Imaging in the era of molecular oncology

Identifying Hepsin as a novel biomarker for human esophageal squamous cell carcinoma (ESCC) and its application in fluorescence imaging

Human Esophageal squamous cell carcinoma (ESCC) represents a type of malignant tumor characterized by a high mortality rate and a generally poor surgical prognosis. The accurate labeling and high-specificity visualization of ESCC cells is extremely importance for its precise diagnosis and effective treatment. Fluorescence molecular imaging has emerged as one of the most critical modalities for cancer detection and therapeutic guidance, owing to its superior sensitivity, cost-effectiveness, portability, real-time imaging, and no damage. In this study, we initially verified that Hepsin, a protease, is highly expressed in ESCC through high-throughput immunocapture (HIC) and Western blot (WB) assays. Subsequently, we designed and synthesized an innovative activatable fluorescent probe, Ac-KQLR Rhodamine 110. It is specifically identified and cleaved by Hepsin, which is over-expressed in ESCC cells. Consequently, the Ac-KQLR Rhodamine 110 could be utilized for the activation fluorescence imaging of ESCC cells, providing a method for their precise visualization. In conclusion, this research highlights that the overexpression of Hepsin serves as a novel biomarker for ESCC. Based on Hepsin's high expression in ESCC, our team has developed a distinctive activation fluorescence imaging strategy that can be employed for the tracking and identification of ESCC. The implementation of this strategy could potentially revolutionize the current methodologies used for monitoring and treating cancer, thereby offering new hope and improved outcomes for patients diagnosed with ESCC.

Noninvasively Real-Time Monitoring In-Vivo Immune Cell and Tumor Cell Interaction by NIR-II Nanosensor

Immunocytotherapy holds significant promise as a novel cancer treatment, but its effectiveness is often hindered by delayed responses, requiring evaluations every 2-3 weeks based on current diagnostic methods. Early assessment of immune cell-tumor cell interactions could provide more timely insights into therapeutic efficacy, enabling adjustments to treatment plans. In this study, a noninvasive nanosensor (C8R-DSNP) for real-time monitoring of in vivo immune cell activities in the second near-infrared long-wavelength (NIR-II-L) window (1500-1900 nm), which offers deep tissue transparency, is reported. The C8R-DSNP responds rapidly to caspase-8, a key apoptotic signaling molecule generated during interactions between natural killer (NK-92) cells and tumor cells. Using ratiometric NIR-II-L fluorescence imaging, dynamic in vivo observations of NK-92 cells' engagement with tumor cells in a mouse model are captured. These results demonstrate tumor cells apoptosis that happens as early as 4.5 h after NK-92 cells infusion. Additionally, in vitro urine imaging confirmed the initiation of apoptosis via cleaved fluorescent small molecules, while single-cell tracking within blood vessels and tumors further elucidated immune cell dynamics. This real-time NIR-II-L monitoring approach offers valuable insights for optimizing immunocytotherapy strategies.

Thioether-bridged carbon dots-dopamine quinone conjugate probe for glutathione sensing and discrimination between glioblastoma and normal cells

Sensitive and specific recognition and imaging of glioblastoma (GBM) cells are crucial for early diagnosis in GBM. Herein, a novel thioether-bridged fluorescence carbon dots (CDs@S for short)-dopamine quinone (DAQ) conjugate (termed as CDs@S-DAQ) probe with red emission was fabricated for sensitive sensing of glutathione (GSH) and selective fluorescence imaging of GBM cells. Due to the strong photo-induced electron transfer (PET) effect between DAQ (the acceptor) and CDs@S (the donor), the red fluorescence of CDs@S is significantly quenched. In the presence of GSH, on the one hand, GSH reduces the quinone structure to a hydroquinone structure via Michael addition reaction, which eliminates the PET effect between DAQ and CDs@S, resulting in the fluorescence restoring of CDs@S; on the other hand, it simultaneously induces the cleavage of the thioether bond linking DAQ and CDs, causing DAQ to detach from the CDs surface and reducing the PET effect, which leads to the fluorescence recovery of CDs. It has been demonstrated that the response of CDs@S-DAQ probe to GSH has a good linear relationship in the range from 0.5 to 10 mM, with an R2 value of 0.9978. Meanwhile, the as-fabricated CDs@S-DAQ probe has excellent stability, superior optical properties and low cytotoxicity. Based on these findings, the probe can be applied in live-cell fluorescence imaging, enabling discrimination between GBM cells and normal tissue cells according to their distinct GSH expression levels.

Anionic Cyanine Membrane Probes for Live Cells and In Vivo Fluorescence Imaging

Molecular probes for cell plasma membranes are indispensable for fluorescence imaging. Herein, we present an array of five anionic cyanine-based turn-on plasma membrane probes with emission spanning from green to near infrared. They are analogous to the commonly used MemBright probe family, where two zwitterionic anchor groups are replaced with anionic sulfonates with dodecyl chains. The developed probes provide selective wash-free staining of plasma membranes of live cells in vitro, featuring improved brightness and slower internalization inside the cells. In comparison to protein-based (wheat germ agglutinin) membrane markers, new membrane probes provide better staining in poorly accessible cell-cell contacts. A key challenge is to stain cell plasma membranes directly in vivo. During in vivo brain tissue imaging in living mice by two-photon microscopy, the anionic cyanine probes allowed us to visualize in detail the pyramidal neurons with high image quality, clearly resolving neuron soma, dendrites with dendritic spines, and axons with axonal boutons. The developed anionic cyanine-based plasma membrane probes constitute an important extension of the toolbox for plasma membrane research.

Oleanolic Acid@SPIONs Alleviates Lipid-Oxidative Stress Injury of Zebrafish Blood Vessels via Regulating the Expression of JNK and MAPK Signaling Pathways in Vascular Endothelial Cells

Background and Aims

The incidence of and mortality due to atherosclerosis, a leading cause of cardiovascular disease, is rising annually. Oleanolic acid (OA), an active component of the traditional Chinese medicine Ligustrum lucidum, has been proven to have significant anti-inflammatory and lipid-lowering potential.

Methods

The fli1a::EGFP+ zebrafish fed with oxidized low-density lipoprotein (oxLDL) diet were used as Atherosclerosis model. The zebrafish Atherosclerosis model were fed with oxalic acid driven by superparamagnetic ferrite nanoparticles (OA@SPIONs). Isolation and enrichment of fli1a::EGFP+ zebrafish endothelial cells (zeECs) from each group and RNA-seq to analyze changes in gene transcription. The H&E, MASSION, Oil red O staining were used to identifying pathological phenotypes.

Results

Pathological staining and ultrastructural identification indicated that oxLDL-treated zebrafish exhibited significant lipid plaque deposition and signs of cellular senescence that were significantly alleviated by OA@SPIONs treatment. OA@SPIONs treatment notably improved the ultrastructural integrity of myocardial, liver, and intestinal tissues in oxLDL-treated zebrafish. The RNA-seq results showed that OA@SPIONs treatment significantly altered the expression levels of multiple gene transcripts in zeECs. The KEGG analysis revealed that in the OA@SPION-treated group zeECs, key genes in the JNK and MAPK signaling pathways, such as Cacna1c, Rab1ab (Ras), Map3k1 (MEKK1), Mapk8b (JNK), and JunD, had significantly lower sequencing signals than in the oxLDL+SPION-treated group zeECs. The qPCR results were highly consistent with the RNA-sequencing data.

Conclusion

Therefore, our results confirm that SPIONs can effectively deliver OA for stable release in zebrafish and provide strong evidence that OA@SPION-polyethyleneimine exerts protective effects against oxLDL-induced damage in zebrafish by downregulating the expression of the JNK and MAPK signaling pathways.

