All-optical forward-viewing photoacoustic probe for high-resolution 3D endoscopy

Phonon imaging in 3D with a fibre probe

We show for the first time that a single ultrasonic imaging fibre is capable of simultaneously accessing 3D spatial information and mechanical properties from microscopic objects. The novel measurement system consists of two ultrafast lasers that excite and detect high-frequency ultrasound from a nano-transducer that was fabricated onto the tip of a single-mode optical fibre. A signal processing technique was also developed to extract nanometric in-depth spatial measurements from GHz frequency acoustic waves, while still allowing Brillouin spectroscopy in the frequency domain. Label-free and non-contact imaging performance was demonstrated on various polymer microstructures. This singular device is equipped with optical lateral resolution, 2.5 μm, and a depth-profiling precision of 45 nm provided by acoustics. The endoscopic potential for this device is exhibited by extrapolating the single fibre to tens of thousands of fibres in an imaging bundle. Such a device catalyses future phonon endomicroscopy technology that brings the prospect of label-free in vivo histology within reach.

Broadband All-Optical Plane-Wave Ultrasound Imaging System Based on a Fabry-Perot Scanner

A broadband all-optical plane-wave ultrasound imaging system for high-resolution 3-D imaging of biological tissues is presented. The system is based on a planar Fabry-Perot (FP) scanner for ultrasound detection and the photoacoustic generation of ultrasound in a carbon-nanotube-polydimethylsiloxane (CNT-PDMS) composite film. The FP sensor head was coated with the CNT-PDMS film which acts as an ultrasound transmitting layer for pulse-echo imaging. Exciting the CNT-PDMS coating with nanosecond laser pulses generated monopolar plane-wave ultrasound pulses with MPa-range peak pressures and a -6-dB bandwidth of 22 MHz, which were transmitted into the target. The resulting scattered acoustic field was detected across a 15 mm ×15 mm scan area with a step size of 100 [Formula: see text] and an optically defined element size of [Formula: see text]. The -3-dB bandwidth of the sensor was 30 MHz. A 3-D image of the scatterer distribution was then recovered using a k -space reconstruction algorithm. To obtain a measure of spatial resolution, the instrument line-spread function (LSF) was measured as a function of position. At the center of the scan area, the depth-dependent lateral LSF ranged from 46 to 65 [Formula: see text] for depths between 1 and 12 mm. The vertical LSF was independent of position and measured to be [Formula: see text] over the entire field of view. To demonstrate the ability of the system to provide high-resolution 3-D images, phantoms with well-defined scattering structures of arbitrary geometry were imaged. To demonstrate its suitability for imaging biological tissues, phantoms with similar impedance mismatches, sound speed and scattering properties to those present in the tissue, and ex vivo tissue samples were imaged. Compared with conventional piezoelectric-based ultrasound scanners, this approach offers the potential for improved image quality and higher resolution for superficial tissue imaging. Since the FP scanner is capable of high-resolution 3-D photoacoustic imaging of in vivo biological tissues, the system could ultimately be developed into an instrument for dual-mode all-optical ultrasound and photoacoustic imaging.

Photoacoustic-guided surgery from head to toe [Invited]

Photoacoustic imaging-the combination of optics and acoustics to visualize differences in optical absorption - has recently demonstrated strong viability as a promising method to provide critical guidance of multiple surgeries and procedures. Benefits include its potential to assist with tumor resection, identify hemorrhaged and ablated tissue, visualize metal implants (e.g., needle tips, tool tips, brachytherapy seeds), track catheter tips, and avoid accidental injury to critical subsurface anatomy (e.g., major vessels and nerves hidden by tissue during surgery). These benefits are significant because they reduce surgical error, associated surgery-related complications (e.g., cancer recurrence, paralysis, excessive bleeding), and accidental patient death in the operating room. This invited review covers multiple aspects of the use of photoacoustic imaging to guide both surgical and related non-surgical interventions. Applicable organ systems span structures within the head to contents of the toes, with an eye toward surgical and interventional translation for the benefit of patients and for use in operating rooms and interventional suites worldwide. We additionally include a critical discussion of complete systems and tools needed to maximize the success of surgical and interventional applications of photoacoustic-based technology, spanning light delivery, acoustic detection, and robotic methods. Multiple enabling hardware and software integration components are also discussed, concluding with a summary and future outlook based on the current state of technological developments, recent achievements, and possible new directions.

Dynamic acoustic focusing in photoacoustic transmitter

Photoacoustic transmitter represents a promising substitute for conventional piezoelectric counterparts. However, lack of easy and effective method for dynamically manipulating the focused acoustic field is a common and tricky problem faced by current photoacoustic technology. In this paper, a new strategy for constructing focus tunable photoacoustic transmitter is proposed. Different from existed prevailing device architecture, a sandwich like photoacoustic conversion layer is innovatively designed into a suspending elastic membrane with clamped boundary and it can be deformed using integrated pneumatic actuator. Owing to the membrane deflection property, concave spherical contours with variable radius of curvature can be obtained. Considering the shape determined sound emission characteristic, continuous tuning on the axial focusing length of the acoustic field has been successfully demonstrated in the photoacoustic transmitter for the first time. Besides, acoustic signal with significantly improved negative pressure has also been achieved especially at the focus, bringing additional advantage for applications.

