Imaging the fate of CAR-T cells in vivo

Despite the remarkable therapeutic efficacy of chimeric antigen receptor T (CAR-T) cell therapy in hematologic malignancies, its clinical translation in solid tumors remains impeded by challenges including insufficient intratumoral infiltration, tumor heterogeneity, and the immunosuppressive tumor microenvironment. Molecular imaging, which enables the visualization and quantitative analysis of the in vivo behavior of CAR-T cells, serves as a critical prerequisite for advancing the clinical application of CAR-T cell therapy in solid tumors. This review summarizes recent advances in molecular imaging techniques for monitoring the in vivo fate of CAR-T cells, covering their dynamic distribution, tumor recognition, and real-time functional activity. Additionally, the potential clinical value and current limitations of these approaches are discussed. It is proposed that this interdisciplinary integration may improve the precision of therapeutic response assessment and facilitate the optimization of personalized treatment strategies in the context of CAR-T cell therapy.