Near-infrared fluorescence probes for surgical navigation

Optical imaging is a promising tool for visualizing fundamental biological processes including disease progression, detection of tumors, and therapeutic monitoring non-invasively. Unlike visible light, near-infrared fluorescence (NIRF) imaging (beyond 700–1,700 nm) offers a competitive advantage to yield high-resolution images within a certain penetration depth (few millimeters to centimeters depending on NIR window). The last few years have witnessed rapid development of new NIRF probes within the span of whole NIR window, including small-molecule dyes, inorganic nanoparticles, and organic macromolecules. Benefitted by this, we observe a continual surge in the number of preclinical and clinical studies of NIRF imaging in surgery and related applications. At present, NIRF-guided imaging has emerged as a quintessential procedure to assist surgeons for intraoperative delineation and resection of tumors. Moreover, NIRF imaging is also used to improve the intraoperative staging, identify the hidden lesion in diseased organs, map lymph node metastases, detect tumor margins, and highlight vital organs intraoperatively. Considering rapid advancement of this field, we review recent progress in the development of NIRF probes, cancer-targeting strategies and their application for surgical navigation, particularly for the sentinel lymph node mapping, detection of tumors, and angiography. Moreover, we spotlight surgical navigation instrumentation that is currently used for intraoperative tumor detection.