Forward-Looking Multimodal Endoscopic System Based on Optical Multispectral and High-Frequency Ultrasound Imaging Techniques for Tumor Detection

We developed a forward-looking (FL) multimodal endoscopic system that offers color, spectral classified, high-frequency ultrasound (HFUS) B-mode, and integrated backscattering coefficient (IBC) images for tumor detection in situ. Examination of tumor distributions from the surface of the colon to deeper inside is essential for determining a treatment plan of cancer. For example, the submucosal invasion depth of tumors in addition to the tumor distributions on the colon surface is used as an indicator of whether the endoscopic dissection would be operated. Thus, we devised the FL multimodal endoscopic system to offer information on the tumor distribution from the surface to deep tissue with high accuracy. This system was evaluated with bilayer gelatin phantoms which have different properties at each layer of the phantom in a lateral direction. After evaluating the system with phantoms, it was employed to characterize forty human colon tissues excised from cancer patients. The proposed system could allow us to obtain highly resolved chemical, anatomical, and macro-molecular information on excised colon tissues including tumors, thus enhancing the detection of tumor distributions from the surface to deep tissue. These results suggest that the FL multimodal endoscopic system could be an innovative screening instrument for quantitative tumor characterization.

Ultra-broadband axicon transducer for optoacoustic endoscopy

Image performance in optoacoustic endoscopy depends markedly on the design of the transducer employed. Ideally, high-resolution performance is required over an expanded depth of focus. Current optoacoustic focused transducers achieve lateral resolutions in the range of tens of microns in the mesoscopic regime, but their depth of focus is limited to hundreds of microns by the nature of their spherical geometry. We designed an ultra-broadband axicon detector with a 2 mm central aperture and investigated whether the imaging characteristics exceeded those of a spherical detector of similar size. We show a previously undocumented ability to achieve a broadband elongated pencil-beam optoacoustic sensitivity with an axicon detection geometry, providing approximately 40 μm-lateral resolution maintained over a depth of focus of 950 μm—3.8 times that of the reference spherical detector. This performance could potentially lead to optoacoustic endoscopes that can visualize optical absorption deeper and with higher resolution than any other optical endoscope today.

Photoacoustic Tomography Opening New Paradigms in Biomedical Imaging

After the emergence of the ultrasound, X-ray CT, PET, and MRI, photoacoustic tomography (PAT) is now in the phase of its exponential growth, with its expected full maturation being another form of mainstream clinical imaging modality. By combining the high contrast benefit of optical imaging and the high-resolution deep imaging capability of ultrasound, PAT can provide unprecedented anatomical image contrasts at clinically relevant depths as well as enable the use of a variety of functional and molecular imaging information, which is not possible with conventional imaging modalities. With these strengths, PAT has achieved numerous breakthroughs in various biomedical applications and also provided new technical platforms that may be able to resolve unmet issues in clinics. In this chapter, we provide an overview of the development of PAT technology for several major biomedical applications and provide an approximate projection of the future of PAT.

Sound Out the Deep Colors: Photoacoustic Molecular Imaging at New Depths

Photoacoustic tomography (PAT) has become increasingly popular for molecular imaging due to its unique optical absorption contrast, high spatial resolution, deep imaging depth, and high imaging speed. Yet, the strong optical attenuation of biological tissues has traditionally prevented PAT from penetrating more than a few centimeters and limited its application for studying deeply seated targets. A variety of PAT technologies have been developed to extend the imaging depth, including employing deep-penetrating microwaves and X-ray photons as excitation sources, delivering the light to the inside of the organ, reshaping the light wavefront to better focus into scattering medium, as well as improving the sensitivity of ultrasonic transducers. At the same time, novel optical fluence mapping algorithms and image reconstruction methods have been developed to improve the quantitative accuracy of PAT, which is crucial to recover weak molecular signals at larger depths. The development of highly-absorbing near-infrared PA molecular probes has also flourished to provide high sensitivity and specificity in studying cellular processes. This review aims to introduce the recent developments in deep PA molecular imaging, including novel imaging systems, image processing methods and molecular probes, as well as their representative biomedical applications. Existing challenges and future directions are also discussed.

Towards non-contact photoacoustic imaging [review]

Photoacoustic imaging (PAI) takes advantage of both optical and ultrasound imaging properties to visualize optical absorption with high resolution and contrast. Photoacoustic microscopy (PAM) is usually categorized with all-optical microscopy techniques such as optical coherence tomography or confocal microscopes. Despite offering high sensitivity, novel imaging contrast, and high resolution, PAM is not generally an all-optical imaging method unlike the other microscopy techniques. One of the significant limitations of photoacoustic microscopes arises from their need to be in physical contact with the sample through a coupling media. This physical contact, coupling, or immersion of the sample is undesirable or impractical for many clinical and pre-clinical applications. This also limits the flexibility of photoacoustic techniques to be integrated with other all-optical imaging microscopes for providing complementary imaging contrast. To overcome these limitations, several non-contact photoacoustic signal detection approaches have been proposed. This paper presents a brief overview of current non-contact photoacoustic detection techniques with an emphasis on all-optical detection methods and their associated physical mechanisms.

Photoacoustic imaging with fiber optic technology: A review

Photoacoustic imaging (PAI) has achieved remarkable growth in the past few decades since it takes advantage of both optical and ultrasound (US) imaging. In order to better promote the wide clinical applications of PAI, many miniaturized and portable PAI systems have recently been proposed. Most of these systems utilize fiber optic technologies. Here, we overview the fiber optic technologies used in PAI. This paper discusses three different fiber optic technologies: fiber optic light transmission, fiber optic US transmission, and fiber optic US detection. These fiber optic technologies are analyzed in different PAI modalities including photoacoustic microscopy (PAM), photoacoustic computed tomography (PACT), and minimally invasive photoacoustic imaging (MIPAI).

