Due to the growing toolkit of targeted contrast agents, molecular imaging continues to play a prominent role in the clinical
care of cancer. Peptide-based imaging approaches are of particular significance due to their favorable pharmacokinetic properties,
established manufacturing infrastructure, and documented clinical success in whole-body imaging. A logical extension of molecular
imaging with peptides is to improve surgical outcomes in cancer through highly sensitive and specific probes which can be used
intraoperatively. Advances in fluorescent imaging have resulted in various peptide labeling strategies with intraoperative indications. In
this review, we focused on the evolving design of peptide imaging agents starting with the clinically used somatostatin targeting peptides.
We then review the current synthetic approaches used for dual-labeled agent development and offer perspectives on optimal protection
schemes that can be used for multimodal probe development.
Keywords: Dual-labeling, molecular imaging, multimodality, peptides, near-infrared fluorescence, nuclear imaging, cancer, Peptide-based imaging, pharmacokinetic properties, surgical outcomes
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