Abstract / Summary
Although magnetic resonance imaging (MRI) remains indispensable in oncology, conventional contrast agents lack the biological specificity required to resolve cellular-level pathological events. This review critically examines pivotal advances (2023–2026) in activatable biomaterial-based MRI nanoprobes for precision theranostics. These intelligent platforms convert tumor-associated biological cues into high-fidelity imaging signals while simultaneously enabling targeted therapeutic interventions. We dissect key structural and compositional innovations, spanning high-relaxivity metal-chelating assemblies, zero-background 19 F MRI platforms, and inherently biocompatible, metal-free organic radicals, alongside their controlled activation via microenvironment-responsive, logic-gate architectures. Importantly, we delineate a conceptual shift from tumor-centric imaging toward non-invasive mapping of tumor immune microenvironment dynamics—including macrophage polarization and inflammatory responses—to track immunotherapy efficacy and provide real-time theranostic feedback. Furthermore, we explore how machine learning algorithms serve as a transformative toolkit to accelerate de novo probe design, refine signal quantification, and decipher tumor microenvironment heterogeneity. Finally, to bridge the lab-to-clinic chasm, we benchmark clinical precedents such as AGuIX and ferumoxytol to establish translation-ready design principles for engineering nanoprobes as “imaging drugs” that deliver reproducible, clinically actionable endpoints for precision oncology.