Use of Magnetic Resonance Imaging for Visualization of Oral Dosage Forms in the Human Stomach: A Scoping Review

• Published in: Molecular pharmaceutics Vol. 21; no. 4; pp. 1553 - 1562
• Main Authors: Akbar, Tejal, Gershkovich, Pavel, Stamatopoulos, Konstantinos, Gowland, Penny A., Stolnik, Snow, Butler, James, Marciani, Luca
• Format: Journal Article
• Language: English
• Published: United States American Chemical Society 01.04.2024
• Subjects: Administration, Oral; Contrast Media; Dosage Forms; Gastrointestinal Tract; Humans; Magnetic Resonance Imaging - methods; Review; Solubility; Stomach - diagnostic imaging; Tablets; MRI contrast agents; magnetic resonance imaging; MRI; oral drug delivery; dosage form disintegration; fasted stomach; in vivo; stomach; fed stomach; MRI contrast markers; oral dosage forms
• ISSN: 1543-8384; 1543-8392; 1543-8392
• DOI: 10.1021/acs.molpharmaceut.3c01123

Oral dosage forms are the most widely and frequently used formulations to deliver active pharmaceutical ingredients (APIs), due to their ease of administration and noninvasiveness. Knowledge of intragastric release rates and gastric mixing is crucial for predicting the API release profile, especially for immediate release formulations. However, knowledge of the intragastric fate of oral dosage forms in vivo to date is limited, particularly for dosage forms administered when the stomach is in the fed state. An improved understanding of gastric food processing, dosage form location, disintegration times, and food effects is essential for greater understanding for effective API formulation design. In vitro standard and controlled modeling has played a significant role in predicting the behavior of dosage forms in vivo. However, discrepancies are reported between in vitro and in vivo disintegration times, with these discrepancies being greatest in the fed state. Studying the fate of a dosage form in vivo is a challenging process, usually requiring the use of invasive methods, such as intubation. Noninvasive, whole body imaging techniques can however provide unique insights into this process. A scoping review was performed systematically to identify and critically appraise published studies using MRI to visualize oral solid dosage forms in vivo in healthy human subjects. The review identifies that so far, an all-purpose robust contrast agent or dosage form type has not been established for dosage form visualization and disintegration studies in the gastrointestinal system. Opportunities have been identified for future studies, with particular focus on characterizing dosage form disintegration for development after the consumption food, as exemplified by the standard Food and Drug Administration (FDA) high fat meal.