Clinical fluorescent probes: mechanisms, advantages and inspirations

Area of Science:

• Oncology
• Surgical Innovation
• Medical Imaging

Background:

• Fluorescence imaging offers superior guidance in oncologic surgery compared to traditional methods.
• Clinical translation of fluorescence probes is hindered by limited regulatory approvals and design challenges.
• Existing probes face limitations in addressing tumor heterogeneity, occult margins, and deep-seated lesions.

Purpose of the Study:

• To review current clinical fluorescence probes across six major organ systems.
• To analyze challenges, strategies, efficacy metrics, and functional extensions of these probes.
• To compare clinical and non-clinical probes and identify gaps for future development.

Main Methods:

• Utilized a challenges-strategy-efficacy-comparison framework for review.
• Examined probes across nervous, circulatory, respiratory, digestive, reproductive, and urinary systems.
• Analyzed clinical quantitative efficacy metrics and functional probe extensions.

Main Results:

• Identified key surgical challenges including tumor heterogeneity and occult margins.
• Highlighted strategies such as ligand targeting, activatable chemistries, and theranostic integration.
• Evaluated efficacy based on distinction, biosafety, signal-to-noise ratio, and operational compatibility.

Conclusions:

• Fluorescent probes play a critical role in enhancing tumor removal during surgery.
• Insights from clinical probe advantages can inspire next-generation probe development.
• Guidance is provided to accelerate the clinical translation of advanced fluorescent probes.