Complex molecular and metabolic phenotypes depict cancers as a constellation of different diseases with common themes. Precision imaging of such phenotypes requires flexible and tunable modalities capable of identifying phenotypic fingerprints by using a restricted number of parameters while ensuring sensitivity to dynamic biological regulation. Common phenotypes can be detected by in vivo imaging technologies, and effectively define the emerging standards for disease classification and patient stratification in radiology. However, for the imaging data to accurately represent a complex fingerprint, the individual imaging parameters need to be measured and analysed in relation to their wider spatial and molecular context. In this respect, targeted palettes of molecular imaging probes facilitate the detection of heterogeneity in oncogene-driven alterations and their response to treatment, and lead to the expansion of rational-design elements for the combination of imaging experiments. In this Review, we evaluate criteria for conducting multiplexed imaging, and discuss its opportunities for improving patient diagnosis and the monitoring of therapy.

复杂的分子和代谢表型将癌症描述为具有共同主题的不同疾病的星座。此类表型的精确成像需要灵活且可调节的模式，这些模式能够通过使用有限数量的参数来识别表型指纹，同时确保对动态生物调节的敏感性。常见的表型可以通过体内成像技术进行检测，并有效地定义了放射学中疾病分类和患者分层的新兴标准。然而，为了使成像数据准确地表示复杂的指纹，需要相对于其更宽的空间和分子环境来测量和分析各个成像参数。在这方面，分子成像探针的靶向调色板有助于检测癌基因驱动的改变中的异质性及其对治疗的反应，并导致结合成像实验的合理设计元素的扩展。在这篇综述中，我们评估了进行多重成像的标准，并讨论了其改善患者诊断和治疗监测的机会。