Evaluation of Reconstruction Methodology for Helical Scan Guided Photoacoustic Endoscopy

Photoacoustic endoscopy (PAE), combining both advantages of optical contrast and acoustic resolution, can visualize the chemical-specific optical information of tissues inside human-body. Recently, its corresponding reconstruction methods have been extensively researched. However, most of them are limited on cylindrical scan trajectories, rather than a helical scan which is more clinically practical. On this note, this article proposes a methodology of imaging reconstruction and evaluation for helical scan guided PAE. Different from traditional reconstruction method, synthetic aperture focusing technique (SAFT), our method reconstructs image using wavefield extrapolation which significantly improves computational efficiency and even takes only 0.25 seconds for 3-D reconstructions. In addition, the proposed evaluation methodology can estimate the resolutions and deviations of reconstructed images in advance, and then can be used to optimize the PAE scan parameters. Groups of simulations as well as ex-vivo experiments with different scan parameters are provided to fully demonstrate the performance of the proposed techniques. The quantitatively measured angular resolutions and deviations agree well with our theoretical derivation results D√{r_s² +h²} / [1.25(r_s r_d +h²)] (rad) and -h l / (r_s r_d +h²) (rad), respectively D,r_d, r_s,h and l represent transducer diameter, radius of scan trajectory, radius of source position, unit helical pitch and the distance from targets to helical scan plane, respectively). This theoretical result also suits for circular and cylindrical scan in case of h = 0 .

Photoacoustic endoscopy: A progress review

Endoscopy has been widely used in biomedical imaging and integrated with various optical and acoustic imaging modalities. Photoacoustic imaging (PAI), one of the fastest growing biomedical imaging modalities, is a noninvasive and nonionizing method that owns rich optical contrast, deep acoustic penetration depth, multiscale and multiparametric imaging capability. Hence, it is preferred to miniaturize the volume of PAI and develop an emerged endoscopic imaging modality referred to as photoacoustic endoscopy (PAE). It has been developed for more than one decade since the first report of PAE. Unfortunately, until now, there is no mature photoacoustic endoscopic technique recognized in clinic due to various technical limitations. To address this concern, recent development of new scanning mechanisms, adoption of novel optical/acoustic devices, utilization of superior computation methods and exploration of multimodality strategies have significantly promoted the progress of PAE toward clinic. In this review, we comprehensively reviewed recent progresses in single- and multimodality PAE with new physics, mechanisms and strategies to achieve practical devices for potential applicable scenarios including esophageal, gastrointestinal, urogenital and intravascular imaging. We ended this review with challenges and prospects for future development of PAE.

Miniature all-optical flexible forward-viewing photoacoustic endoscopy probe for surgical guidance

A miniature flexible photoacoustic endoscopy probe that provides high-resolution 3D images of vascular structures in the forward-viewing configuration is described. A planar Fabry-Perot ultrasound sensor with a -3dB bandwidth of 53 MHz located at the tip of the probe is interrogated via a flexible fiber bundle and a miniature optical relay system to realize an all-optical probe measuring 7.4 mm in outer diameter at the tip. This approach to photoacoustic endoscopy offers advantages over previous piezoelectric based distal-end scanning probes. These include a forward-viewing configuration in widefield photoacoustic tomography mode, finer spatial sampling (87 µm spatial sampling interval), and wider detection bandwidth (53 MHz) than has been achievable with conventional ultrasound detection technology and an all-optical passive imaging head for safe endoscopic use.

A Review of Endogenous and Exogenous Contrast Agents Used in Photoacoustic Tomography with Different Sensing Configurations

Optical-based sensing approaches have long been an indispensable way to detect molecules in biological tissues for various biomedical research and applications. The advancement in optical microscopy is one of the main drivers for discoveries and innovations in both life science and biomedical imaging. However, the shallow imaging depth due to the use of ballistic photons fundamentally limits optical imaging approaches’ translational potential to a clinical setting. Photoacoustic (PA) tomography (PAT) is a rapidly growing hybrid imaging modality that is capable of acoustically detecting optical contrast. PAT uniquely enjoys high-resolution deep-tissue imaging owing to the utilization of diffused photons. The exploration of endogenous contrast agents and the development of exogenous contrast agents further improve the molecular specificity for PAT. PAT’s versatile design and non-invasive nature have proven its great potential as a biomedical imaging tool for a multitude of biomedical applications. In this review, representative endogenous and exogenous PA contrast agents will be introduced alongside common PAT system configurations, including the latest advances of all-optical acoustic sensing techniques.

Capacitive micromachined ultrasound transducers for intravascular ultrasound imaging

Intravascular ultrasound (IVUS) is a burgeoning imaging technology that provides vital information for the diagnosis of coronary arterial diseases. A significant constituent that enables the IVUS system to attain high-resolution images is the ultrasound transducer, which acts as both a transmitter that sends acoustic waves and a detector that receives the returning signals. Being the most mature form of ultrasound transducer available in the market, piezoelectric transducers have dominated the field of biomedical imaging. However, there are some drawbacks associated with using the traditional piezoelectric ultrasound transducers such as difficulties in the fabrication of high-density arrays, which would aid in the acceleration of the imaging speed and alleviate motion artifact. The advent of microelectromechanical system (MEMS) technology has brought about the development of micromachined ultrasound transducers that would help to address this issue. Apart from the advantage of being able to be fabricated into arrays with lesser complications, the image quality of IVUS can be further enhanced with the easy integration of micromachined ultrasound transducers with complementary metal-oxide-semiconductor (CMOS). This would aid in the mitigation of parasitic capacitance, thereby improving the signal-to-noise. Currently, there are two commonly investigated micromachined ultrasound transducers, piezoelectric micromachined ultrasound transducers (PMUTs) and capacitive micromachined ultrasound transducers (CMUTs). Currently, PMUTs face a significant challenge where the fabricated PMUTs do not function as per their design. Thus, CMUTs with different array configurations have been developed for IVUS. In this paper, the different ultrasound transducers, including conventional-piezoelectric transducers, PMUTs and CMUTs, are reviewed, and a summary of the recent progress of CMUTs for IVUS is presented.

