Molecular imaging opens up new perspectives for the early diagnosis of cancer and cardiovascular diseases.
The use of “smart” contrast agents, capable of detecting changes at the molecular level before clinical or anatomical signs appear, could redefine or decisively alter the diagnosis and monitoring of cardiovascular diseases and metastatic cancer. This was the main message of the seminar given by researcher Sara Lacerda, from Centre de Biophysique Moléculaire (CNRS, Orléans, France).
The session, entitled Towards better detection of cardiovascular disease and metastatic cancer, took place on 4th November 2025, in the Auditorium of Campus Tecnológico e Nuclear Library in Loures. The event was promoted by the C2TN Academy, as part of ‘Radiopharmaceutical Sciences and Health Physics’ Thematic Line, and introduced by C2TN researcher Paula Campello.
The initiative was part of Sara Lacerda’s scientific mission at this Research Unit, within the scope of an international collaboration project with Paula Campello, funded by PHC PESSOA – Portugal-France Bilateral Cooperation programme (PHC Pessoa 2025). Aimed at students, researchers and teachers, the presentation explained, in an accessible way, the contribution of coordination chemistry to the development of medical imaging.
According to the researcher, the aim was to show ‘how coordination chemistry can contribute to advances in medical imaging through the development of imaging probes capable of detecting specific biomarkers’. These biomarkers, small molecules, proteins or cellular parameters, show changes at the molecular or cellular level long before the disease is visible externally. By detecting them, the probes increase the contrast of the image, allowing tumours or diseased tissues to be identified early, emphasising that ‘this approach leads to earlier and more accurate diagnoses’.
Despite therapeutic advances, cancer and cardiovascular disease continue to be the leading causes of premature death. The researcher pointed out that ‘medical imaging does not really contribute to prevention, as tests are generally prescribed when the patient already has symptoms and the problem is already present.’ In breast cancer, for example, ‘a tumour detected and treated early has a five-year survival rate of around 87%, a figure that drops to 23% when metastases are already present’, she added.
Non-invasive imaging is also crucial for assessing the effectiveness of treatments. ‘In many cases, it is necessary to wait weeks to see if a treatment is working. If the effect can be detected earlier, doctors gain time to adjust the therapeutic strategy’, explained Sara Lacerda.
In the cardiovascular field, more accurate images allow for assessing the need for and the most appropriate timing of surgical interventions, with early detection contributing to improving patients’ quality of life and reducing long-term treatment costs.
A central point of the seminar was the distinction between traditional methods and molecular imaging. While conventional methods mainly produce anatomical images, molecular imaging allows ongoing biological processes to be monitored, identifying molecular or cellular changes before they become visible with traditional techniques.
Among the most promising approaches are peptide-based contrast agents. ‘By detecting specific biomarkers, these agents enable more accurate diagnoses and faster assessment of therapeutic effect’, explained the researcher. The chemical diversity of probes, through radioiodination, radiofluorination or coordination of metals such as gadolinium (Gd³⁺), allows physical and chemical properties to be exploited to obtain detailed images and, in some cases, guide therapeutic strategies with less impact on healthy tissue.
During the session, examples of probes for specific biomarkers were presented, namely: the detection of tropoelastin, which identifies vulnerable atherosclerotic plaques or aneurysms at risk of rupture, type III collagen, which allows cardiac inflammation to be monitored after a heart attack and, finally, netrin-1, which is associated with tumour aggressiveness and metastatic risk.
Despite their potential, the clinical translation of these probes faces challenges. ‘The development of new molecules for clinical use is time-consuming and expensive’, acknowledged Sara Lacerda, referring to the pharmaceutical industry’s limited interest in highly specific agents. Still, she left an optimistic message: “Despite the slowness of the process, there is a lot of research with promising results that contribute to a better understanding of the disease’s biomarkers and validate new therapies”.