Non-invasive active surveillance and risk-stratification of drug-resistant colon cancer is imperative, in order to facilitate disease management and tailor therapeutic interventions. This research demonstrates that acquired drug resistance in colon cancer is associated with enhanced expression of extracellular matrix oncoprotein extradomain-B fibronectin (EDB-FN). MR molecular imaging of EDB-FN at a subclinical dose of macrocyclic ZD2-targeted contrast agent ZD2-N3-Gd(HP-DO3A) facilitates effective assessment of drug-resistant colon cancer in two independent models, highlighting the potential of EDB-FN as a diagnostic molecular marker for invasive colon cancer.
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