Molecular and Functional Imaging and Theranostics of the Tumor Microenvironment

Abstract The tumor microenvironment (TME) is a dynamic structure that is highly interactive with cancer cells and is shaped to a large extent by these cells. Abnormal vasculature, hypoxia, acidic extracellular pH, an altered extracellular matrix, and stromal cells such as cancer-associated fibroblasts, macrophages, and immune cells are some of the characteristics of the TME. These characteristics contribute significantly to cancer progression but also provide novel opportunities for cancer-specific therapeutic strategies. The fluidity of the TME, with its spatial and temporal heterogeneities, makes noninvasive molecular and functional imaging technologies highly important to image TME components and to develop image-guided theranostic strategies for cancer-specific precision treatments. Here we have reviewed the characteristics of the TME, the imaging modalities available to visualize the TME components, and the theranostic strategies that are available for image-guided therapy of the TME.