. s, 2H), 5.44-5.58 (m, 1H), 4.67-4.80 (m, 1H), 3.19-4.56 (m, 10H), 2.08,2.12 (2s, 15H), 1.20,1.25,1.28,1.34,1.40,1.45 (6s, 6H).

13C NMR (CDCl3) : 170.3,170.2,169.9,169.0,151.2,146.9, 9,98.8, 98.0,97.9,97.5,75.2,73.6,69.6,68.3,66.3,64.8, 62.8,61.9,32.7,30.9,26.9,26.8,25.4,21.0,20.9, 20.8,20.6. b. 5-[N'-2,3-Dihydroxypropyl)-hydroxyacetamido]-3- hydroxymethyl-N-(1 3 4-trihydroxybut-2-yl)-2. 4(1 3 4-trihydroxybut-2-yl)-2. 4 6- triiodobenzamide Hydrolysis of the compound of Example 36a followed the procedure in Example 26b. Yield: 44% after preparative HPLC.

MS (ESP, m/e): 780 ([M] +, 100%).

1H NMR (DMSO-d6): 7.68-8.22 (m, 1H), 5.22 (t, 1H, J=6 Hz), 4.98 (s, 2H), 4.80-4.93 (s, 1H), 4.63,4.76 (2s, 2H), 4.55,4.46,4.44 (3s, 3H), 3.64-4.04 (m, 6H), 3.40- 3.62 (m, 5H), 3.16-3.32 (m, 2H).

3C NMR (DMSO-d6): 172.6,172.4,172.0,171.7,169.9, 169.7,151.9,151.7,147.4,147.1,147.0,146.0,107.6, 106.9,100.0,99.4,98.7,74.9,74.6,69.8,69.1,-69.0,

68.8,64.6,64.4,63.7,63.5,61.9,61.7,58.7,54.0, 53.0,52.2,52.0.

Example 3.3.5-Bis- (2. 3-dihydroxypropionylamino)-2, 4,6- triiodo-(2 3-dihydroxypropyl)-benzene a. 3,5-Dinitro- (3-propenyl)-benzene 3,5-Dinitroiodobenzene (5.0 g, 17.0 mmol), triphenylphosphine (0.54 g, 2.04 mmol), palladium (0) bis (dibenzylideneacetone) (0.23 g, 0.26 mmol) and copper (I) iodide (0.19 g, 1.02 mmol) were all mixed in 75 ml of dioxane. The mixture was heated to 50°C, and allyltributyltin (5.6 g, 17.0 mmol) was added.

The temperature was increased to 95°C and the mixture was stirred under an inert atmosphere. After 36h a new portion of allyltributyltin was added and after further 36h a second extra portion of allyltributyltin was added.

After 1 week the reaction mixture was cooled to room temperature, and a solution of potassium fluoride (38 g) in water (500 ml) was added. Stirring was continued for 30 minutes. The mixture was extracted with methylene chloride (3x150 ml). The organic phases were washed with water (60 ml), dried (Na2SO4), and the solvent evaporated. The semisolid residue was purified by preparative HPLC, which gave the product as a light yellow syrup. Yield: 0.75 g (21%).

1H NMR (CDCl3): 8.91 (t, 1H, J=2 Hz), 8.40 (d, 2H, J=2H), 5.89-6.04 (m, 1H), 5.18-5.32 (m, 2H), 3.63 (br. d, 2H, J=7 Hz).

13C NMR (CDCl3): 169.7,148.5,144.5,133.9,128.8,119.1, 116.9,39.4. b. 3.5-Dinitro-(2. 3-dihydroxypropyl) benzene 3,5-Dinitro- (3-propenyl) benzene (0. 10 g, 0.48 mmol) was dissolved in 20 ml of acetone and 2.5 ml of water-and the

solution cooled in an ice-bath. Osmium tetroxide (17 mg, 0.066 mmol), and an excess of t-butylhydroperoxide, was added. 4-Methylmorpholine N-oxide (0.12 g, 0.96 mmol) was added and the mixture was stirred at room temperature for 48h. The reaction was then quenched by addition of a saturated solution of sodium hydrogen sulphite (60 ml).

The mixture was then extracted with ethyl acetate (2x250 ml). The organic extracts were washed with water (70 ml), dried (Na2SO4), and the solvent evaporated. A white crystalline product 0.11 g (94%) resulted.