Gold Cluster-Based Profiling of Early Stage Acute Kidney Injury through Second Near-Infrared Fluorescence Imaging and Mass Spectrometry Imaging

Acute kidney injury (AKI) poses a major challenge due to the rapid deterioration of renal function, for which the optimal intervention timing has already passed until clinical diagnostics sense abnormalities. Meanwhile, the lack of means to visually understand early-stage AKI at the molecular level hinders the development of interventive strategies. Herein, we developed a high-orthogonal dual-mode imaging strategy integrating second near-infrared (NIR-II) fluorescence imaging and mass spectrometry imaging (MSI) based on gold clusters for profiling early-stage AKI. Through fabrication and screening, we obtained β-cyclodextrin-capped gold clusters (CD-AuNCs) demonstrating stable NIR-II fluorescence emission, satisfactory ionizing capability, the renal-excreted route, and excellent biocompatibility. Following intravenous injection, CD-AuNCs rapidly (as soon as 5 min post injection) and sensitively sensed the subtle abnormal variation of renal functions during AKI to exhibit differential renal-excreted behaviors. This achieved much earlier detection of AKI by NIR-II fluorescence imaging in a noninvasive real-time manner than invasive clinically adopted blood testing (at least 22 h earlier) and histopathological examination (at least 4 h earlier). Furthermore, CD-AuNCs-based MSI enabled molecular-level investigation of early-stage AKI, visually identifying key endogenous lipids that were remodeled in the renal cortex and medulla. In view of the excellent biocompatibility and easily scalable one-pot synthesis of CD-AuNCs, our strategy holds the potential for clinical translation.

Design, Synthesis, and Evaluation of Boron Dipyrromethene-Based Fluorescent Probes Targeting BRAF for Melanoma Diagnosis

Fluorescent dyes are widely applied in clinical diagnosis, detection, and treatment of diseases. Several image probes such as ICG, MB, and 5-ALA have been approved by FDA. However, the limited tumor-targeting capability of these dyes hinders their effectiveness in oncological imaging. Currently, various ligand-based targeting probes have been developed to minimize nonspecific background emission. BRAF, especially BRAF V600E, is a common cancer gene and undergoes frequent mutation in melanoma. Small molecular BRAF kinase inhibitors have been approved for the treatment of melanoma patients carrying the BRAF V600E mutation, including Vemurafenib, Dabrafenib and so on. Boron dipyrromethene (BODIPY) as an important fluorescent class has been investigated extensively. Vemurafenib-BODIPY has been reported to visualize BRAF V600E mutated cancer cells. Herein, the designed BODIPY-based Vemurafenib derivatives targeting BRAF for cancer cell imaging are reported. The fluorescent probes are characterized and evaluated of photophysical properties, targeted binding and live cell imaging. Compound 1a exhibited promising fluorescence imaging ability. To improve fluorescence quantum yield, structural optimization is performed by incorporating meso N,N'-dialkyl-substituted amides to BODIPY core. Compound 1d shows excellent fluorescence properties and nice binding affinity. It allows visualization of BRAF V600E mutated cancer cells at low concentrations.

Temozolomide-loaded bacterial magnetosomes improve targeted therapy for brain tumors

Novel active-targeting nano-therapeutic, Temozolomide-loaded magnetosomes conjugate has been developed to address the challenges of high metastatic rates and recurrence of tumors due to tumor circulating cells. Temozolomide-loaded magnetosomes as drug conjugate were characterized through a scanning electron microscope, Zeta-sizer, and UV-visible spectroscopy. The anti-tumor activity was studied in vitro (Cell viability, Cell proliferation, and flow cytometry) and in vivo (Xenograft tumor model). The particle size of temozolomide-coated magnetosomes is larger than that of uncoated magnetosomes. The zeta potential decreased to -11.2 from -21.6 mV for Temozolomide- magnetosomes conjugates. The drug-coated magnetosomes can sustain drug release, reducing the frequency of administration and enhancing their therapeutic effect. The study found that Temozolomide-loaded magnetosomes conjugate showed enhanced tumor cytotoxicity and apoptosis than free Temozolomide or magnetosomes. In vivo, the treatment of mice with Temozolomide-loaded magnetosomes inhibited tumor growth to 405.25 mm3 and reduced tumor weight (0.60 g), with fewer juvenile cells and increased necrotic area. These results suggest Bacterial magnetosomes as an appropriate choice for cancer therapy since they may be superior drug carriers with increased therapeutic efficacy and no undesirable side effects to the brain.

Terahertz scanning near-field optical microscopy for biomedical detection: Recent advances, challenges, and future perspectives

Terahertz (THz) radiation is widely recognized as a non-destructive, label-free, and highly- sensitive tool for biomedical detections. Nevertheless, its application in precision biomedical fields faces challenges due to poor spatial resolution caused by intrinsically long wavelength characteristics. THz scanning near-field optical microscopy (THz-SNOM), which surpasses the Rayleigh criterion, offers micrometer and nanometer-scale spatial resolution, making it possible to perform precise bioinspection with THz imaging. THz-SNOM is attracting considerable attention for its potential in advanced biomedical research and diagnosis. Currently, its family typically includes four members based on distinct principles, which are suitable for different biological applications. This review provides an overview of the principles of these THz-SNOM modalities, outlines their various applications, identifies the obstacles hindering their performance, and envisions their future development.

Monolithic U-shaped crystal design for TOF-DOI detectors: a flat top versus a tapered top

For brain-dedicated positron emission tomography (PET) scanners, depth-of-interaction (DOI) information is essential to achieve uniform spatial resolution across the field-of-view (FOV) by minimizing parallax error. Time-of-flight (TOF) information can enhance the image quality. In this study, we proposed a novel monolithic U-shaped crystal design that had a tapered geometry to achieve good coincidence timing resolution (CTR) and DOI resolution simultaneously. We compared a novel tapered U-shaped crystal design with a conventional flat-top geometry for PET detectors. Each crystal had outer dimensions of 5.85 × 2.75 × 15 mm3, with a 0.2 mm central gap forming physically isolated bottom surfaces (2.85 × 2.75 mm2). The novel U-shape crystal design with a tapered top roof resulted in the best CTR of 201 ± 3 ps, and DOI resolution of 3.1 ± 0.6 mm, which were better than flat top geometry. In the next study, we plan to optimize the crystal surface treatment and reflector to further improve the CTR and DOI resolution.

From detection to elimination: iron-based nanomaterials driving tumor imaging and advanced therapies

Iron-based nanomaterials (INMs), due to their particular magnetic property, excellent biocompatibility, and functionality, have been developed into powerful tools in both tumor diagnosis and therapy. We give an overview here on how INMs such as iron oxide nanoparticles, element-doped nanocomposites, and iron-based organic frameworks (MOFs) display versatility for tumor imaging and therapy improvement. In terms of imaging, INMs improve the sensitivity and accuracy of techniques such as magnetic resonance imaging (MRI) and photoacoustic imaging (PAI) and support the development of multimodal imaging platforms. Regarding treatment, INMs play a key role in advanced strategies such as immunotherapy, magnetic hyperthermia, and synergistic combination therapy, which effectively overcome tumor-induced drug resistance and reduce systemic toxicity. The integration of INMs with artificial intelligence (AI) and radiomics further expands its capabilities for precise tumor identification, and treatment optimization, and amplifies treatment monitoring. INMs now link materials science with advanced computing and clinical innovations to enable next-generation cancer diagnostics and therapeutics.

HClO-Activated Near-Infrared Chemiluminescent Probes with a Malononitrile Group for In-Vivo Imaging

Chemiluminescence (CL) imaging has emerged as a powerful approach to molecular imaging that allows exceptional sensitivity with virtually no background interference because of its unique capacity to emit photons without an external excitation source. Despite its high potential, the application of this nascent technique faces challenges because the current chemiluminescent agents have limited reactive sites, require complex synthesis, are insufficiently bright, and lack near-infrared emission. Herein, a series of HClO-activated chemiluminescent probes that exhibit robust near-infrared emission are studied. Specifically engineered to respond to HClO, a known biomarker of acute inflammation, these probes achieve high-contrast in vivo imaging by eliminating the need for constant external excitation. Comprehensive experimental and theoretical investigations demonstrate that the CL of the probes depends on the reactivity of the vinylene bonds, following a concerted decomposition of the oxidized chemiluminescent molecule. The application of these chemiluminescent nanoparticles in vivo facilitates high-contrast imaging of acute inflammation, providing real-time, high-contrast visualization of inflammatory conditions. This advancement signifies a leap forward for chemiluminescent nanoplatforms in biomedical imaging and expands the available methodologies in this field.

