Biologically relevant photoacoustic imaging phantoms with tunable optical and acoustic properties

Remote photoacoustic sensing using speckle-analysis

Laser surgery is a rising surgical technique, which offers several advantages compared to the traditional scalpel. However, laser surgery lacks a contact-free feedback system which offers high imaging contrast to identify the tissue type ablated and also a high penetration depth. Photoacoustic imaging has the potential to fill this gap. Since photoacoustic detection is commonly contact based, a new non-interferometric detection technique based on speckle-analysis for remote detection is presented in this work. Phantom and ex-vivo experiments are carried out in transmission and reflection-mode for proof of concept. In summary, the potential of the remote speckle sensing technique for photoacoustic detection is demonstrated. In future, this technique might be applied for usage as a remote feedback system for laser surgery, which could help to broaden the applications of lasers as smart surgical tools.

Adjustable photoacoustic tomography probe improves light delivery and image quality

One cause for suboptimal photoacoustic tomography (PAT) penetration depth is attenuation of incident light by soft tissue. To better understand this problem, we investigated the effects of illumination fiber optic bundle geometry on PAT penetration depth and signal-to-noise ratio. An adjustable, motorized PAT probe was used to reduce probe-skin reflection artifacts and improve light distribution in the image acquisition plane by tuning fiber orientation. We validated our motorized PAT probe through Monte Carlo simulations and ex vivo imaging of a tissue mimicking phantom, and in vivo imaging of murine periaortic fat. Overall, our ex vivo results showed a several millimeter improvement in penetration depth and in vivo results showed a >62% increase in lipid signal-to-noise ratio. Our PAT probe also utilized a 7-μm aluminum filter to block in vivo probe-skin reflection artifacts. Together, these findings showed the importance of optimizing illumination geometry to enhance PAT image quality.

Clinical optoacoustic imaging combined with ultrasound for coregistered functional and anatomical mapping of breast tumors

Optoacoustic imaging, based on the differences in optical contrast of blood hemoglobin and oxyhemoglobin, is uniquely suited for the detection of breast vasculature and tumor microvasculature with the inherent capability to differentiate hypoxic from the normally oxygenated tissue. We describe technological details of the clinical ultrasound (US) system with optoacoustic (OA) imaging capabilities developed specifically for diagnostic imaging of breast cancer. The combined OA/US system provides co-registered and fused images of breast morphology based upon gray scale US with the functional parameters of total hemoglobin and blood oxygen saturation in the tumor angiogenesis related microvasculature based upon OA images. The system component that enabled clinical utility of functional OA imaging is the hand-held probe that utilizes a linear array of ultrasonic transducers sensitive within an ultrawide-band of acoustic frequencies from 0.1 MHz to 12 MHz when loaded to the high-impedance input of the low-noise analog preamplifier. The fiberoptic light delivery system integrated into a dual modality probe through a patented design allowed acquisition of OA images while minimizing typical artefacts associated with pulsed laser illumination of skin and the probe components in the US detection path. We report technical advances of the OA/US imaging system that enabled its demonstrated clinical viability. The prototype system performance was validated in well-defined tissue phantoms. Then a commercial prototype system named Imagio™ was produced and tested in a multicenter clinical trial termed PIONEER. We present examples of clinical images which demonstrate that the spatio-temporal co-registration of functional and anatomical images permit radiological assessment of the vascular pattern around tumors, microvascular density of tumors as well as the relative values of the total hemoglobin [tHb] and blood oxygen saturation [sO2] in tumors relative to adjacent normal breast tissues. The co-registration technology enables increased accuracy of radiologist assessment of malignancy by confirming, upgrading and/or downgrading US categorization of breast tumors according to Breast Imaging Reporting And Data System (BI-RADS). Microscopic histologic examinations on the biopsied tissue of the imaged tumors served as a gold standard in verifying the functional and anatomic interpretations of the OA/US image feature analysis.