Time delay effect in a microchip pulse laser for the nonlinear photoacoustic signal enhancement

The Grüneisen relaxation effect has been successfully employed to improve the photoacoustic (PA) imaging contrast. However, complex system design and cost hinder the progress from benchside to bedside, since an additional pre-heating laser source needs to be coupled into the original light path and synchronized with other equipment for conducting the nonlinear effect. To overcome the limitation, we propose a time delay heating PA imaging (TDH-PAI) method based on the time delay effect in a passively Q-switched laser. Experimentally, only one single microchip pulse laser is built and utilized for the nonlinear PA signal enhancement without additional components. The 808 nm pump pulse of the laser diode and the excited 1064 nm pulse are respectively used for pre-heating and acquiring PA signals. The heating effect is optimized by adjusting the input parameters and an enhancement of more than 30% in PA signals is achieved. TDH-PAI reduces the cost and complexity of the nonlinear PA system, which provides an efficient way for achieving a high-contrast PA imaging.

Optical Biopsy of Melanoma and Basal Cell Carcinoma Progression by Noncontact Photoacoustic and Optical Coherence Tomography: In Vivo Multi-Parametric Characterizing Tumor Microenvironment

Measuring the structural and functional status of tumor microenvironment for malignant melanoma (MM) and basal cell carcinoma (BCC) is of profound significance in understanding dermatological condition for biopsy. However, conventional optical imaging techniques are limited to visualize superficial skin features and parameter information is deficient to depict pathophysiology correlations of skin diseases. Here, we demonstrate a preclinical device, all-optically integrated photoacoustic and optical coherence tomography (AOPA/OCT), that, for the first time, can simultaneously provide label-free biomarkers of vascular patterns, temporal and spatial heterogeneity of blood flow, and tissue micro-structure changes during tumor growth with pathophysiological correlations in mice models. We found that tumor microenvironment of MM and BCC led to the alternation in spatial-temporal heterogeneity that affected morphological and functional parameters, performing the AOPA/OCT quantitative metrics. A robust correlation between imaging biomarkers derived from this in vivo technique and histopathology validation ex vivo in distinguishing benign from malignant is also presented. In receiver operating characteristics (ROC) analysis, multi-parametric AOPA/OCT yields improved diagnostic accuracy of 98.4% and 95.8% for MM and BCC respectively, which indicate that AOPA/OCT represents a high-performance and clinically translatable technique for accurate diagnosis and therapy monitoring in dermatology.

Electrothermal-MEMS-induced nonlinear distortion correction in photoacoustic laparoscopy

Micro-electro-mechanical systems (MEMS) scanner has significant advantages of miniature size, fast response and high stability, which is particularly applicable to photoacoustic laparoscopy (PAL). However, tilt angle-voltage curve of electrothermal MEMS shows a nonlinear character, which leads to inevitable nonlinear distortion in photoacoustic imaging. To overcome this problem, a nonlinear distortion correction was developed for the high-resolution forward-scanning electrothermal-MEMS-based PAL. The adaptive resampling method (ARM) was introduced to adaptively calibrate the projection of non-uniform scanning region to match the uniform scanning region. The correction performed low time complexity and high portability owing to the adaptive capacity of distortion decomposition in the reconstruction of physical models. Compared with the sample structure, phantom experiments demonstrated that the distortion was calibrated in all directions and the corrected image provided up to 96.82% high structural similarity in local subset. Furthermore, ARM was applied to imaging the abdominal cavity of rat and the vascular morphology was corrected in real-time display within a delay less than 2 seconds. All these results demonstrated that the nonlinear distortion correction possessed timely and effective correction in PAL, which suggested that it had the potential to employ to any other electrothermal-MEMS-based photoacoustic imaging systems for accurate and quantitative functional imaging.

High-Resolution Photoacoustic Tomography for Early-Stage Cancer Detection and Its Clinical Translation

Diagnosing cancer during early stages can substantially increase the cure rate, decrease the recurrence rate, and reduce health care costs. Over the past few decades, the continual development of new medical imaging modalities has been an important factor for diagnosing cancer, selecting therapies, and monitoring response to treatment. Photoacoustic tomography (PAT) is a hybrid imaging modality combining optical contrast from absorption of light with the outstanding spatiotemporal resolution of US imaging, providing biomedical morphologic and functional information of early-stage cancer. In this review, the basics and modalities of PAT, as well as a summary of its state-of-art applications in early-stage cancer (breast cancer, melanoma, and prostate cancer) detection and treatment guidance will be introduced. The potential clinical translation in cancer detection of PAT and prospects for the possibilities to lead to further clinical breakthroughs will also be discussed. Keywords: Molecular Imaging-Cancer, Photoacoustic Imaging © RSNA, 2020.