Optical imaging guidance in oncologic surgery and interventional oncology

Over recent decades, optical imaging (OI) has become an integral part of medical imaging, offering significant advantages over other modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI). OI is distinguished by its real-time imaging capability, cost-effectiveness, portability, absence of ionizing radiation, and high patient acceptability. The introduction of advanced optical dyes (including FDA-approved agents like indocyanine green, Cytalux, and Gleolan) has greatly enhanced its clinical utility. OI has shown clear benefits in the management of patients with cancer, originally by open surgery and now extending to minimally invasive, image-guided interventional procedures. This review highlights recent developments in OI for oncology, emphasizing its benefits for clinicians in guiding surgical and interventional procedures.

Tumor agnostic ultrasmall nanoprobes for fluorescence-guided surgical resection in peritoneal metastasis

PURPOSE

Surgical excision of metastases is the only curative treatment strategy in peritoneal carcinomatosis management, and the completeness of tumor resection determines the success of the surgery. Tumor-specific fluorescence-guided probes can improve the outcomes of cytoreductive surgery and thereby prognosis. This study aimed to develop and evaluate the feasibility of fluorescently labeled ultrasmall porous silica nanoparticles (UPSN) for image-guided resection of peritoneally disseminated tumors of different origins.

METHODS

Ultrasmall fluorescent nanoprobes were synthesized and characterized for their physicochemical properties and stability. Tumor-specific uptake and biodistribution profiles were evaluated in syngeneic CT26 colorectal and KPC-689 pancreatic cancer murine models. The practicability of real-time optical UPSN-guided resection was examined in the CT26 colorectal cancer model using a surgical stereomicroscope. Quantitative measurements of tumor sensitivity and specificity were performed. Histopathological examination validated in vivo findings about tumor-specific accumulation and safety of ultrasmall fluorescent probes.

RESULTS

As-synthesized UPSNs were successfully surface modified with Cy5 or Cy3 dyes maintaining sub-15 nm size and near neutral charge which is beneficial for optimized in vivo pharmacokinetics. UPSN-Cy5 demonstrated high tumor-specific uptake and favorable biodistribution profiles in peritoneal metastasis models of CT26 and KPC tumors. Dye-conjugated UPSN enabled resection of microscopic lesions and achieved a higher tumor-to-background ratios in comparison to FDA-approved indocyanine green (ICG) dye in both models. Microscopic evaluation showed tumor localization and off-target safety profile of the UPSN-Cy5.

CONCLUSION

Ultrasmall fluorescent probes were effective in surgical resection of peritoneal metastases with high sensitivity and specificity, thus emerging as promising tumor agnostic agents for image-guided cancer surgery.

A state-of-the-art review of the recent advances of theranostic liposome hybrid nanoparticles in cancer treatment and diagnosis

Theranostics is a way of treating illness that blends medicine with testing. Specific characteristics should be present in the best theranostic agents for cancer: (1) the drugs should be safe and non-toxic; (2) they should be able to treat cancer selectively; and (3) they should be able to build up only in the cancerous tissue. Liposomes (LPs) are one of the most efficient drug delivery methods based on nanotechnology. Stealth LPs and commercial LPs have recently had an impact on cancer treatment. Using the valuable information from each imaging technique, along with the multimodality imaging functionality of liposomal therapeutic agents, makes them very appealing for personalized monitoring of how well therapeutic drugs are working against cancer in vivo and for predicting how well therapies will work. On the other hand, their use as nanoparticle delivery systems is currently in the research and development phase. Nanoscale delivery system innovation has made LP-nanoparticle hybrid structures very useful for combining therapeutic and imaging methods. LP-hybrid nanoparticles are better at killing cancer cells than their LP counterparts, making them excellent options for in vivo and in vitro drug delivery applications. Hybrid liposomes (HLs) could be used in the future as theranostic carriers to find and treat cancer targets. This would combine the best features of synthetic and biological drug delivery systems. Overarchingly, this article provided a comprehensive overview of the many LP types used in cancer detection, therapy, and theranostic analysis. An evaluation of the pros and cons of the many HLs types used in cancer detection and treatment has also been conducted. The study also included recent and significant research on HLs for cancer theranostic applications. We conclude by outlining the potential benefits and drawbacks of this theranostic approach to the concurrent detection and treatment of different malignancies, as well as its prospects.

Fluorescent Particles Based on Aggregation-Induced Emission for Optical Diagnostics of the Central Nervous System

In 2001, Tang's team discovered a unique type of luminogens with substantial enhanced fluorescence upon aggregation and introduced the concept of "aggregation-induced emission (AIE)". Unlike conventional fluorescent materials, AIE luminogens (AIEgens) emit weak or no fluorescence in solution but become highly fluorescent in aggregated or solid states, due to a mechanism known as restriction of intramolecular motions (RIM). Initially considered a purely inorganic chemical phenomenon, AIE was later applied in biomedicine to improve the sensitivity of immunoassays. Subsequently, AIE has been extensively explored in various biomedical applications, especially in cell imaging. Early studies achieved nonspecific cell imaging using nontargeted AIEgens, and later, specific cellular imaging was realized through the design of targeted AIEgens. These advancements have enabled the visualization of various biomacromolecules and intracellular organelles, providing valuable insights into cellular microenvironments and statuses. Neurological disorders affect over 3 billion people worldwide, highlighting the urgent need for advanced diagnostic and therapeutic tools. AIEgens offer promising opportunities for imaging the central nervous system (CNS), including nerve cells, neural tissues, and blood vessels. This review focuses on the application of AIEgens in CNS imaging, exploring their roles in the diagnosis of various neurological diseases. We will discuss the evolution and conclude with an outlook on the future challenges and opportunities for AIEgens in clinical diagnostics and therapeutics of CNS disorders.

Aggregation-Induced Emission Luminogens Realizing High-Contrast Bioimaging

A revolutionary transformation in biomedical imaging is unfolding with the advent of aggregation-induced emission luminogens (AIEgens). These cutting-edge molecules not only overcome the limitations of traditional fluorescent probes but also improve the boundaries of high-contrast imaging. Unlike conventional fluorophores suffering from aggregation-caused quenching, AIEgens exhibit enhanced luminescence when aggregated, enabling superior imaging performance. This review delves into the molecular mechanisms of aggregation-induced emission (AIE), demonstrating how strategic molecular design unlocks exceptional luminescence and superior imaging contrast, which is crucial for distinguishing healthy and diseased tissues. This review also highlights key applications of AIEgens, such as time-resolved imaging, second near-infrared window (NIR-II), and the advancement of AIEgens in sensitivity to physical and biochemical cue-responsive imaging. The development of AIE technology promises to transform healthcare from early disease detection to targeted therapies, potentially reshaping personalized medicine. This paradigm shift in biophotonics offers efficient tools to decode the complexities of biological systems at the molecular level, bringing us closer to a future where the invisible becomes visible and the incurable becomes treatable.

Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature

Postoperative chylothorax is a serious complication after oesophagectomy. Real-time identification of the thoracic duct (TD) could prevent injury or facilitate prompt management when it occurs. Intraoperative TD lymphography with indocyanine green (ICG) is a novel technique that may help prevent chyle leaks following thoracic surgery. A systematic search of PubMed, Embase, MEDLINE, Scopus, and the Cochrane Library for studies published until July 2024 evaluating ICG for TD identification during oesophagectomy was performed. Studies were included in the review if they assessed intraoperative TD identification with ICG to prevent chyle leakage in patients undergoing oesophagectomy. Nine of 265 screened papers were included in the present review, with 3 reporting comparative techniques of TD identification between patients. Only 1 study had a control group without ICG administration. TD was identified in 281 of the 303 patients who received ICG. Chyle leak incidence was 0.66% in the ICG group. The mean observation time of TD after ICG administration was 162 minutes. Most of the included patients received neoadjuvant treatment before surgery. Different application routes of ICG have been reported, with the most prominent one being through the inguinal region under ultrasound guidance. Real- time TD identification with ICG might be a valuable tool for avoiding injury or managing it intraoperatively. To our knowledge, this is the first systematic review on this complex topic. However, as no randomized controlled trials have been published, sufficient evidence is needed to determine whether the aforementioned method can sufficiently reduce the chyle leak rate.

Optical histopathology based on the nonlabeling analysis with multiphoton excitation imaging

Histopathological diagnosis is the definitive method for the evaluation of disease status; however, some problems need to be solved, such as invasiveness, time consumption, and difficulty in three-dimensional observation. To overcome these problems, a novel observation method, distinct from conventional histology, using tissue sections and glass slides is desirable. Fluorescence imaging of human tissues with multiphoton excitation imaging (MpEI), which was originally used for intravital imaging in biological research, is a promising method. Label-free MpEI, which requires only near-infrared excitation, can construct images with autofluorescent signals from fresh tissues, as well as nonlinear optical phenomena. It is possible to perform real-time three-dimensional imaging of human tissues without any tissue removal, fixation, or staining. This method has been reported to be useful for histopathological classification in multiple organs and tissues. Moreover, it is very compatible with quantitative image analyses, including artificial intelligence. Based on these characteristics, label-free MpEI has sufficient potential for clinical applications such as in endoscopy and intraoperative rapid diagnosis. The clinical application of label-free MpEI will bring changes not only to histopathology examination but also the clinical bedside and will contribute to the further development of histopathology.

Carbon-based Nanomaterials in Photothermal Therapy Guided by Photoacoustic Imaging: State of Knowledge and Recent Advances

Carbon-based nanomaterials (CBNM) have been widely used in various fields due to their excellent physicochemical properties. In particular, in the area of tumor diagnosis and treatment, researchers have frequently reported them for their potential fluorescence, photoacoustic (PA), and ultrasound imaging performance, as well as their photothermal, photodynamic, sonodynamic, and other therapeutic properties. As the functions of CBNM are increasingly developed, their excellent imaging properties and superior tumor treatment effects make them extremely promising theranostic agents. This review aims to integrate the considered and researched information in a specific field of this research topic and systematically present, summarize, and comment on the efforts made by authoritative scholars. In this review, we summarized the work exploring carbon-based materials in the field of tumor imaging and therapy, focusing on PA imaging-guided photothermal therapy (PTT) and discussing their imaging and therapeutic mechanisms and developments. Finally, the current challenges and potential opportunities of carbon-based materials for PA imaging-guided PTT are presented, and issues that researchers should be aware of when studying CBNM are provided.

Optical molecular imaging technology and its application in precise surgical navigation of liver cancer

Recent innovations in medical imaging technology have placed molecular imaging techniques at the forefront of diagnostic advancements. The current research trajectory in this field aims to integrate personalized molecular data of patients and diseases with traditional anatomical imaging data, enabling more precise, non-invasive, or minimally invasive diagnostic options for clinical medicine. This article provides an in-depth exploration of the basic principles and system components of optical molecular imaging technology. It also examines commonly used targeting mechanisms of optical probes, focusing especially on indocyanine green-the FDA-approved optical dye widely used in clinical settings-and its specific applications in diagnosing and treating liver cancer. Finally, this review highlights the advantages, limitations, and future challenges facing optical molecular imaging technology, offering a comprehensive overview of recent advances, clinical applications, and potential impacts on liver cancer treatment strategies.

Infrared thermal modulation endoscopy for label-free tumor detection

In optical imaging of solid tumors, signal contrasts derived from inherent tissue temperature differences have been employed to distinguish tumor masses from surrounding tissue. Moreover, with the advancement of active infrared imaging, dynamic thermal characteristics in response to exogenous thermal modulation (heating and cooling) have been proposed as novel measures of tumor assessment. Contrast factors such as the average rate of temperature changes and thermal recovery time constants have been investigated through an active thermal modulation imaging approach, yielding promising tumor characterization results in a xenograft mouse model. Here, to assess its clinical potential, we developed and deployed an endoscopic infrared thermal modulation imaging system, incorporating anti-reflection germanium lenses. Employing tissue cooling, we evaluated the feasibility of detecting in situ tumors in a syngeneic rectal tumor mouse model. Consequently, early-stage tumors were successfully localized and evaluated based on their heat signatures. Notably, tumors exhibited a higher rate of temperature change induced by thermal modulation compared to adjacent tissues. Through the introduction of this label-free technology, Infrared Thermal Modulation Endoscopy (ITME), our study showcased an effective method for optically delineating and assessing solid tumors. This innovative diagnostic technology holds significant promise for enhancing our ability to detect, classify, and characterize abnormal tissues.

Application of rare earth elements in dual-modality molecular probes

The unique 4f subshell electronic structure of rare earth elements endows them with exceptional properties in electrical, magnetic, and optical domains. These properties include prolonged fluorescence lifetimes, large Stokes shifts, distinctive spectral bands, and strong resistance to photobleaching, making them ideal for the synthesis of molecular probes. Each imaging technique possesses unique advantages and specific applicabilities but also inherent limitations due to its operational principles. Dual-modality molecular probes effectively address these limitations, particularly in applications involving high-resolution Magnetic Resonance Imaging (MRI) such as MRI/OI, MRI/PET, MRI/CT, and MRI/US. This review summarizes the applications, advantages, challenges, and current research status of rare earth elements in these four dual imaging modalities, providing a theoretical basis for the future development and application of rare earth elements in the field of dual-modality molecular probes.

Dual Enzyme-Driven Cascade Reactions Modulate Immunosuppressive Tumor Microenvironment for Catalytic Therapy and Immune Activation

Lactate-enriched tumor microenvironment (TME) fosters an immunosuppressive milieu to hamper the functionality of tumor-associated macrophages (TAMs). However, tackling the immunosuppressive effects wrought by lactate accumulation is still a big challenge. Herein, we construct a dual enzyme-driven cascade reaction platform (ILH) with immunosuppressive TME modulation for photoacoustic (PA) imaging-guided catalytic therapy and immune activation. The ILH is composed of iridium (Ir) metallene nanozyme, lactate oxidase (LOx), and hyaluronic acid (HA). The combination of Ir nanozyme and LOx can not only efficiently consume lactate to reverse the immunosuppressive TME into an immunoreactive one by promoting the polarization of TAMs from the M2 to M1 phenotype, thus enhancing antitumor defense, but also alleviate tumor hypoxia as well as induce strong oxidative stress, thus triggering immunogenic cell death (ICD) and activating antitumor immunity. Furthermore, the photothermal performance of Ir nanozyme can strengthen the cascade catalytic ability and endow ILH with a PA response. Based on the changes in PA signals from endogenous molecules, three-dimensional multispectral PA imaging was utilized to track the process of cascade catalytic therapy in vivo. This work provides a nanoplatform for dual enzyme-driven cascade catalytic therapy and immune activation by regulating the immunosuppressive TME.

Molecular Imaging Biomarkers for Early Cancer Detection: A Systematic Review of Emerging Technologies and Clinical Applications

BACKGROUND

Early cancer detection is crucial for improving patient outcomes. Molecular imaging biomarkers offer the potential for non-invasive, early-stage cancer diagnosis.

OBJECTIVES

To evaluate the effectiveness and accuracy of molecular imaging biomarkers for early cancer detection across various imaging modalities and cancer types.

METHODS

A comprehensive search of PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus was performed, covering the period from January 2010 to December 2023. Eligibility criteria included original research articles published in English on molecular imaging biomarkers for early cancer detection in humans. The risk of bias for included studies was evaluated using the QUADAS-2 tool. The findings were synthesized through narrative synthesis, with quantitative analysis conducted where applicable.