Dynamic blood flow phantom with negative and positive photoacoustic contrasts

In vivo photoacoustic (PA) flow cytometry (PAFC) has great clinical potential for early, noninvasive diagnosis of cancer, infections (e.g., malaria and bacteremia), sickle anemia, and cardiovascular disorders, including stroke prevention through detection of circulating white clots with negative PA contrast. For clinical applications, this diagnostic platform still requires optimization and calibration. We have already demonstrated that this need can be partially addressed by in vivo examination of large mouse blood vessels, which are similar to human vessels used. Here, we present an alternative method for PAFC optimization that utilizes novel, clinically relevant phantoms resembling pigmented skin, tissue, vessels, and flowing blood. This phantom consists of a scattering-absorbing medium with a melanin layer and plastic tube with flowing beads to model light-absorbing red blood cells (RBCs) and circulating tumor cells (CTCs), as well as transparent beads to model white blood cells and clots. Using a laser diode, we demonstrated the extraordinary ability of PAFC to dynamically detect fast-moving mimic CTCs with positive PA contrast and white clots with negative PA contrast in an RBC background. Time-resolved detection of the delayed PA signals from blood vessels demonstrated complete suppression of the PA background from the modeled pigmented skin. This novel, medically relevant, dynamic blood flow phantom can be used to calibrate and maintain PAFC parameters for routine clinical applications.

Tissue mimicking materials in image-guided needle-based interventions: A review

Image-guided interventions are widely employed in clinical medicine, which brings significant revolution in healthcare in recent years. However, it is impossible for medical trainees to experience the image-guided interventions physically in patients due to the lack of certificated skills. Therefore, training phantoms, which are normally tissue mimicking materials, are widely used in medical research, training, and quality assurance. This review focuses on the tissue mimicking materials used in image-guided needle-based interventions. In this case, we need to investigate the microstructure characteristics and mechanical properties (for needle intervention), optical properties and acoustical properties (for imaging) of these training phantoms to compare with the related properties of human real tissues. The widely used base materials, additives and the corresponding concentrations of the training phantoms are summarized from the literatures in recent ten years. The microstructure characteristics, mechanical behavior, optical properties and acoustical properties of the tissue mimicking materials are investigated, accompanied with the common experimental methods, apparatus and theoretical algorithm. The influence of the concentrations of the base materials and additives on these characteristics are compared and classified. In this review, we assess a comprehensive overview of the existing techniques with the main accomplishments, and limitations as well as recommendations for tissue mimicking materials used in image-guided needle-based interventions.

Agarose-based Tissue Mimicking Optical Phantoms for Diffuse Reflectance Spectroscopy

This protocol describes how to make agarose-based tissue-mimicking phantoms and demonstrates how to determine their optical properties using a conventional optical system with an integrating sphere. Measuring systems for the acquisition of the diffuse reflectance and total transmittance spectra are constructed with a broadband white light source, a light guide, an achromatic lens, an integrating sphere, a sample holder, an optical fiber probe, and a multi-channel spectrometer. An acrylic mold consisting of two rectangular acrylic pieces and a U-shaped acrylic piece is constructed to create an epidermal phantom and a dermal phantom with whole blood. The application of a sodium dithionite (Na2S2O4) solution to the dermal phantom enables the researcher to deoxygenate hemoglobin in red blood cells distributed in the dermal phantom. The inverse Monte Carlo simulation with the diffuse reflectance and total transmittance spectra measured by a spectrometer with an integrating sphere is performed to determine the absorption coefficient spectrum µa(λ) and the reduced scattering coefficient spectrum µs'(λ) of each layer phantom. A two-layered phantom mimicking the diffuse reflectance of human skin tissue is also demonstrated by piling up the epidermal phantom on the dermal phantom.

Gel wax-based tissue-mimicking phantoms for multispectral photoacoustic imaging

Tissue-mimicking phantoms are widely used for the calibration, evaluation and standardisation of medical imaging systems, and for clinical training. For photoacoustic imaging, tissue-mimicking materials (TMMs) that have tuneable optical and acoustic properties, high stability, and mechanical robustness are highly desired. In this study, gel wax is introduced as a TMM that satisfies these criteria for developing photoacoustic imaging phantoms. The reduced scattering and optical absorption coefficients were independently tuned with the addition of TiO₂ and oil-based inks. The frequency-dependent acoustic attenuation obeyed a power law; for native gel wax, it varied from 0.71 dB/cm at 3 MHz to 9.93 dB/cm at 12 MHz. The chosen oil-based inks, which have different optical absorption spectra in the range of 400 to 900 nm, were found to have good photostability under pulsed illumination with photoacoustic excitation light. Optically heterogeneous phantoms that comprised of inclusions with different concentrations of carbon black and coloured inks were fabricated, and multispectral photoacoustic imaging was performed with an optical parametric oscillator and a planar Fabry-Pérot sensor. We conclude that gel wax is well suited as a TMM for multispectral photoacoustic imaging.

