Fluorescence imaging for liver diseases: probe design strategies and diagnostic applications

Liver diseases, encompassing hepatocellular carcinoma, hepatic fibrosis, and metabolic dysfunction-associated steatotic liver disease, constitute a severe global health burden, for which early and accurate diagnosis is in urgent need. Conventional methods are constrained by the invasiveness of biopsy or insufficient spatial resolution of non-invasive imaging, failing to detect early micro-lesions and track pathological progression. Fluorescence imaging features high spatiotemporal resolution, real-time monitoring, and favorable compatibility with small-molecule and nanoscale fluorescent probes, yet its advancement is hampered by fragmented studies that separate probe design parameters from disease-specific requirements. This review coherently integrates two interdependent core modules. The first systematically summarizes liver-adapted probe design strategies, including molecular optimization and nanomaterial engineering, such as spectral optimization for deep hepatic tissue penetration, stimuli-responsive mechanisms for pathological microenvironment recognition, and biocompatibility enhancement for in vivo applicability. The second demonstrates probe applications in the three liver diseases, establishing solid connections between probe design features and disease-specific pathological characteristics. Key challenges and future directions are briefly addressed. This work provides a structured reference for researchers to optimize liver-specific fluorescent probes and explore disease-matched imaging applications.