RESULTS

In total, 50 studies were included. Positron emission tomography (PET)-based biomarkers showed the highest sensitivity (mean: 89.5%, range: 82-96%) and specificity (mean: 91.2%, range: 85-100%). Novel tracers such as [68Ga]-PSMA for prostate cancer and [18F]-FES for breast cancer demonstrated promising outcomes. Optical imaging techniques showed high specificity in intraoperative settings.

CONCLUSIONS

Molecular imaging biomarkers show significant potential for improving early cancer detection. Integration into clinical practice could lead to earlier interventions and improved outcomes. Further research is needed to address standardization and cost-effectiveness.

Nanoscale Metal-Organic Frameworks as a Photoluminescent Platform for Bioimaging and Biosensing Applications

The tracking of nanomedicines in their concentration and location inside living systems has a pivotal effect on the understanding of the biological processes, early-stage diagnosis, and therapeutic monitoring of diseases. Nanoscale metal-organic frameworks (nano MOFs) possess high surface areas, definite structure, regulated optical properties, rich functionalized sites, and good biocompatibility that allow them to excel in a wide range of biomedical applications. Controllable syntheses and functionalization endow nano MOFs with better properties as imaging agents and sensing units for the diagnosis and treatment of diseases. This minireview summarizes the tunable synthesis strategies of nano MOFs with controllable size, shape, and regulated luminescent performance, and pinpoints their recent advanced applications as optical elements in bioimaging and biosensing. The current limitations and future development directions of nano MOF-contained materials in bioimaging and biosensing applications are also discussed, aiming to expand the biological applications of nano MOF-based nanomedicine and facilitate their production or clinical translation.

Dynamic synthetic-scanning photoacoustic tracking monitors hepatic and renal clearance pathway of exogeneous probes in vivo

Advancements in precision medicine necessitate understanding drug clearance pathways, especially in organs like the liver and kidneys. Traditional techniques such as PET/CT pose radiation hazards, whereas optical imaging poses challenges in maintaining both depth penetration and high resolution. Moreover, very few longitudinal studies have been performed for drug candidates for different symptoms. Leveraging non-ionizing photoacoustic tomography for deep tissue imaging, we developed a spatiotemporally resolved clearance pathway tracking (SRCPT) method, providing unprecedented insights into drug clearance dynamics within vital organs. SRCPT addresses challenges like laser fluence attenuation, enabling dynamic visualization of drug clearance pathways and essential parameter extraction. We employed a novel frequency component selection based synthetic aperture focusing technique (FCS-SAFT) with respiratory-artifacts-free weighting factors to enhance three-dimensional imaging resolutions. Inspired by this, we investigated the clearance pathway of a clinical drug, mitoxantrone, revealing reduced liver clearance when hepatic function is impaired. Furthermore, immunoglobulin G clearance analysis revealed significant differences among mice with varying renal injury degrees. The accuracy of our method was validated using a double-labeled probe [68Ga]DFO-IRDye800CW, showing a strong positive correlation between SRCPT and PET. We believe that this powerful SRCPT promises precise mapping of drug clearance pathways and enhances diagnosis and treatment of liver and kidney-related diseases.

γ-Glutamyltranspeptidase fluorescence lifetime response probe for precision tumor detection unveiling A549 cancer cell specificity

γ-Glutamyltranspeptidase (γ-GGT), as a key enzyme, exhibits markedly higher expression levels in tumor cells compared to normal cells. Under normal conditions, γ-GGT activity on the cell membrane is relatively low, but it undergoes a significant upregulation in cancer cells, making it a potential cancer biomarker. Particularly in A549 cells, a prominent cancer cell line, the pronounced upregulation of γ-GGT expression emphasizes its potential as a unique recognition target and a robust marker for A549 cells. This study successfully synthesized a highly selective γ-GGT fluorescent probe, the exhibits commendable sensitivity (LOD = 0.0021U/mL) and selectivity, achieving efficient detection at the cellular level and providing accurate insights into differential expression between normal and cancer cells. The alterations in fluorescence lifetime observed before and after the probe's reaction with γ-GGT serve as a crucial foundation for fluorescence lifetime imaging on living cells. The probe has become a powerful tool for precise localization of tumor cells, particularly demonstrating its capability for specific recognition in A549 cells. Overall, this research highlights the potential of γ-GGT as a target for fluorescent probes, emphasizing its prospects in specific recognition, particularly in A549 cells, with profound implications for advancing early cancer diagnosis and treatment methods.

The Application of Nanoparticle-Based Imaging and Phototherapy for Female Reproductive Organs Diseases

Various female reproductive disorders affect millions of women worldwide and bring many troubles to women's daily life. Let alone, gynecological cancer (such as ovarian cancer and cervical cancer) is a severe threat to most women's lives. Endometriosis, pelvic inflammatory disease, and other chronic diseases-induced pain have significantly harmed women's physical and mental health. Despite recent advances in the female reproductive field, the existing challenges are still enormous such as personalization of disease, difficulty in diagnosing early cancers, antibiotic resistance in infectious diseases, etc. To confront such challenges, nanoparticle-based imaging tools and phototherapies that offer minimally invasive detection and treatment of reproductive tract-associated pathologies are indispensable and innovative. Of late, several clinical trials have also been conducted using nanoparticles for the early detection of female reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics. However, these nanoparticle trials are still nascent due to the body's delicate and complex female reproductive system. The present review comprehensively focuses on emerging nanoparticle-based imaging and phototherapies applications, which hold enormous promise for improved early diagnosis and effective treatments of various female reproductive organ diseases.

Optimized in vivo multispectral bioluminescent imaging of tumor biology using engineered BRET reporters

The ability to visualize and track multiple biological processes in vivo in real time is highly desirable. Bioluminescence imaging (BLI) has emerged as an attractive modality for non-invasive cell tracking, with various luciferase reporters enabling parallel monitoring of several processes. However, simultaneous multiplexed imaging in vivo is challenging due to suboptimal reporter intensities and the need to image one luciferase at a time. We report a multiplexed BLI approach using a single substrate that leverages bioluminescence resonance energy transfer (BRET)-based reporters with distinct spectral profiles for triple-color BLI. These luciferase-fluorophore fusion reporters address light transmission challenges and use optimized coelenterazine substrates. Comparing BRET reporters across two substrate analogs identified a green-yellow-orange combination that allows simultaneous imaging of three distinct cell populations in vitro and in vivo. These tools provide a template for imaging other biological processes in vivo during a single BLI session using a single reporter substrate.

Tandem Targeting and Dual Aggregation of an AIEgen for Enhanced Near-Infrared Fluorescence Imaging of Tumors

Near-infrared (NIR) aggregation-induced emission luminogens (AIEgens) are excellent probes for tumor imaging, but there still is space to improve their imaging specificity and sensitivity. In this work, a strategy of tandem targeting and dual aggregation of an AIEgen is proposed to achieve these two purposes. An AIEgen, β-tBu-Ala-Cys(StBu)-Lys(Biotin)-Pra(QMT)-CBT (Ala-Biotin-QMT), is designed to tandem target the biotin receptor and leucine aminopeptidase of a cancer cell and thereafter undergo CBT-Cys click reaction-mediated dual aggregations in the cell. Experimental results show that Ala-Biotin-QMT renders 4.8-fold and 7.9-fold higher NIR fluorescence signals over those in the "biotin + LAP inhibitor"-treated control groups in living HepG2 cells and HepG2 tumor-bearing mice, respectively. We anticipate that Ala-Biotin-QMT, which has the tandem targeting and dual aggregation property to simultaneously achieve enhanced tumor enrichment and fluorescence onset, could be applied for accurate cancer diagnosis in the clinic in the future.