Algorithm for rapid determination of optical scattering parameters

Preliminary experiments at the NIST Spectral Tri-function Automated Reference Reflectometer (STARR) facility have been conducted with the goal of providing the diffuse optical properties of a solid reference standard with optical properties similar to human skin. Here, we describe an algorithm for determining the best-fit parameters and the statistical uncertainty associated with the measurement. The objective function is determined from the profile log likelihood, including both experimental and Monte Carlo uncertainties. Initially, the log likelihood is determined over a large parameter search box using a relatively small number of Monte Carlo samples such as 2·104. The search area is iteratively reduced to include the 99.9999% confidence region, while doubling the number of samples at each iteration until the experimental uncertainty dominates over the Monte Carlo uncertainty. Typically this occurs by 1.28·106 samples. The log likelihood is then fit to determine a 95% confidence ellipse. The inverse problem requires the values of the log likelihood on many points. Our implementation uses importance sampling to calculate these points on a grid in an efficient manner. Ultimately, the time-to-solution is approximately six times the cost of a Monte Carlo simulation of the radiation transport problem for a single set of parameters with the largest number of photons required. The results are found to be 64 times faster than our implementation of Particle Swarm Optimization.

Phantom-based image quality test methods for photoacoustic imaging systems

As photoacoustic imaging (PAI) technologies advance and applications arise, there is increasing need for standardized approaches to provide objective, quantitative performance assessment at various stages of the product development and clinical translation process. We have developed a set of performance test methods for PAI systems based on breast-mimicking tissue phantoms containing embedded inclusions. Performance standards for mature imaging modalities [magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound] were used to guide selection of critical PAI image quality characteristics and experimental methods. Specifically, the tests were designed to address axial, lateral, and elevational spatial resolution, signal uniformity, penetration depth, sensitivity, spatial measurement accuracy, and PAI-ultrasound coregistration. As an initial demonstration of the utility of these test methods, we characterized the performance of a modular, bimodal PAI-ultrasound system using four clinical ultrasound transducers with varying design specifications. Results helped to inform optimization of acquisition and data processing procedures while providing quantitative elucidation of transducer-dependent differences in image quality. Comparison of solid, tissue-mimicking polymer phantoms with those based on Intralipid indicated the superiority of the former approach in simulating real-world conditions for PAI. This work provides a critical foundation for the establishment of well-validated test methods that will facilitate the maturation of PAI as a medical imaging technology.

The development and characterization of a novel yet simple 3D printed tool to facilitate phantom imaging of photoacoustic contrast agents

We report a new approach to preparing phantoms using 3D printing. This device supports plastic tubing containing the contrast agent and is immersed in a solution with absorption or scattering properties that mimic tissue. Up to 12 tubing samples could be placed in the device with sample-to-sample spacing as low as 0.3 mm and at a constant distance from the transducer (±0.16 mm), which is critical in validating photoacoustic contrast agents. We also studied different types of tubing and found that tubing with a larger outside diameter has more inherent signal. Both 40% India Ink and lipids in the immersion media modulated the signal. Finally, we created a depth phantom and found that signal decayed following a linear relationship (R² = 0.997) with respect to distance from the focal point. We include computer-assisted drafting code the community can use to print this phantom or customized versions of this phantom.

Characterisation of a phantom for multiwavelength quantitative photoacoustic imaging

Quantitative photoacoustic imaging (qPAI) has the potential to provide high- resolution in vivo images of chromophore concentration, which may be indicative of tissue function and pathology. Many strategies have been proposed recently for extracting quantitative information, but many have not been experimentally verified. Experimental phantom-based validation studies can be used to test the robustness and accuracy of such algorithms in order to ensure reliable in vivo application is possible. The phantoms used in such studies must have well-characterised optical and acoustic properties similar to tissue, and be versatile and stable. Polyvinyl chloride plastisol (PVCP) has been suggested as a phantom for quality control and system evaluation. By characterising its multiwavelength optical properties, broadband acoustic properties and thermoelastic behaviour, this paper examines its potential as a phantom for qPAI studies too. PVCP's acoustic properties were assessed for various formulations, as well as its intrinsic optical absorption, and scattering with added TiO2, over a range of wavelengths from 400-2000 nm. To change the absorption coefficient, pigment-based chromophores that are stable during the phantom fabrication process, were used. These yielded unique spectra analogous to tissue chromophores and linear with concentration. At the high peak powers typically used in photoacoustic imaging, nonlinear optical absorption was observed. The Grüneisen parameter was measured to be [Formula: see text]  =  1.01  ±  0.05, larger than typically found in tissue, though useful for increased PA signal. Single and multiwavelength 3D PA imaging of various fabricated PVCP phantoms were demonstrated.