Carbon Dots Meet MRI: Metal Doping for a Smart Contrast Agent Design

In clinical and preclinical magnetic resonance imaging (MRI), image quality is often limited by intrinsic tissue contrast, so paramagnetic agents are used to amplify relaxation differences and improve lesion detectability. Widely used gadolinium-based contrast agents present recognized drawbacks, stimulating interest in nanoscale platforms with tuneable magnetic and biological properties. This review provides a critical analysis on the use of metal-doped carbon nanodots (C-dots) as MRI contrast candidates. We briefly revisit MRI signal formation, spin-lattice (T1) and spin-spin (T2) relaxation, and relaxometric parameters r1 and r2 and outline how pulse-sequence choice favours T1- or T2-dominant agents. We compare approved small-molecule agents with nanostructured systems, highlighting unmet needs in safety, field-strength dependence, multimodality, and organ-specific imaging. A central focus is how nano- and molecular architectures of metal-doped carbon dots govern r1 and r2: the metal species and oxidation state, its location within the carbon matrix, surface chemistry and hydration, and the accessibility for proton and water exchange can shift performance toward T1 or T2. Engineered C-dots with controlled composition and metal dopants have proven to pair improved relaxivity with fluorescence, targeting ligands, or therapeutic payloads. Overall, metal-doped C-dots represent a flexible and potentially safer alternative to classical contrast agents; however, successful clinical translation and market uptake will still require standardized relaxometry at clinical field strengths, scalable and reproducible synthesis, and comprehensive in vivo safety and efficacy validation.