Alkaline Phosphatase-Instructed Peptide Assemblies for Imaging and Therapeutic Applications

Self-assembly, a powerful strategy for constructing highly stable and well-ordered supramolecular structures, widely exists in nature and in living systems. Peptides are frequently used as building blocks in the self-assembly process due to their advantageous characteristics, such as ease of synthesis, tunable mechanical stability, good biosafety, and biodegradability. Among the initiators for peptide self-assembly, enzymes are excellent candidates for guiding this process under mild reaction conditions. As a crucial and commonly used biomarker, alkaline phosphatase (ALP) cleaves phosphate groups, triggering a hydrophilicity-to-hydrophobicity transformation that induces peptide self-assembly. In recent years, ALP-instructed peptide self-assembly has made breakthroughs in biological imaging and therapy, inspiring the development of self-assembly biomaterials for diagnosis and therapeutics. In this review, we highlight the most recent advancements in ALP-instructed peptide assemblies and provide perspectives on their potential impact. Finally, we briefly discuss the ongoing challenges for future research in this field.

Near-Infrared Emissive Super Penetrating Conjugated Polymer Dots for Intratumoral Imaging in 3D Tumor Spheroid Models

This study describes the formation of single-chain polymer dots (Pdots) via ultrasonic emulsification of nonionic donor-acceptor-donor type (D-A-D) alkoxy thiophene-benzobisthiadiazole-based conjugated polymers (Poly BT) with amphiphilic cetyltrimethylammonium bromide (CTAB). The methodology yields Pdots with a high cationic surface charge (+56.5 mV ± 9.5) and average hydrodynamic radius of 12 nm. Optical characterization reveals that these Pdots emit near-infrared (NIR) light at a maximum wavelength of 860 nm owing to their conjugated polymer backbone consisting of D-A-D monomers. Both colloidal and optical properties of these Pdots make them promising fluorescence emissive probes for bioimaging applications. The significant advantage of positively charged Pdots is demonstrated in diffusion-limited mediums such as tissues, utilizing human epithelial breast adenocarcinoma, ATCC HTB-22 (MCF-7), human bone marrow neuroblastoma, ATCC CRL-2266 (SH-SY5Y), and rat adrenal gland pheochromocytoma, CRL-1721 (PC-12) tumor spheroid models. Fluorescence microscopy analysis of tumor spheroids from MCF-7, SH-SY5Y, and PC-12 cell lines reveals the intensity profile of Pdots, confirming extensive penetration into the central regions of the models. Moreover, a comparison with mitochondria staining dye reveals an overlap between the regions stained by Pdots and the dye in all three tumor spheroid models. These results suggest that single-chain D-A-D type Pdots, cationized via CTAB, exhibit long-range mean free path of penetration (≈1 µm) in dense mediums and tumors.

Translational molecular imaging: Thrombosis imaging with positron emission tomography

A key focus of cardiovascular medicine is the detection, treatment, and prevention of disease, with a move towards more personalized and patient-centred treatments. To achieve this goal, novel imaging approaches that allow for early and accurate detection of disease and risk stratification are needed. At present, the diagnosis, monitoring, and prognostication of thrombotic cardiovascular diseases are based on imaging techniques that measure changes in structural anatomy and biological function. Molecular imaging is emerging as a new tool for the non-invasive detection of biological processes, such as thrombosis, that can improve identification of these events above and beyond current imaging modalities. At the forefront of these evolving techniques is the use of high-sensitivity radiotracers in conjunction with positron emission tomography imaging that could revolutionise current diagnostic paradigms by improving our understanding of the role and origin of thrombosis in a range of cardiovascular diseases.

Erythrocyte Membrane Camouflaged Nanotheranostics for Optical Molecular Imaging-Escorted Self-Oxygenation Photodynamic Therapy

Hypoxic tumor microenvironment (TME) hampers the application of oxygen (O2)-dependent photodynamic therapy (PDT) in solid tumors. To address this problem, a biomimetic nanotheranostics (named MMCC@EM) is developed for optical molecular imaging-escorted self-oxygenation PDT. MMCC@EM is synthesized by encapsulating chlorin e6 (Ce6) and catalase (CAT) in metal-organic framework (MOF) nanoparticles with erythrocyte membrane (EM) camouflage. Based on the biomimetic properties of EM, MMCC@EM efficiently accumulates in tumor tissues. The enriched MMCC@EM achieves TME-activatable drug release, thereby releasing CAT and Ce6, and this process can be monitored through fluorescence (FL) imaging. In addition, endogenous hydrogen peroxide (H2O2) will be decomposed by CAT to produce O2, which can be reflected by the measurement of intratumoral oxygen concentration using photoacoustic (PA) imaging. Such self-oxygenation nanotheranostics effectively mitigate tumor hypoxia and improve the generation of singlet oxygen (1O2). The 1O2 disrupts mitochondrial function and triggers caspase-3-mediated cellular apoptosis. Furthermore, MMCC@EM triggers immunogenic cell death (ICD) effect, leading to an increased infiltration of cytotoxic T lymphocytes (CTLs) into tumor tissues. As a result, MMCC@EM exhibits good therapeutic effects in 4T1-tumor bearing mice under the navigation of FL/PA duplex imaging.

Near-infrared II theranostic agents for the diagnosis and treatment of Alzheimer's disease

BACKGROUND

Near-infrared II theranostic agents have gained great momentum in the research field of AD owing to the appealing advantages. Recently, an array of activatable NIR-II fluorescence probes has been developed to specifically monitor pathological targets of AD. Furthermore, various NIR-II-mediated nanomaterials with desirable photothermal and photodynamic properties have demonstrated favorable outcomes in the management of AD.

METHODS

We summerized amounts of references and focused on small-molecule probes, nanomaterials, photothermal therapy, and photodynamic therapy based on NIR-II fluorescent imaging for the diagnosis and treatment in AD. In addition, design strategies for NIR-II-triggered theranostics targeting AD are presented, and some prospects are also addressed.

RESULTS

NIR-II theranostic agents including small molecular probes and nanoparticles have received the increasing attention for biomedical applications. Meanwhile, most of the theranostic agents exhibited the promising results in animal studies. To our surprise, the multifunctional nanoplatforms also show a great potential in the diagnosis and treatment of AD.

CONCLUSIONS

Although NIR-II theranostic agents showed the great potential in diagnosis and treatment of AD, there are still many challenges: 1) Faborable NIR-II fluorohpores are still lacking; 2) Biocompatibility, bioseurity and dosage of NIR-II theranostic agents should be further revealed; 3) New equipment and software associated with NIR-II imaging system should be explored.

Recent Advances on Pt-Based Compounds for Theranostic Applications

Since the discovery of cisplatin's antitumoral activity and its approval as an anticancer drug, significant efforts have been made to enhance its physiological stability and anticancer efficacy and to reduce its side effects. With the rapid development of targeted and personalized therapies, and the promising theranostic approach, platinum drugs have found new opportunities in more sophisticated systems. Theranostic agents combine diagnostic and therapeutic moieties in one scaffold, enabling simultaneous disease monitoring, therapy delivery, response tracking, and treatment efficacy evaluation. In these systems, the platinum core serves as the therapeutic agent, while the functionalized ligand provides diagnostic tools using various imaging techniques. This review aims to highlight the significant role of platinum-based complexes in theranostic applications, and, to the best of our knowledge, this is the first focused contribution on this type of platinum compounds. This review presents a brief introduction to the development of platinum chemotherapeutic drugs, their limitations, and resistance mechanisms. It then describes recent advancements in integrating platinum complexes with diagnostic agents for both tumor treatment and monitoring. The main body is organized into three categories based on imaging techniques: fluorescence, positron emission tomography (PET), single-photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI). Finally, this review outlines promising strategies and future perspectives in this evolving field.

Augmenting Laparoscopic Surgery with Fluorescence Imaging

Minimally invasive endoscopic surgery is growing in veterinary medicine, in large part, due to the advantages associated with reduced pain, potential for decreased complications, and increased visualization of structures through magnification and illumination. With advancing technologies, we can now improve upon natural "white light" endoscopy with fluorescence-guided imaging. Near-infrared (NIR) cameras allow for real-time, high-definition visualization of vessels, anatomic structures, and perfusion. New uses of NIR technologies during laparoscopy are continuing to grow for vascular, lymphatic, and oncologic-related techniques. Limitations exist, and future efforts need to determine optimal dosing, tissue-specific fluorophores, and veterinary-specific techniques.

