Molecular
imaging is advantageous for screening diseases such as
breast cancer by providing precise spatial information on disease-associated
biomarkers, something neither blood tests nor anatomical imaging can
achieve. However, the high cost and risks of ionizing radiation for
several molecular imaging modalities have prevented a feasible and
scalable approach for screening. Clinical studies have demonstrated
the ability to detect breast tumors using nonspecific probes such
as indocyanine green, but the lack of molecular information and required
intravenous contrast agent does not provide a significant benefit
over current noninvasive imaging techniques. Here we demonstrate that
negatively charged sulfate groups, commonly used to improve solubility
of near-infrared fluorophores, enable sufficient oral absorption and
targeting of fluorescent molecular imaging agents for completely noninvasive
detection of diseased tissue such as breast cancer. These functional
groups improve the pharmacokinetic properties of affinity ligands
to achieve targeting efficiencies compatible with clinical imaging
devices using safe, nonionizing radiation (near-infrared light). Together,
this enables development of a “disease screening pill”
capable of oral absorption and systemic availability, target binding,
background clearance, and imaging at clinically relevant depths for
breast cancer screening. This approach should be adaptable to other
molecular targets and diseases for use as a new class of screening
agents.