What is it about?
This article explains how scientists use folic acid (vitamin B9) and its related compounds to improve medical imaging in cancer and inflammation. Many cancer cells and activated immune cells (especially macrophages involved in inflammation) have high numbers of folate receptors on their surface. Healthy cells usually have very few of these receptors. Because of this difference, researchers can attach folic acid to imaging agents such as PET tracers, SPECT radiotracers, MRI contrast molecules, or fluorescent dyes. After injection, these folate-linked agents travel through the body and selectively attach to cells with many folate receptors. This makes tumors or inflamed tissues easier to detect. The article reviews different imaging methods that benefit from this strategy and describes ongoing clinical uses such as image-guided cancer surgery using fluorescent folate probes. It also discusses technical challenges, such as unwanted accumulation in the kidneys or difficulty distinguishing cancer-related receptors from inflammation-related ones. Overall, the article shows how folate-targeted imaging works, where it is currently used, what its benefits are, and what challenges remain.
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Why is it important?
This topic is important because accurate and early detection of cancer and inflammation can significantly improve patient outcomes. Many imaging agents used today are not very specific, meaning they accumulate in both healthy and diseased tissues, which lowers image quality. Folate-based targeting offers a simple, low-cost, and highly selective way to deliver imaging agents directly to diseased cells without affecting the rest of the body. Since folate receptors are overexpressed in many cancers and inflammatory diseases, this approach can improve diagnosis, guide treatment decisions, and help surgeons identify cancerous tissue more precisely during operations. It also opens the door for “theranostics,” where the same folate-based molecule can be used for both imaging and targeted therapy. The article emphasizes that although there are challenges—like kidney uptake or variability between different folate receptor types—the potential for better disease visualization makes this an exciting and growing field.
Perspectives
The future of folate-targeted imaging looks promising. Researchers are working on designing more selective folate conjugates that can distinguish between different types of folate receptors, allowing better differentiation between cancer and inflammation. Improved chemical linkers and nanoparticle systems may reduce kidney uptake and increase circulation time, making imaging clearer and safer. Clinical trials of folate-based fluorescent agents for cancer surgery are already showing success, and expanded use in PET and MRI imaging is expected. There is also strong potential for combining folate-targeted imaging with targeted drug delivery to create dual-purpose theranostic tools. In the long term, folate-based imaging could become a routine part of cancer diagnosis, treatment planning, and monitoring inflammatory diseases. Researchers also foresee integrating these imaging biomarkers with machine learning models to better predict treatment outcomes and personalize therapy.
Dr. Pouya Saraei
Shiraz University of Medical Sciences
Read the Original
This page is a summary of: Folic Acid, Folate Conjugates and Folate Receptors: Novel Applications in Imaging of Cancer and Inflammation-Related Conditions, Cancer Management and Research, November 2025, Taylor & Francis,
DOI: 10.2147/cmar.s549662.
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