Emerging Innovations in Gadolinium-Based Imaging and Therapy

Gadolinium, a 64-atomic-number rare-earth lanthanide metal, is crucial in modern diagnostic medicine due to its paramagnetic properties. Its strong magnetic properties speed up the relaxation of water protons in MRI, making Gadolinium-Based Contrast Agents (GBCAs) important for accurate and early disease diagnosis. Gadolinium has also found utility in nuclear medicine, particularly in neutron capture therapy (NCT) for certain cancers. It is also explored in advanced bioimaging techniques due to its luminescence when doped with ligands or nanostructures. However, the clinical application of gadolinium is not without risks, including the toxic nature of free Gd³⁺ ions and potential side effects, especially in patients with impaired renal function. A recent review focuses on improving the biocompatibility and safety of GBCAs by developing macromolecular carriers, nanoparticle formulations and smart ligands that release gadolinium only under specific physiological conditions. These innovations aim to optimize distribution, minimise toxicity, and broaden the scope of gadolinium’s biomedical applications.