50-nm Gas-Filled Protein Nanostructures to Enable the Access of Lymphatic Cells by Ultrasound Technologies

Ultrasound imaging and ultrasound-mediated gene and drug delivery are rapidly advancing diagnostic and therapeutic methods; however, their use is often limited by the need for microbubbles, which cannot transverse many biological barriers due to their large size. Here, the authors introduce 50-nm gas-filled protein nanostructures derived from genetically engineered gas vesicles(GVs) that are referred to as 50 nmGVs. These diamond-shaped nanostructures have hydrodynamic diameters smaller than commercially available 50-nm gold nanoparticles and are, to the authors' knowledge, the smallest stable, free-floating bubbles made to date. 50 nmGVs can be produced in bacteria, purified through centrifugation, and remain stable for months. Interstitially injected 50 nmGVs can extravasate into lymphatic tissues and gain access to critical immune cell populations, and electron microscopy images of lymph node tissues reveal their subcellular location in antigen-presenting cells adjacent to lymphocytes. The authors anticipate that 50 nmGVs can substantially broaden the range of cells accessible to current ultrasound technologies and may generate applications beyond biomedicine as ultrasmall stable gas-filled nanomaterials.

Impact of autofluorescence-guided surgery of parathyroid glands during total thyroidectomy in experienced surgeons: A randomized clinical trial

INTRODUCTION

Post-surgical hypoparathyroidism often occurs after total thyroidectomy (TT). The aim of this study is to investigate whether the use of near-infrared autofluorescence (NIRAF) of parathyroid glands (PGs) can aid experienced surgeons in identifying more PGs during surgery, potentially reducing unintended resection, and assessing its impact on post-surgical hypoparathyroidism.

MATERIALS AND METHODS

All patients undergoing at least a TT by two experienced surgeons, between 2020 and 2021, were enrolled and randomized into two cohorts: NIRAF group (NG) and CONTROL group (CG). Transient hypoparathyroidism was defined by serum concentration of PTH<12 ng/mL at the 1st post-operative day and permanent by the need of calcium-active vitamin D treatment >6 months from the surgery with still undetectable PTH or <12 ng/m.

RESULTS

Among 236 patients (111 in NG, 125 in CG), the number of PGs identified was higher in NG (93.9%, 417/444) compared to CG (81.4%, 407/500) (p < 0.001), with a mean of 3.76 ± 0.44 PGs per patient in NG and 3.25 ± 0.79 in CG. The number of unintendedly resected PGs was 14 in NG and 42 in CG (p < 0.0001). Transient hypoparathyroidism was observed in 18 patients (16.2%) in NG and 40 patients (32.0%) in CG (p = 0.004). Permanent hypoparathyroidism affected 1 patient in NG and 7 patients in CG (p = 0.06). The mean operative time was longer in NG (104.3 ± 32.08 min) compared to CG (85.5 ± 40.62 min) (p < 0.001).

CONCLUSIONS

NIRAF enhances the identification of PGs, preventing their inadvertent resection and reducing the overall incidence of post-surgical hypoparathyroidism.

An Allysine-Conjugatable Probe for Fluorogenically Imaging Fibrosis

Allysine, a pivotal biomarker in fibrogenesis, has prompted the development of various radioactive imaging probes. However, fluorogenic probes targeting allysine remain largely unexplored. Herein, by leveraging the equilibrium between the nonfluorescent spirocyclic and the fluorescent zwitterionic forms of rhodamine-cyanine hybrid fluorophores, we systematically fine-tuned the environmental sensitivity of this equilibrium toward the development of fluorogenic probes for fibrosis. The trick lies in modulating the nucleophilicity of the ortho-carboxyl group, which is terminated with a hydrazide group for allysine conjugation. Probe B2 was developed with this strategy, which featured an N-sulfonyl amide group and exhibited superior fibrosis-to-control imaging contrast. Initially presenting as nonfluorescent spirocyclic aggregates in aqueous solutions, B2 displayed a notable fluorogenic response upon conjugation with protein allysine through its hydrazide group, inducing deaggregation and switching to the fluorescent zwitterionic form. Probe B2 outperformed the traditional Masson stain in imaging contrast, achieving an about 260-2600-fold ratio for fibrosis-to-control detection depending on fibrosis severity. Furthermore, it demonstrated efficacy in evaluating antifibrosis drugs. Our results emphasize the potential of this fluorogenic probe as an alternative to conventional fibrosis detection methods. It emerges as a valuable tool for antifibrosis drug evaluation.

An Indocyanine Green-Based Nanocluster for Imaging Orthodox Endometriosis Lesions with Negative Contrast

Indocyanine green (ICG), as the sole near-infrared dye FDA-approved, is limited in biomedical applications because of its poor photostability, lack of targeting, and rapid removal in vivo. Herein, we presented a nanoformulation of poly-l-lysine-indocyanine green-hyaluronic acid (PIH) and demonstrated that it can image orthodox endometriosis (EM) lesions with a negative contrast. The PIH nanocluster, with an average diameter of approximately 200 nm, exhibited improved fluorescence photostability and antioxidant ability compared to free ICG. In the in vivo imaging, EM lesions were visualized, featuring apparent voids and clear boundaries. After colocalizing with the green fluorescent protein, we concluded that the contrast provided by PIH peaked at 4 h postinjection and was observable for at least 8 h. The negative contrast, clear boundaries, and enhanced observable time might be due to the low permeation of PIH to lesions and the enhanced retention on the surfaces of lesions. Thus, our findings suggest an ICG-based nanoprobe with the potential to diagnose abdominal diseases.

A Dual-Cascade Activatable Near-Infrared Fluorescent Probe for Precise Intraoperative Imaging of Tumor

Accurate intraoperative tumor delineation is critical to achieving successful surgical outcomes. However, conventional techniques typically suffer from poor specificity and low sensitivity and are time-consuming, which greatly affects intraoperative decision-making. Here, we report a cascade activatable near-infrared fluorescent (NIRF) probe IR780SS@CaP that can sequentially respond to tumor acidity and elevated glutathione levels for accurate intraoperative tumor localization. Compared with nonactivatable and single-factor activatable probes, IR780SS@CaP with a cascade strategy can minimize nonspecific activation and false positive signals in a complicated biological environment, affording a superior tumor-to-normal tissue ratio to facilitate the delineation of abdominal metastases. Small metastatic lesions that were less than 1 mm in diameter can be precisely identified by IR780SS@CaP and completely excised under NIRF imaging guidance. This study could benefit tumor diagnosis and image-guided tumor surgery by providing real-time information and reliable decision support, thus reducing the risk of both recurrence and complications to improve patient outcomes.

Cucurbit[8]uril-based supramolecular theranostics

Different from most of the conventional platforms with dissatisfactory theranostic capabilities, supramolecular nanotheranostic systems have unparalleled advantages via the artful combination of supramolecular chemistry and nanotechnology. Benefiting from the tunable stimuli-responsiveness and compatible hierarchical organization, host-guest interactions have developed into the most popular mainstay for constructing supramolecular nanoplatforms. Characterized by the strong and diverse complexation property, cucurbit[8]uril (CB[8]) shows great potential as important building blocks for supramolecular theranostic systems. In this review, we summarize the recent progress of CB[8]-based supramolecular theranostics regarding the design, manufacture and theranostic mechanism. Meanwhile, the current limitations and corresponding reasonable solutions as well as the potential future development are also discussed.

