Highly sensitive detection of small, deep tumors for early diagnosis and surgical interventions remains a challenge for conventional imaging modalities. Second-window near-infrared light (NIR2, 950-1,400 nm) is promising for in vivo fluorescence imaging due to deep tissue penetration and low tissue autofluorescence. With their intrinsic fluorescence in the NIR2 regime and lack of photobleaching, single-walled carbon nanotubes (SWNTs) are potentially attractive contrast agents to detect tumors. Here, targeted M13 virus-stabilized SWNTs are used to visualize deep, disseminated tumors in vivo. This targeted nanoprobe, which uses M13 to stably display both tumor-targeting peptides and an SWNT imaging probe, demonstrates excellent tumor-to-background uptake and exhibits higher signal-to-noise performance compared with visible and near-infrared (NIR1) dyes for delineating tumor nodules. Detection and excision of tumors by a gynecological surgeon improved with SWNT image guidance and led to the identification of submillimeter tumors. Collectively, these findings demonstrate the promise of targeted SWNT nanoprobes for noninvasive disease monitoring and guided surgery.cancer imaging | fluorescence-guided surgery | M13 bacteriophage I n clinical oncology, in vivo fluorescence imaging has emerged as a valuable tool for improving diagnosis, staging tumors, monitoring response to therapy, and detecting recurrent or residual disease. Compared with existing imaging modalities, fluorescence imaging offers a low-cost, portable, and safe alternative (i.e., nonionizing radiation), with key advantages including realtime imaging, superior resolution, and high specificity for small tumor nodules during diagnostic and intraoperative surgical procedures (1, 2). Although efforts have focused on using visible and short near-infrared (NIR1, 650-900 nm) wavelength fluorescent dyes as contrast agents for delineating tumor margins in both preclinical cancer models (2, 3) and human patients (4), these agents are suboptimal for noninvasive, reflectance-based imaging due to limited penetration depth (3-5 mm) and high tissue autofluorescence. During intraoperative surgery, these dyes may additionally undergo photobleaching, thereby reducing the ability of the surgeon to readily locate and resect tumors. Alternative approaches to specifically permit noninvasive imaging and limited photobleaching would be highly desirable for diagnostic and surgical applications.Single-walled carbon nanotubes (SWNTs) hold great promise as fluorescence imaging agents due to the large interband difference between their excitation and emission wavelengths, resulting in minimal spectral overlap and tissue autofluorescence. In particular, the low tissue autofluorescence observed with SWNTs greatly enhances target-to-background ratios (TBRs) necessary for improved detection of small tumor nodules in confined anatomic regions. SWNT emission at longer wavelengths in the near-infrared second window (NIR2, 950-1,400 nm) results in less optical scattering and deeper tissue p...