Zhu Li, Jiang Yu, Tian Haijun, Yu Yongle, Gan Ye, Li Hong, Yuan Mingqing, Huang Xialing, Liu Xu
Guangxi Key Laboratory of Special Biomedicine; School of Medicine, Guangxi University, Nanning, Guangxi Zhuang Autonomous Region, 530004, People's Republic of China.
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
Int J Nanomedicine. 2025 Aug 29;20:10503-10540. doi: 10.2147/IJN.S529003. eCollection 2025.
Cancer remains one of the leading causes of mortality worldwide. Although conventional treatment strategies such as chemotherapy, radiotherapy, and surgery have demonstrated therapeutic potential, their clinical effectiveness is often limited by poor targeting specificity, systemic toxicity, and inadequate treatment monitoring. Magnetic resonance imaging (MRI) has emerged as a powerful diagnostic modality owing to its non-invasive nature, high spatial resolution, deep tissue penetration, and real-time imaging capabilities, making it particularly suitable for guiding and evaluating cancer therapies. Recent advances have led to the development of MRI-based nanotheranostic platforms that integrate diagnostic and therapeutic functions within a single system, enabling precise tumor imaging alongside targeted treatment. This review presents a comprehensive overview of recent progress in MRI-guided nanotheranostic agents for cancer diagnosis and therapy, with a focus on their structural design, functional mechanisms, and biomedical applications in both single treatment approaches such as photothermal therapy, photodynamic therapy, chemodynamic therapy, immunotherapy, and ferroptosis, as well as combined therapeutic strategies. In addition, the contribution of MRI to improving treatment precision through image-guided delivery, real-time therapeutic monitoring, and stimulus-responsive activation is discussed. Key challenges including biosafety, design complexity, and barriers to clinical translation are also examined, along with perspectives on future directions for developing intelligent and clinically viable MRI-integrated therapeutic systems.
癌症仍然是全球主要的死亡原因之一。尽管化疗、放疗和手术等传统治疗策略已显示出治疗潜力,但其临床疗效往往受到靶向特异性差、全身毒性和治疗监测不足的限制。磁共振成像(MRI)因其非侵入性、高空间分辨率、深层组织穿透能力和实时成像能力,已成为一种强大的诊断方式,使其特别适合用于指导和评估癌症治疗。最近的进展促使基于MRI的纳米诊疗平台的发展,该平台在单个系统中整合了诊断和治疗功能,能够在进行靶向治疗的同时实现精确的肿瘤成像。本文综述了用于癌症诊断和治疗的MRI引导纳米诊疗剂的最新进展,重点介绍了它们的结构设计、功能机制以及在光热疗法、光动力疗法、化学动力疗法、免疫疗法和铁死亡等单一治疗方法以及联合治疗策略中的生物医学应用。此外,还讨论了MRI通过图像引导给药、实时治疗监测和刺激响应激活对提高治疗精度的贡献。还研究了包括生物安全性、设计复杂性和临床转化障碍在内的关键挑战,以及开发智能且具有临床可行性的MRI集成治疗系统的未来方向。