Whole Reconstruction-Free System Design for Direct Positron Emission Imaging From Image Generation to Attenuation Correction

Direct positron emission imaging (dPEI), which does not require a mathematical reconstruction step, is a next-generation molecular imaging modality. To maximize the practical applicability of the dPEI system to clinical practice, we introduce a novel reconstruction-free image-formation method called direct μCompton imaging, which directly localizes the interaction position of Compton scattering from the annihilation photons in a three-dimensional space by utilizing the same compact geometry as that for dPEI, involving ultrafast time-of-flight radiation detectors. This unique imaging method not only provides the anatomical information about an object but can also be applied to attenuation correction of dPEI images. Evaluations through Monte Carlo simulation showed that functional and anatomical hybrid images can be acquired using this multimodal imaging system. By fusing the images, it is possible to simultaneously access various object data, which ensures the synergistic effect of the two imaging methodologies. In addition, attenuation correction improves the quantification of dPEI images. The realization of the whole reconstruction-free imaging system from image generation to quantitative correction provides a new perspective in molecular imaging.

Near-infrared cholangiography with intragallbladder indocyanine green injection in minimally invasive cholecystectomy

Laparoscopic cholecystectomy (LC) remains one of the most commonly performed procedures in adult and paediatric populations. Despite the advances made in intraoperative biliary anatomy recognition, iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems. A series of methods have been proposed to prevent bile duct injury, among them the use of indocyanine green (ICG) fluorescence. The most commonly reported method of ICG injection is the intravenous administration, while literature is lacking studies investigating the direct intragallbladder ICG injection. This narrative mini-review aims to assess the potential applications, usefulness, and limitations of intragallbladder ICG fluorescence in LC. Authors screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy, as well as special issues regarding its use. Literature search retrieved four prospective cohort studies, three case-control studies, and one case report. In the three case-control studies selected, intragallbladder near-infrared cholangiography (NIRC) was compared with standard LC under white light, with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography (IOC). In total, 133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during LC. Literature includes several reports of intragallbladder ICG administration, but a standardized technique has not been established yet. Published data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping, overwhelming limitations of IOC including intervention and radiation exposure, as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG fluorescence. Evidence-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of further studies and multicenter data collection into large registries.

Synthesis and Evaluation of [64Cu]Cu-NOTA-HFn for PET Imaging of Transferrin Receptor 1 Expression in Nasopharyngeal Carcinoma

As recurrent and metastatic nasopharyngeal carcinoma (NPC) is the most common cause of death among patients with NPC, there is an urgent clinical need for the development of precision diagnosis to guide personalized treatment. Recent emerging evidence substantiates the increased expression of transferrin receptor 1 (also known as cluster of differentiation 71, CD71) within tumor tissues and the inherent targeting capability of natural heavy-chain ferritin (HFn) toward CD71. This study aimed to synthesize and assess a radiotracer ([64Cu]Cu-NOTA-HFn) designed to target CD71 for positron emission tomography (PET) imaging in an NPC tumor-bearing mouse model. The entire radiolabeling process of [64Cu]Cu-NOTA-HFn was completed within 15 min with high yield (>98.5%) and high molar activity (72.96 ± 21.33 GBq/μmol). The in vitro solubility and stability experiments indicated that [64Cu]Cu-NOTA-HFn had a high water solubility (log P = -2.42 ± 0.52, n = 6) and good stability in phosphate-buffered saline (PBS) for up to 48 h. The cell saturation binding assay indicated that [64Cu]Cu-NOTA-HFn had a nanomolar affinity (Kd = 10.9 ± 6.1 nM) for CD71-overexpressing C666-1 cells. To test the target engagement in vivo, prolonged-time PET imaging was performed at 1, 6, 12, 24, and 36 h postinjection (p.i.) of [64Cu]Cu-NOTA-HFn to C666-1 NPC tumor-bearing mice. The C666-1 tumors could be visualized by [64Cu]Cu-NOTA-HFn and blocked by nonradiolabeled HFn. PET imaging quantitative analysis demonstrated that the uptake of [64Cu]Cu-NOTA-HFn in C666-1 tumors peaked at 6 h p.i. and the best radioactive tumor-to-muscle ratio was 10.53 ± 3.11 (n = 3). Ex vivo biodistribution assay at 6 h p.i. showed that the tumor uptakes were 1.43 ± 0.23%ID/g in the nonblock group and 0.92 ± 0.2%ID/g in the block group (n = 3, p < 0.05). Immunohistochemistry and immunofluorescence staining confirmed positive expression of CD71 and the uptake of HFn in C666-1 tumor tissues. In conclusion, our experiments demonstrated that [64Cu]Cu-NOTA-HFn possesses a very high target engagement for CD71-positive NPC tumors and provided a fundamental basis for further clinical translation.

Computer-Aided Multiphoton Microscopy Diagnosis of 5 Different Primary Architecture Subtypes of Meningiomas

Meningiomas rank among the most common intracranial tumors, and surgery stands as the primary treatment modality for meningiomas. The precise subtyping and diagnosis of meningiomas, both before and during surgery, play a pivotal role in enabling neurosurgeons choose the optimal surgical program. In this study, we utilized multiphoton microscopy (MPM) based on 2-photon excited fluorescence and second-harmonic generation to identify 5 common meningioma subtypes. The morphological features of these subtypes were depicted using the MPM multichannel mode. Additionally, we developed 2 distinct programs to quantify collagen content and blood vessel density. Furthermore, the lambda mode of the MPM characterized architectural and spectral features, from which 3 quantitative indicators were extracted. Moreover, we employed machine learning to differentiate meningioma subtypes automatically, achieving high classification accuracy. These findings demonstrate the potential of MPM as a noninvasive diagnostic tool for meningioma subtyping and diagnosis, offering improved accuracy and resolution compared with traditional methods.

Nanocarriers address intracellular barriers for efficient drug delivery, overcoming drug resistance, subcellular targeting and controlled release

The cellular barriers are major bottlenecks for bioactive compounds entering into cells to accomplish their biological functions, which limits their biomedical applications. Nanocarriers have demonstrated high potential and benefits for encapsulating bioactive compounds and efficiently delivering them into target cells by overcoming a cascade of intracellular barriers to achieve desirable therapeutic and diagnostic effects. In this review, we introduce the cellular barriers ahead of drug delivery and nanocarriers, as well as summarize recent advances and strategies of nanocarriers for increasing internalization with cells, promoting intracellular trafficking, overcoming drug resistance, targeting subcellular locations and controlled drug release. Lastly, the future perspectives of nanocarriers for intracellular drug delivery are discussed, which mainly focus on potential challenges and future directions. Our review presents an overview of intracellular drug delivery by nanocarriers, which may encourage the future development of nanocarriers for efficient and precision drug delivery into a wide range of cells and subcellular targets.

In-vivo correlations of fluorescent or radioisotope glucose-analogs in imaging cancer metabolism

OBJECTIVE

To investigate the impact of different tracer modifications on the imaging of cancer metabolism, focusing on the comparison of fluorescent glucose-analog tracers (2-NBDG and 2-DG-750) and the radiolabeled tracer 18F-FDG in both in-vitro and in-vivo settings.

METHODS

We conducted an in-vitro comparative study using four cancer cell lines, each with unique glucose uptake characteristics. The study involved direct comparison of three tracers: 2-NBDG, 2-DG-750 and 18F-FDG, examining their internalization behaviors, metabolic functionality and localization effects in cancer metabolism imaging.

RESULTS

The study revealed that each tracer exhibits distinct internalization behaviors correlated with imaging label size and type. 18F-FDG showed the highest uptake efficiency. Fluorescent molecules were found to accumulate in tumors primarily due to hydrophobic interactions and possible aggregation, indicating inefficiency in metabolism and suitability for imaging metabolic phenomena when compared to radiolabeled biomolecules.

CONCLUSION

Our findings demonstrate that despite certain impracticalities, nuclear imaging, particularly using radiolabeled biomolecules like 18F-FDG, offers significant potential for accurately capturing biological phenomena. This is crucial for future advancements in both clinical and research settings. The study emphasizes the limitations of fluorescent molecules in imaging metabolic activities due to their inefficient metabolism and aggregation tendencies.