1H NMR (CD3CN): 8.82 (t, 1H, J=2 Hz), 8.54 (d, 2H, J=2 Hz), (m, 1H), 3.43-3.58 (m, 2H), (m, 4H).

13C NMR (CD3CN): 148.3,144.2,130.0,116.5,104.8,71.8, 65.3,38.6. c. 3 5-Diamino- 3-dihydroxypropyl) benzene- hydrochloride salt benzene (0.12 g, 0.49 mmol) was dissolved in 25 ml of methanol. Pd/C (10%, 0.05 g) was added and the substance was hydrogenated in a Parr apparatus at 60 psi. After complete hydrogen consumption the catalyst was filtered off and the filtrate was added to hydrochloric acid (2M, 0.5 ml).

The solution was evaporated to dryness. Yield: 0.12 g (100%) after pump drying. The product was used without further purification.

MS (ESP, m/e): 181 ([M] +, 100%). d. 3,5-Diamino-2,4,6-triiodo-(2, 3-dihydropropyl) benzene benzene-hydrochloride salt (0.72 g, 2.82 mmol) was dissolved in 25% methanol (8 ml), and hydrochloric acid (2M, 1 ml) was added. To this mixture, with stirring, was added potassium iododichloride (2.27 g, 9.59 mmol, 70% w/w). A

precipitate immediately formed and was filtered off after 2 minutes. The filtercake was treated with a saturated solution of sodium hydrogen sulphite (2 ml) and filtered, washed with water (3 ml) and dried. A tan coloured product of 0.96 g (61%) resulted.

MS (ESP, m/e): 560 ([M] +, 40%), 433 ( (M-I]', 10%), 374 ( [M-I-CH (OH) CH2OH] +, 100%).

1H NMR (DMSO-d6): 5.20 (br. s, 4H), 3.73-3.94 (m, 1H), 3.58-3.62 (m, 2H), 3.26-3.35 (m, 4H). e. 3, 5-Diamino-2 4,6-triiodo- (2,3- diacetoxypropyl)benzene Acetylation of the product of Example 64d followed the general method in Example 24e. After work up the product was chromatographed on a short column of alumina with ethyl acetate as the eluent. Evaporation of the solvent gave a white crystalline residue in 70% yield.

1H NMR (CDcl3) : 5.47-5.50 (m, 1H), 4.78 (br. s, 4H), 4.19-4.38 (m, 2H), 3.38-3.74 (m, 2H), 2.10 (s, 3H), 1.99 (s, 3H). f. 3,5-Bis-(2, 2-dimethyl-1 3-dioxolane-4-carbamido)- 2.4.6-triiodo-(2 3-diacetoxypropyl) benzene Acylation of the product of Example 64e with 2,2- dimethyl-1,3-dioxolane-4-carboxylic chloride was effected according to the method in Example 29a. After workup, the crude product was purified by preparative HPLC and isolated in 43% yield.

MS (ESP, m/e): 901 ([M]+, 100%). g.3,5-Bis-(2,3-dihydroxypropionylamino)-2,4,6-triiodo- (2,3-dihydroxypropyl)-benzene Hydrolysis and ketal cleavage of the product of Example 64f were performed according to the procedure of Example

29b. After workup the product was purified by preparative HPLC and isolated in 10% yield.

MS (ESP, m/e): 737 ([M] +, 100%).

N,N'-Bis-(2,3,4-trihydroxybutanoyl)-3,5-Example4. diamino-2 4.6-triiodobenzyl alcohol a. bromide 2,3,4-Triacetoxybutanoyl chloride (39.9g, 0.142 mol), prepared according to the liteature procedure Glattfeld, J. and Kribben, B., J. Am. Chem. Soc. 61 (1939) 1720) was mixed with lithium bromide (30. g, 0.356 mol) in methylene chloride (400 ml) and stirred at ambient temperature for 24 h. The mixture was filtered, the solid was washed with additional methylene chloride (50 ml) and the filtrate was evaporated at ambient temperature to give 45g (97%) of the crude product as an oil.

