Recent Advances in Interventional Fluorescence Imaging: Toward the Precise Visualization of Transarterial Mini-Invasive Delivery Systems

ConspectusInterventional fluorescence imaging has gradually developed into a promising imaging strategy for the diagnosis of diseases in clinic. This strategy could benefit interventional targeted treatment because of the clear display of microstructures at the margins and boundaries. There are some stranded crucial issues in clinical application: (i) fast clearance of fluorescence probes; (ii) light instability and photobleaching; and (iii) residual and microsatellite lesions. The development of superstable homogeneous intermixed formulation technology (SHIFT) can solve the aforementioned clinical problems for precision hepatectomy. Interventional fluorescence imaging based on SHIFT-prepared product has some advantages such as (i) strong stability, (ii) greatly extending imageable time window, and (iii) precisely visualizing microsatellite lesions. In this Account, we overview our current progress in interventional fluorescence imaging based on SHIFT method for surgical resection following long-lasting embolization conversion. To greatly realize interventional fluorescence imaging, we summarize clinical and preclinical application of interventional fluorescence imaging in a transarterial delivery system. Indeed, compared with conventional fluorescence imaging, interventional fluorescence imaging possesses non-negligible strengths on improved intensity in target location and step-down systemic toxicity. Unfortunately, a challenging issue is that immobile fluorescence performance is difficult to maintain after long-time embolization, resulting in a failed hepatectomy. On this basis, associated with our previous research, SHIFT was proposed and developed. Thus, we detailedly introduce and account the development and preponderance of SHIFT on interventional fluorescence imaging. Predictably, after lengthy embolization, its lightful fluorescence was still observable in tumor targets of a clinical trial. To regulate the fluorescence rendering of microsatellite lesion, SHIFT combining with pure nanoprobes (nanoICG) occurs, namely SHIFT nanoICG, and we dwell on its performance in transarterial invasive surgical navigation and its clinical application under interventional fluorescence imaging compared with conventional indocyanine green (ICG) formulations. Amazingly, the SHIFT nanoICG brings us an extraordinary imaging consequence for deep-seated tumor tissues and imperceptible microsatellite lesions. Finally, we offer perspectives on the future tendency of interventional imaging-guided SHIFT products in clinical translation such as chemoembolization, radioembolization, and immunotherapy. Actually, these directions have been underway for some time, and even relative products are already applied for clinical trials, exhibiting effective therapeutic outcomes. Our green high-performance SHIFT products are concentrated on meeting clinical needs and solving clinical problems, breaking through the cure limitations of patients with advanced diseases. Thus, the discovery offers insight into the development and superiority of SHIFT products under interventional fluorescence imaging and simultaneously provides a new view on the development of clinically pragmatic products.