Photothermally tunable Fabry-Pérot fiber interferometer for photoacoustic mesoscopy

An optical fiber based Fabry-Pérot interferometer whose resonant wavelength can be dynamically tuned was designed and realized for photoacoustic mesoscopy. The optical path length (OPL) of the Fabry-Pérot cavity can be modulated by a photothermal heating process, which was achieved by adjusting the power of a 650 nm heating laser. The optical heating process can effectively change the thickness and refractive index of the polymer spacer of the sensor cavity. The robustness of the sensor can be greatly improved by proper packaging. The interferometer was interrogated by a relatively cheap wavelength-fixed 1550 nm laser for broadband and sensitive ultrasound detection, eliminating the requirement for an expensive tunable interrogation laser. The sensing module was then integrated into a photoacoustic mesoscopic imaging system. Two phantom imaging experiments and an ex vivo imaging experiment demonstrated the capability of such a miniature sensor. The interferometer has an acoustic detection bandwidth of up to 30 MHz and a noise equivalent pressure of 40 mPa/Hz^1/2 (i.e., 220 Pa over the full detection bandwidth). The new tuning mechanism and the batch-production compatibility of the sensor holds promises for commercialization and parallelized detection.

Photoacoustic imaging of the human placental vasculature

Minimally invasive fetal interventions require accurate imaging from inside the uterine cavity. Twin-to-twin transfusion syndrome (TTTS), a condition considered in this study, occurs from abnormal vascular anastomoses in the placenta that allow blood to flow unevenly between the fetuses. Currently, TTTS is treated fetoscopically by identifying the anastomosing vessels, and then performing laser photocoagulation. However, white light fetoscopy provides limited visibility of placental vasculature, which can lead to missed anastomoses or incomplete photocoagulation. Photoacoustic (PA) imaging is an alternative imaging method that provides contrast for hemoglobin, and in this study, two PA systems were used to visualize chorionic (fetal) superficial and subsurface vasculature in human placentas. The first system comprised an optical parametric oscillator for PA excitation and a 2D Fabry-Pérot cavity ultrasound sensor; the second, light emitting diode arrays and a 1D clinical linear-array ultrasound imaging probe. Volumetric photoacoustic images were acquired from ex vivo normal term and TTTS-treated placentas. It was shown that superficial and subsurface branching blood vessels could be visualized to depths of approximately 7 mm, and that ablated tissue yielded negative image contrast. This study demonstrated the strong potential of PA imaging to guide minimally invasive fetal therapies.

Use of a flexible optical fibre bundle to interrogate a Fabry-Perot sensor for photoacoustic imaging

Photoacoustic imaging systems based on a Fabry Perot (FP) ultrasound sensor that is read-out by scanning a free-space laser beam over its surface can provide high resolution photoacoustic images. However, this type of free-space scanning usually requires a bulky 2-axis galvanometer based scanner that is not conducive to the realization of a lightweight compact imaging head. It is also unsuitable for endoscopic applications that may require complex and flexible access. To address these limitations, the use of a flexible, coherent fibre bundle to interrogate the FP sensor has been investigated. A laboratory set-up comprising an x-y scanner, a commercially available, 1.35 mm diameter, 18,000 core flexible fibre bundle with a custom-designed telecentric optical relay at its distal end was used. Measurements of the optical and acoustic performance of the FP sensor were made and compared to that obtained using a conventional free-space FP based scanner. Spatial variations in acoustic sensitivity were greater and the SNR lower with the fibre bundle implementation but high quality photoacoustic images could still be obtained. 3D images of phantoms and ex vivo tissues with a spatial resolution and fidelity consistent with a free-space scanner were acquired. By demonstrating the feasibility of interrogating the FP sensor with a flexible fibre bundle, this study advances the realization of compact hand-held clinical scanners and flexible endoscopic devices based on the FP sensing concept.

Optical-Resolution Photoacoustic Microscopy Using Transparent Ultrasound Transducer

The opacity of conventional ultrasound transducers can impede the miniaturization and workflow of current photoacoustic systems. In particular, optical-resolution photoacoustic microscopy (OR-PAM) requires the coaxial alignment of optical illumination and acoustic-detection paths through complex beam combiners and a thick coupling medium. To overcome these hurdles, we developed a novel OR-PAM method on the basis of our recently reported transparent lithium niobate (LiNbO3) ultrasound transducer (Dangi et al., Optics Letters, 2019), which was centered at 13 MHz ultrasound frequency with 60% photoacoustic bandwidth. To test the feasibility of wearable OR-PAM, optical-only raster scanning of focused light through a transducer was performed while the transducer was fixed above the imaging subject. Imaging experiments on resolution targets and carbon fibers demonstrated a lateral resolution of 8.5 µm. Further, we demonstrated vasculature mapping using chicken embryos and melanoma depth profiling using tissue phantoms. In conclusion, the proposed OR-PAM system using a low-cost transparent LiNbO3 window transducer has a promising future in wearable and high-throughput imaging applications, e.g., integration with conventional optical microscopy to enable a multimodal microscopy platform capable of ultrasound stimulation.

Contact-free endoscopic photoacoustic sensing using speckle analysis

Photoacoustic endoscopy (PAE) is an emerging imaging modality, which offers a high imaging penetration and a high optical contrast in soft tissue. Most of the developed endoscopic photoacoustic sensing systems use miniaturized contact ultrasound transducers or complex optical approaches. In this work, a new fiber-based detection technique using speckle analysis for contact-free signal detection is presented. Phantom and ex vivo experiments are performed in transmission and reflection mode for proof of concept. In summary, the potential of the technique for endoscopic photoacoustic signal detection is demonstrated. The new technique might help in future to broaden the applications of PAE in imaging or guiding minimally invasive laser procedures.