'H NMR (CDC13) : 5.58-5. 80 (m, 1H), 5.35-5. 45 (m, 1H), 4.15-4.55 (m, 2H), 2.06,2.08,2.11,2.23 (4s, 9H). b. N, N'-Bis-(2, 3, 4-triacetoxybutanoyl)-3, 5-diamino-2, 4.6- triiodobenzyl acetate 3,5-Diamino-2,4,6-triiodobenzyl acetate (10.0 g, 17.9 mmol) was dissolved in dry N, N-dimethylacetamide (60 ml), and added dropwise with efficient stirring to 2,3,4- triacetoxybutanoyl bromide (34.7 g, 0.107 mol) cooled to 0°C. After complete addition, the mixture was stirred at ambient temperature for 2.5 h. The mixture was slowly poured into an aqueous solution of NaHCO3 (5%, 700 ml).

A semicrystalline precipitate was formed, filtered off and dissolved in ethyl acetate (300 ml). This solution was washed with a diluted solution of NaHCO3 (5%, 70 ml), three times with aqueous HCl (0.5 M, 70 ml) and at last twice with a solution of NaCl (5%, 70 ml). The organic

phase was dried (NaSO4) and the solvent was evaporated to a semicrystalline residue, which was purified on a column of silica with methylene chloride/ethyl acetate (1: 1) as the eluent. After evaporation of the solvent the residue was further purified by preparative HPLC to give 9.4 g (50%) of the product.

MS (ESP, m/e): 1046 ([M] +, 100%).

1H NMR (CDCl3) : 8.06 (s, 2H), 5.71-5.78 (m, 2H), 5.62- 5.70 (m, 2H), 5.58 (s, 2H), 4.34-4.47 (m, 2H), 4.11-4.25 (m, 2H), 2.06,2.11 (2s, 21H). c. N. N'-Bis-(2. 3 4-trihydroxybutanoyl)-3. 5-diamino-2. 4.6- triiodobenzyl alcohol N, N-Bis- (2,3,4-triacetoxybutanoyl)-3, 5-diamino-2,4,6- triiodobenzyl acetate (8.7g, 8.35 mmol) was dissolved in methanol (40 ml) and sodium hydroxide (2.8 g, 70 mmol) dissolved in water (10 ml) was added dropwise, with efficient stirring at ambient temperature. After 5 min additional water (30 ml) was added and after 30 min the mixture was treated with a strongly acidic ion exchange resin (Amberlyst 15) to bring pH of the solution to 2-3.

The resin was filtered off and the filtrate was treated with a weakly basic ion exchange resin (Amberlyst A-21) to bring pH to 6. The resin was filtered off and the filtrate evaporated to a oil, which was purified by preparative HPLC to give 3.5 g (56%) of the product.

MS (ESP, m/e): 748 ( [M] +, 100%), 766 ( [M+H201+, 200-.).

Example 5.5-rN'- (2, 3, 4-Trihydroxybutanoyl) aminol-3- hydroxymethyl-N-(2 3-dihydroxypropyl)-2 4,(2 3-dihydroxypropyl)-2 4, 6- triiodobenzamide a. 5-EN'- (2,3,4-Triacetoxybutanoyl) aminol-3- acetoxymethyl-N-(2 3-diacetoxypropyl)-2. 4(2 3-diacetoxypropyl)-2. 4 6- triiodobenzamide 5-Amino-3-acetoxymethyl-N- (2,3-diacetoxypropyl)-2,4,6- triiodobenzamide (30.0 g, 40.3 mmol) was dissolved in dry N, N-dimethylacetamide (50 ml) and added dropwise to 2,3,4-triacetoxybutanoyl bromide (26.0 g, 0.93 mol) at 0°C. The mixture was stirred at ambient temperature for 5h, and then added slowly to an aqueous solution of NaHC03 (5%, 500 ml). A semi-crystalline precipitate was formed, filtered off and dissolved in ethyl acetate (200 ml). The organic phase was washed three times with diluted HC1 (5%, 80 ml) and then twice with water (80 ml). After drying (Na2SO4) the solvent was evaporated to a semisolid residue. The residue was purified on a column of silica using methylene chloride/acetonitrile (4: 1-3: 2) as the eluent. The solvent was evaporated and the residue was further purified by preparative HPLC to give 13.8 g (35%) of the product.

