Juliana de Souza Bragança, Juliana Ferreira Gois, Cíntia Loss Kanitz, Marcella Porto Tavares, Suzana Kanawati Pinheiro Kerr, Herllon Karllos Athaydes Kerr
Magnetic resonance imaging (MRI) is based on the excitation of protons in response to intense magnetic fields and radiofrequency pulses, providing high-resolution images and soft tissue contrast. MRI frequently employs contrast agents, with gadolinium (Gd3+) being the most common. However, free Gd3+ can accumulate in tissues, leading to toxic effects and nephrogenic systemic fibrosis (NSF), particularly in patients with renal dysfunction. A systematic review of the literature explores alternatives, such as superparamagnetic iron oxide nanoparticles (SPIONs), which have demonstrated higher relaxivity and lower toxicity in preclinical studies. Other options include nitroxide-based agents and zero-valent iron nanoparticles, which offer enhanced stability and biocompatibility. Despite promising advances, such as the functionalization of SPIONs for specific applications, challenges remain regarding long-term toxicity and technical limitations. The search for safer and more effective contrast agents remains essential to expanding the clinical applications of MRI.