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Advances in NIR-II Fluorescence Laparoscopy for Precision Diagnosis and Theranostics of Urological Oncology
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DOI：10.2147/ijn.s628675.png)
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Abstract
En 中文
Precision surgical intervention in urological oncology is inherently constrained by the limited penetration depth and lack of tactile feedback in traditional endoscopy. Near infrared II (NIR-II, 1000– 1700 nm) fluorescence laparoscopy overcomes these limitations by drastically suppressing photon scattering and tissue auto-fluorescence, facilitating sub-millimeter deep-tissue navigation. However, navigating the urological system requires circumventing unique physiological barriers, notably dense adipose encapsulation and fluid-filled cavities. This review comprehensively evaluates the translational integration of high-performance InGaAs hardware architectures and advanced nanomedicines designed to conquer these specialized anatomical niches. We trace the evolution of NIR-II molecular probes from leveraging the tail fluorescence of ICG to biomarker-driven active targeting (eg, PSMA, CAIX, Nectin-4) and tumor micro-environment (TME)-responsive smart nanoplatforms. By meticulously modulating supramolecular physical chemistry, such as leveraging lipid critical packing parameter (CPP) phase transitions and mitigating aggregation-caused quenching (ACQ). These platforms achieve spatially synchronized diagnostic imaging and targeted phototheranostic ablation. Preclinically and in early human trials, this synergy enables precise primary lesion delineation, trans-adipose pelvic lymph node mapping, and neurovascular bundle (NVB) preservation across prostate, renal, and bladder malignancies. It also fosters systemic anti-tumor immunity through immunogenic cell death. Despite these breakthroughs, broad clinical translation remains impeded by formidable nanotoxicological hurdles, particularly reticuloendothelial system sequestration and the accelerated blood clearance (ABC) phenomenon, alongside robotic surgery integration challenges. To rewrite standard-of-care guidelines, future paradigms must prioritize "safe-by-design” architectures, logic-gated multi-receptor targeting to eliminate diagnostic ambiguity, and large-scale, multicenter randomized controlled trials evaluating long-term oncological outcomes.
Keywords:
NIR-II fluorescence imaging
nanotheranostics
image-guided surgery
urological oncology
stimuli-responsive nanomedicine
translational nanotoxicology
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6.5
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4.2W
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