Minimally invasive photoacoustic imaging: Current status and future perspectives

Photoacoustic imaging (PAI) is an emerging biomedical imaging modality that is based on optical absorption contrast, capable of revealing distinct spectroscopic signatures of tissue at high spatial resolution and large imaging depths. However, clinical applications of conventional non-invasive PAI systems have been restricted to examinations of tissues at depths less than a few cm due to strong light attenuation. Minimally invasive photoacoustic imaging (miPAI) has greatly extended the landscape of PAI by delivering excitation light within tissue through miniature fibre-optic probes. In the past decade, various miPAI systems have been developed with demonstrated applicability in several clinical fields. In this article, we present an overview of the current status of miPAI and our thoughts on future perspectives.

In vivo three-dimensional evaluation of tumour hypoxia in nasopharyngeal carcinomas using FMT-CT and MSOT

Purpose

Accurate evaluation of hypoxia is particularly important in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy. The aim of this study was to propose a novel imaging strategy for quantitative three-dimensional (3D) evaluation of hypoxia in a small animal model of NPC.

Methods

A carbonic anhydrase IX (CAIX)-specific molecular probe (CAIX-800) was developed for imaging of hypoxia. Mouse models of subcutaneous, orthotopic, and spontaneous lymph node metastasis from NPC (5 mice per group) were established to assess the imaging strategy. A multi-modality imaging method that consisted of a hybrid combination of fluorescence molecular tomography-computed tomography (FMT-CT) and multispectral optoacoustic tomography (MSOT) was used for 3D quantitative evaluation of tumour hypoxia. Magnetic resonance imaging, histological examination, and immunohistochemical analysis were used as references for comparison and validation.

Results

In the early stage of NPC (2 weeks after implantation), FMT-CT enabled precise 3D localisation of the hypoxia biomarker with high sensitivity. At the advanced stage (6 weeks after implantation), MSOT allowed multispectral analysis of the biomarker and haemoglobin molecules with high resolution. The combination of high sensitivity and high resolution from FMT-CT and MSOT could not only detect hypoxia in small-sized NPCs but also visualise the heterogeneity of hypoxia in 3D.

Conclusions

Integration of FMT-CT and MSOT could allow comprehensive and quantifiable evaluation of hypoxia in NPC. These findings may potentially benefit patients with NPC undergoing radiotherapy in the future.

Graphical abstract

Lithium niobate-based transparent ultrasound transducers for photoacoustic imaging

This Letter demonstrates lithium niobate (LiNbO₃)-based transparent ultrasound transducers (TUTs) for photoacoustic imaging applications. The TUTs were fabricated by coating the top and bottom surfaces of a 0.25 mm thick LiNbO₃wafer with transparent indium-tin-oxide (ITO) electrodes. The resulting transducers showed ∼80% optical transparency in the wavelength range of 690-970 nm. The TUTs had a resonant frequency of 14.5 MHz and ∼70% photoacoustic bandwidth. The versatility of the TUT approach is demonstrated by introducing two different transparent photoacoustic imaging (PAI) geometries. In one method, which suits endoscopy applications, an optical fiber of a laser diode is directly fixed on the backside of a 2.5 mm diameter TUT, and the fiber-TUT device is raster scanned to form 3D photoacoustic images. In the second method, which suits high-throughput applications, a free-space optical-only raster scanning of the laser fiber across a 1  cm×1  cm planar TUT yielded 3D photoacoustic images. The proposed TUT approach is low in cost, easy to manufacture, compatible with conventional clinical ultrasound electronics, and scalable for different configurations, including 2D TUT arrays to achieve real-time 3D high-throughput PAI.

Optoacoustic image formation approaches-a clinical perspective

Clinical translation of optoacoustic imaging is fostered by the rapid technical advances in imaging performance as well as the growing number of clinicians recognizing the immense diagnostic potential of this technology. Clinical optoacoustic systems are available in multiple configurations, including hand-held and endoscopic probes as well as raster-scan approaches. The hardware design must be adapted to the accessible portion of the imaged region and other application-specific requirements pertaining the achievable depth, field of view or spatio-temporal resolution. Equally important is the adequate choice of the signal and image processing approach, which is largely responsible for the resulting imaging performance. Thus, new image reconstruction algorithms are constantly evolving in parallel to the newly-developed set-ups. This review focuses on recent progress on optoacoustic image formation algorithms and processing methods in the clinical setting. Major reconstruction challenges include real-time image rendering in two and three dimensions, efficient hybridization with other imaging modalitites as well as accurate interpretation and quantification of bio-markers, herein discussed in the context of ongoing progress in clinical translation.

Review on practical photoacoustic microscopy

Photoacoustic imaging (PAI) has many interesting advantages, such as deep imaging depth, high image resolution, and high contrast to intrinsic and extrinsic chromophores, enabling morphological, functional, and molecular imaging of living subjects. Photoacoustic microscopy (PAM) is one form of the PAI inheriting its characteristics and is useful in both preclinical and clinical research. Over the years, PAM systems have been evolved in several forms and each form has its relative advantages and disadvantages. Thus, to maximize the benefits of PAM for a specific application, it is important to configure the PAM system optimally by targeting a specific application. In this review, we provide practical methods for implementing a PAM system to improve the resolution, signal-to-noise ratio (SNR), and imaging speed. In addition, we review the preclinical and the clinical applications of PAM and discuss the current challenges and the scope for future developments.