MS (ESP, m/e): 988 ([M] +, 100%). b. 5-EN'-(2. 3, 4-Trihydroxybutanoyl) aminol-3- hydroxymethyl-N-(2 3-dihydroxypro-pyl)-2.(2 3-dihydroxypro-pyl)-2. 4.6- triiodobenzamide <BR> <BR> <BR> <BR> <BR> <BR> 5- [N'- (2,3,4-Triacetoxybutanoyl) amino]-3-acetoxymethyl-N- (2,3-diacetoxypropyl)-2,4,6-triiodobenzamide (13.8 g, 14.0 mmol) was hydrolysed using sodium hydroxide (4.0g, 0.10 mol) according to the procedure given in Example 79c. The product was isolated in 68% yield after purification.

MS (ESP, m/e) : 736 ([M]+, 100%).

Example 6. Acute toxicity Experiments were carried out to determine the toxicity of the compounds of the present invention compared to known contrast media and compounds previously proposed for use as contrast agents.

The compounds were administered as a single intravenous dose followed by an observation period of 14 days, to obtain information on acute toxicity and to determine the Maximum Tolerated Dose (MTD in grams of iodine/kg of body weight) representing the maximum non-lethal dose of the compound. The test compounds were supplied as sterile solutions ready for intravenous injections. The concentrations were 350 mg I/ml in all cases. The compounds were administered at approximately 22°C. The experiments were performed on female NMRI mice from the Bomholtgård Breeding & Research Centre A/S, Denmark. The body weights were between 18 and 22 grams. Randomly selected mice were individually weighed, then injected intravenously via the lateral tail vein. All injections were administered as a single bolus administration at a rate of 1.2 ml/min. The mice were then observed for any signs of toxicity immediately after administration of the test article. Surviving mice were group-housed during the study period (maximum 5 animals/cage) and the mice had ad libitum access to food and water. The results are expressed as a range, where the lower number signifies a dose where all animals survived, and the higher number a dose where at least one animal died, see Tables 1 and 2 below and Figure 3.

Table 1-Prior art contrast media

I MTD (g I/kg)"LD50 (g I/kg) -15.0Omnipaque12.5 18.7 Imagopaque 12.5-15.0 14.8 Ultravist 12.5-15.0 16.3 1-2. 5 10 51.7141< 151 10.0 - 12. 5 13.7 Example No.. in WO 96/09282 Table 2-Compounds according to the invention (gI/kg)#LD50(gI/kg)CompoundMTD (ExampleNo.) 2 12. 5-15.0 15.4 1 10. 0-12.5 15.8 5 12.5-15.0 ~15.0 4412.5 15.0 #15.0 -17.517.1315.0 Example 7. Determination of viscosity The apparatus consisted of a thermostated 10 µl graduated sample syringe connected to a conical shaped 100 yl sample vial. The syringe needle as well as a probe for temperature measurements (0.2°C) was inserted through an airtight septum at the top of the vial. Through the septum was also inserted a small tubing connected to an air syringe via a PTFE tubing.

To determine viscosity, 15-75 Hl of the sample liquid was placed at the bottom of the sample vial. The liquid was forced up into the sample syringe by a slight over pressure generated manually by the air syringe. When the

syringe was almost filled, the over pressure was released so the liquid, forced only by gravity, could flow freely out from the syringe back into the vial. The time for the liquid surface to pass between the marks of e. g. 5 and 10 Fl in the syringe was measured.

The viscosity is calculated as follows: <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> nS=R (dS/dR) (tS/tR)<BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> <BR> ps= Viscosity of the sample<BR> <BR> <BR> <BR> <BR> <BR> <BR> r) R= Viscosity of a reference sample with known viscosity and with similar composition as the sample e. g. Iohexol or Iodixanol ds= Density of sample solution dR= Density of reference solution ts= Average time for sample surface to pass between two marks in the syringe tR= Corresponding time for reference sample The results of these determinations of viscosity are shown in Figure 1. The viscosity data for iomeprol and iopamidol are taken from Pitre, D. and Felder, E. in Investigative Radiology [1980] Vol. 15, SJO2 and Gallotti, A. et al. in European Journal of Radiology (1994) Vol. 18 (Suppl. 1) 51.

The osmolality of the test solutions were measured using a standard Wescor 5500 vapor pressure osmometer at 37°C.

The results of these determinations of osmolality are provided in Figure 2.