Hossein Omidian, Erma J. Gill
Accurate tumor visualization remains a central challenge in oncology, as single-modality imaging often lacks the depth, sensitivity, and specificity needed for precise therapeutic guidance. Nano-theranostic platforms address this by combining multimodal imaging with tumor-responsive activation and therapeutic functions within a single system. Advances in carbon-based nanomaterials, metallic and metal oxide nanoplatforms, polymeric and lipid carriers, and biomimetic architectures enable integration of fluorescence (FL), near-infrared II fluorescence (NIR-II FL), photoacoustic (PA), magnetic resonance (MRI), computed tomography (CT), and ultrasound (US) imaging for comprehensive anatomical, functional, and molecular tumor characterization. Coupled with photothermal therapy (PTT), photodynamic therapy (PDT), chemo-dynamic therapy (CDT), ferroptosis induction, metabolic modulation, gas-based therapeutics, and immune activation, these nanoplatforms transform imaging from a passive diagnostic tool into an active, feedback-regulated therapeutic modality. This review outlines the mechanistic foundations, integrated functionalities, and preclinical significance of synergistic imaging-guided nano-theranostics. We also highlight emerging priorities-including adaptive closed-loop platforms, streamlined multifunctional designs, immunotherapy integration, and scalable, biocompatible manufacturing-to advance clinically viable nano-theranostics for precision oncology.