Contrast medium or diagnostic imaging agent is a substance that enhances the contrast of structures and fluids present inside the body in medical imaging. The widely used contrast mediums are generally based on gadolinium (Gd). Based on the chemical structure and chelating part, these gadolinium-based contrast mediums are categorized into linear and macrocyclic agents. The macromolecule with cyclic portion structure is referred as macrocyclic compound. Gadolinium-based macrocyclic compounds used as contrast medium are referred as macrocyclic agents.

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Gadolinium-based macrocyclic agents include gadobutrol and gadoteridol. There are two structurally different compounds available: open chain and cyclic chain. The open chain agents are also called linear agents. The gadolinium ion is captured into ligand cavity to produce macrocyclic agents. Owing to lesser degree of dissociation, macrocyclic agents are considered more stable than linear agents. Stability of macrocyclic agents depend on the degree of dissociation and how tightly the chelates are formed with the gadolinium ion. Macrocyclic agents have proven to be the most stable agents as these do not bind to serum proteins. The stable macrocyclic agents are recommended in pregnancy and lactating patients. Ideally, macrocyclic agents should have the following characteristics: selectivity for biochemical targets, good ratio of specific to nonspecific binding, better safety profile, and signal amplification capabilities.

Increasing number of diagnostic procedures and growing medical infrastructure are anticipated to drive the global macrocyclic agents market. Macrocyclic agents available in the market include Gadovist, ProHance, and Clariscan. Increase in the global use of gadolinium-based contrast agents is expected to fuel the growth of the global macrocyclic agents market. However, high costs are likely to hamper the growth of the global macrocyclic agents market.

The global macrocyclic agents market has been segmented based on route of administration, procedure, application, and region. In terms of route of administration, the market has been segmented into oral, rectal, urethral, and parenteral. Increasing use of injectables in various procedures such as X-ray, CT scan, MRI, and ultrasound is expected to drive the global macrocyclic agents market. Based on procedure, the global macrocyclic agents market has been classified into X-ray, CT scan, MRI, and ultrasound. High number of approvals for MRI contrast media in various markets is one of the key factors driving the MRI segment.

Based on application, the global macrocyclic agents market has been divided into radiology, interventional cardiology, interventional radiology, and others. The radiology segment is estimated to hold the largest market share due to increasing number of diagnostic procedures.

In terms of region, the global macrocyclic agents market has been segmented into five key regions: Asia Pacific, North America, Europe, Latin America, and Middle East & Africa. North America is projected to hold the largest share of the global macrocyclic agents market during the forecast period. This is attributed to highly-developed medical infrastructure and increasing number of diagnostic procedures. Europe is expected to be the second largest market for macrocyclic agents. Rapidly developing countries such as India and China are anticipated to fuel the growth of the macrocyclic agents market in Asia Pacific.

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Major players in the global macrocyclic agents market include GE Healthcare, Bayer AG, Bracco Imaging S.p.A., Daiichi Sankyo Company Limited, Eisai Co. Ltd., and Guerbet Group. Bayer AG and Bracco Imaging S.p.A. are expected to account for considerable share of the global macrocyclic agents market.

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