A team from Fudan University and Shanghai Huashan Hospital has developed a surgical imaging technique that visualizes liver tumour boundaries in real time without injecting contrast agents. The method, called Tissue Autofluorescence NIR‑II Imaging (TANI), exploits differences in endogenous fluorescence emitted by tissues in the second near‑infrared window (NIR‑II, 1,000–1,700 nm) to render malignant lesions with high contrast during operations.
The researchers report that TANI produces clear delineation of multiple types of malignant liver tumours while suppressing common sources of intraoperative interference such as blood and bile contamination, the background signal from cirrhotic tissue and confusing signals from benign lesions. Their findings were published in Nature Biomedical Engineering under the title "Marker‑free tissue NIR‑II autofluorescence imaging for visualization of human liver malignant tumours."
For practising surgeons, the practical benefits are immediate: unlike conventional fluorescence guidance that relies on injected dyes such as indocyanine green (ICG), TANI requires no exogenous tracer, avoiding the waiting times, dosing uncertainties and rare allergic or renal complications associated with contrast agents. NIR‑II wavelengths also scatter less and penetrate deeper into tissue than visible or first‑window near‑infrared light, yielding sharper images of subsurface structures.
Liver cancer is a major global health burden, and in East Asia it is a leading cause of cancer mortality. Complete surgical resection remains the best chance of cure for many patients, but positive or uncertain margins are a major driver of local recurrence. Anything that improves intraoperative confidence about where tumour ends and healthy liver begins could translate into fewer incomplete resections and better long‑term outcomes.
The work builds on growing interest in label‑free optical diagnostics that read native biochemical and structural contrast in tissue. Endogenous fluorophores—molecules such as certain porphyrins, metabolic cofactors and bile pigments—give rise to autofluorescence signals whose strength and spectral character differ between tumour and non‑tumour tissue. TANI leverages those subtle contrasts in the NIR‑II band and pairs them with imaging hardware and algorithms tuned for the operating theatre.
Important caveats remain. The published report demonstrates feasibility and promising contrast, but broader clinical validation will be needed across larger patient cohorts, tumour subtypes and surgical settings. Practical adoption will hinge on integration of specialised NIR‑II cameras into theatre suites, regulatory approval, cost considerations and training for surgical teams accustomed to ultrasound and dye‑based fluorescence methods.
If those hurdles are cleared, the technology could reshape fluorescence‑guided liver surgery by removing the need for injected contrast, shortening set‑up times and making margin visualisation more robust in the messy, blood‑soaked environment of open or laparoscopic liver resections. Commercialisation and multicentre trials will determine how quickly TANI moves from an academic advance to a standard operating‑room tool.
Beyond liver surgery, the broader significance is that label‑free NIR‑II imaging may provide a platform for intraoperative decision‑making in other organs where endogenous optical contrast is exploitable. That prospect will attract attention from device makers, surgical oncologists and health systems seeking cost‑effective ways to improve oncologic outcomes.