PMN-PT/Epoxy 1-3 composite based ultrasonic transducer for dual-modality photoacoustic and ultrasound endoscopy

Endoscopic dual-modality photoacoustic (PA) and ultrasound (US) imaging has the capability of providing morphology and molecular information simultaneously. An ultrasonic transducer was applied for detecting PA signals and performing US imaging which determines the sensitivity and performance of a dual-modality PA/US system. In our study, a miniature single element 32-MHz lead magnesium niobate-lead titanate (PMN-PT) epoxy 1-3 composite based ultrasonic transducer was developed. A miniature endoscopic probe based on this transducer has been fabricated. Using the dual modality PA/US system with a PMN-PT/epoxy 1-3 composite based ultrasonic transducer, phantom and in vivo animal studies have been conducted to evaluate the performance. The preliminary results show enhanced bandwidths of the new ultrasonic transducer and improved signal-to-noise ratio of PA and US images of rat colorectal wall compared with PMN-PT and lead zirconate titanate (PZT) composite based ultrasonic transducers.

Photoacoustic imaging for guidance of interventions in cardiovascular medicine

Imaging guidance is paramount to procedural success in minimally invasive interventions. Catheter-based therapies are the standard of care in the treatment of many cardiac disorders, including coronary artery disease, structural heart disease and electrophysiological conditions. Many of these diseases are caused by, or effect, a change in vasculature or cardiac tissue composition, which can potentially be detected by photoacoustic imaging. This review summarizes the state of the art in photoacoustic imaging approaches that have been proposed for intervention guidance in cardiovascular care. All of these techniques are currently in the preclinical phase. We will conclude with an outlook towards clinical applications.

Photoacoustic Imaging with Capacitive Micromachined Ultrasound Transducers: Principles and Developments

Photoacoustic imaging (PAI) is an emerging imaging technique that bridges the gap between pure optical and acoustic techniques to provide images with optical contrast at the acoustic penetration depth. The two key components that have allowed PAI to attain high-resolution images at deeper penetration depths are the photoacoustic signal generator, which is typically implemented as a pulsed laser and the detector to receive the generated acoustic signals. Many types of acoustic sensors have been explored as a detector for the PAI including Fabry-Perot interferometers (FPIs), micro ring resonators (MRRs), piezoelectric transducers, and capacitive micromachined ultrasound transducers (CMUTs). The fabrication technique of CMUTs has given it an edge over the other detectors. First, CMUTs can be easily fabricated into given shapes and sizes to fit the design specifications. Moreover, they can be made into an array to increase the imaging speed and reduce motion artifacts. With a fabrication technique that is similar to complementary metal-oxide-semiconductor (CMOS), CMUTs can be integrated with electronics to reduce the parasitic capacitance and improve the signal to noise ratio. The numerous benefits of CMUTs have enticed researchers to develop it for various PAI purposes such as photoacoustic computed tomography (PACT) and photoacoustic endoscopy applications. For PACT applications, the main areas of research are in designing two-dimensional array, transparent, and multi-frequency CMUTs. Moving from the table top approach to endoscopes, some of the different configurations that are being investigated are phased and ring arrays. In this paper, an overview of the development of CMUTs for PAI is presented.

High-resolution and extended-depth-of-field photoacoustic endomicroscopy by scanning-domain synthesis of optical beams

Photoacoustic endomicroscopy (PAEM) is capable of imaging fine structures in digestive tract. However, conventional PAEM employs a tightly focused laser beam to irradiate the object, which results in a limited depth-of-field (DOF). Here, we propose a scanning-domain synthesis of optical beams (SDSOB) to optimize both transverse resolution and the DOF by synthetic effective focused beams in scanning domain for the PAEM. By utilizing the SDSOB technique, multiple defocused and scattered beams are refocused to synthesize virtual focuses covering a large range of depth. A transverse point spread function that is 5.7-time sharper, and a transverse spatial bandwidth that is 8.5-time broader than those of the conventional PAEM were simulatively obtained through SDSOB-PAEM at the defocus distance of 2.4 mm. We validated the transverse resolution improvement at both in- and out-focus positions via phantom experiments of carbon fibers. In addition, in vivo rabbit experiments were conducted to acquire vascular images over radial depth range of 900 µm. And further morphological analysis revealed that the SDSOB images were acquired with abundant vascular branches and nodes, large total-length and small average-length of blood vessels, which indicated that the SDSOB-PAEM achieved high-resolution imaging in distinct rectal layers. All these results suggest that the SDSOB-PAEM possesses high transverse resolution and extended DOF, which demonstrates the SDSOB-PAEM can provide more accurate information for clinical assessment.

In vivo label-free functional photoacoustic monitoring of ischemic reperfusion

Pressure ulcer formation is a common problem among patients confined to bed or restricted to wheelchairs. The ulcer forms when the affected skin and underlying tissues go through repeated cycles of ischemia and reperfusion, leading to inflammation. This theory is evident by intravital imaging studies performed in immune cell-specific, fluorescent reporter mouse skin with induced ischemia-reperfusion (I-R) injuries. However, traditional confocal or multiphoton microscopy cannot accurately monitor the progression of vascular reperfusion by contrast agents, which leaks into the interstitium under inflammatory conditions. Here, we develop a dual-wavelength micro electro mechanical system (MEMS) scanning-based optical resolution photoacoustic microscopy (OR-PAM) system for continuous label-free functional imaging of vascular reperfusion in an IR mouse model. This MEMS-OR-PAM system provides fast scanning speed for concurrent dual-wavelength imaging, which enables continuous monitoring of the reperfusion process. During reperfusion, the revascularization of blood vessels and the oxygen saturation (sO₂ ) changes in both arteries and veins are recorded, from which the local oxygen extraction ratios of the ischemic tissue and the unaffected tissue can be quantified. Our MEMS-OR-PAM system provides novel perspectives to understand the I-R injuries. It solves the problem of dynamic label-free functional monitoring of the vascular reperfusion at high spatial resolution.

