<p>New biomedical imaging technologies require a platform with high sensitivity, tunability, and multiplexing to sensitise to small molecule and cellular signals. Traditional bioimaging modalities are usually characterized by a poor spatial resolution and suboptimal contrast with weakly scattering biological structures. In this paper, we suggest a platform of tunable optical metasurfaces with coupled plasmonic modes to realize better bioimaging sensitivity. The system offers good confinement of the near-field and controllable resonance frequencies through the engineering of hybrid plasmonic resonances at the metasurface interface. This allows the selective amplification of optical signals of biomolecules with low background interference. Resonance splitting, field enhancement and spectral tunability are described using coupled plasmon hybridization theory and numerical modeling. Approaches to fabrication of noble-metal nanostructures, layers of graphene, and dielectric surfaces are described, as well as tuning schemes based on voltage as well as strain. Computer simulations indicate that sensitivity and signal-to-noise increase by orders of magnitude over the traditional plasmonic substrates, and limit-of-detection limits approach the femtomolar range. Areas of potential use are early cancer biomarker detection, neural imaging, and multiplexed biosensing. The tunable metasurface framework is a step toward real-time, high throughput, portable bioimaging platforms in clinical diagnostics.</p>