An image reconstruction method for endoscopic photoacoustic tomography in tissues with heterogeneous sound speed

The idealized assumption of a constant speed of sound (SOS) in acoustically inhomogeneous biological tissues usually results in blurred details, acoustic distortion and artifacts in in vivo endoscopic photoacoustic tomographic (EPAT) images. In this paper, we propose an image reconstruction method to improve EPAT imaging for luminal structures with the variable SOS. In our method, an optimal SOS providing the maximal local focusing of a measuring location within the imaging region is firstly determined. The deviation in the ultrasonic propagation time caused by the variable SOS is then compensated. The grayscale images of the optical absorption distribution on the cross-sections of the luminal structures are finally reconstructed with a filtered back-projection (FBP) algorithm based on the corrected propagation time. Any prior knowledge of the SOS distribution in the imaged tissues is not required. The results of numerical simulation experiments demonstrated that the proposed method can effectively improve the image quality by reducing the misalignment of tissues, acoustic distortion and artifacts caused by the variable SOS.

Functional endoscopy techniques for tracking stem cell fate

Tracking and monitoring implanted stem cells are essential to maximize benefits and to minimize the side effects of stem cell therapy for personalized or "precision" medicine. Previously, we proposed a comprehensive biological Global Positioning System (bGPS) to track and monitor stem cells in vivo. Magnetic resonance imaging (MRI), positron emission tomography (PET), bioluminescent imaging, fluorescence imaging, and single-photon emission computerized tomography (SPECT) have been utilized to track labeled or genetically-modified cells in vivo in rats and humans. A large amount of research has been dedicated to the design of reporter genes and molecular probes for imaging and the visualization of the biodistribution of the implanted cells in high resolution. On the other hand, optical-based functional imaging, such as photoacoustic imaging (PAI), optical coherence tomography (OCT), and multiphoton microscopy (MPM), has been implemented into small endoscopes to image cells inside the body. The optical fiber allows miniaturization of the imaging probe while maintaining high resolution due to light-based imaging. Upon summarizing the recent progress in the design and application of functional endoscopy techniques for stem cell monitoring, we offer perspectives for the future development of endoscopic molecular imaging tools for in vivo tracking of spatiotemporal changes in subclonal evolution at the single cell level.

Label-Free Multiphoton Endomicroscopy for Minimally Invasive In Vivo Imaging

Multiphoton microscopy of cellular autofluorescence and second harmonic generation from collagen facilitates imaging of living cells and tissues without the need for additional fluorescent labels. Here, a compact multiphoton endomicroscope for label-free in vivo imaging in small animals via side-viewing needle objectives is presented. Minimal invasive imaging at cellular resolution is performed in colonoscopy of mice without surgical measures and without fluorescent dyes as a contrast agent. The colon mucosa is imaged repeatedly in the same animal in a mouse model of acute intestinal inflammation to study the process of inflammation at the tissue level within a time period of ten days, demonstrating the capabilities of label-free endomicroscopy for longitudinal studies for the first time.

Strategies for Image-Guided Therapy, Surgery, and Drug Delivery Using Photoacoustic Imaging

Photoacoustic imaging is a rapidly maturing imaging modality in biological research and medicine. This modality uses the photoacoustic effect ("light in, sound out") to combine the contrast and specificity of optical imaging with the high temporal resolution of ultrasound. The primary goal of image-guided therapy, and theranostics in general, is to transition from conventional medicine to precision strategies that combine diagnosis with therapy. Photoacoustic imaging is well-suited for noninvasive guidance of many therapies and applications currently being pursued in three broad areas. These include the image-guided resection of diseased tissue, monitoring of disease states, and drug delivery. In this review, we examine the progress and strategies for development of photoacoustics in these three key areas with an emphasis on the value photoacoustics has for image-guided therapy.

Spectral photoacoustic imaging to estimate in vivo placental oxygenation during preeclampsia

Preeclampsia is a pregnancy-related hypertensive disorder accounting for 14% of global maternal deaths annually. Preeclampsia - maternal hypertension and proteinuria - is promoted by placental ischemia resulting from reduced uteroplacental perfusion. Here, we assess longitudinal changes in placental oxygenation during preeclampsia using spectral photoacoustic imaging. Spectral photoacoustic images were acquired of the placenta of normal pregnant (NP) and preeclamptic reduced uterine perfusion pressure (RUPP) Sprague Dawley rats on gestational days (GD) 14, 16, and 18, corresponding to mid- to late gestation (n = 10 per cohort). Two days after implementation of the RUPP surgical model, placental oxygen saturation decreased 12% in comparison with NP. Proteinuria was determined from a 24-hour urine collection prior to imaging on GD18. Blood pressure measurements were obtained on GD18 after imaging. Placental hypoxia in the RUPP was confirmed with histological staining for hypoxia-inducible factor (HIF)-1α, a cellular transcription regulator which responds to local oxygen levels. Using in vivo, longitudinal imaging methods we determined that the placenta in the reduced uterine perfusion pressure rat model of preeclampsia is hypoxic, and that this hypoxia is maintained through late gestation. Future work will utilize these methods to assess the impact of novel therapeutics on placental ischemia and the progression of preeclampsia.