Monitoring peripheral hemodynamic response to changes in blood pressure via photoacoustic imaging

Therapeutic and Contrast Agents for Photoacoustic Imaging-Guided Photothermal Therapy: A Narrative Review

Photoacoustic imaging is a hybrid modality that combines high-contrast and spectroscopy-based optical imaging specificity with the high spatial resolution of ultrasonography. This review highlights the development and progress of photoacoustic imaging technology over the past decade. This imaging technology has evolved to be more user-friendly, cost-effective, and portable, demonstrating its potential for diverse clinical applications. A potential clinical application lies in the use of photoacoustic imaging as a guiding tool for photothermal therapy. This review was conducted by initially filtering through three databases, namely, Google Scholar, PubMed, and Scopus, resulting in 460 articles published between 2019 and May 2023. Of these, 54 articles were deemed suitable for review after identification. The selected articles were research papers focusing on the development of therapeutic agents that enhance contrast in photoacoustic imaging. All reviewed articles tested these agents both in vitro and in vivo. This review focuses on wavelength absorption and radiation sources for photothermal therapy. The developed agents predominantly used NIR-I wavelengths, whereas the NIR-II region has been less explored, indicating significant potential for future research. This review provides comprehensive insights into the advancement of compounds serving as therapeutic agents and contrast agents in photoacoustic imaging-guided photothermal therapy.

Mini review of photoacoustic clinical imaging: a noninvasive tool for disease diagnosis and treatment evaluation

Significance

Photoacoustic (PA) imaging is an imaging modality that integrates anatomical, functional, metabolic, and histologic insights. It has been a hot topic of medical research and draws extensive attention.

Aim

This review aims to explore the applications of PA clinical imaging in human diseases, highlighting recent advancements.

Approach

A systemic survey of the literature concerning the clinical utility of PA imaging was conducted, with a particular focus on its application in tumors, autoimmune diseases, inflammatory conditions, and endocrine disorders.

Results

PA imaging is emerging as a valuable tool for human disease investigation. Information provided by PA imaging can be used for diagnosis, grading, and prognosis in multiple types of tumors including breast tumors, ovarian neoplasms, thyroid nodules, and cutaneous malignancies. PA imaging facilitates the monitoring of disease activity in autoimmune and inflammatory diseases such as rheumatoid arthritis, systemic sclerosis, arteritis, and inflammatory bowel disease by capturing dynamic functional alterations. Furthermore, its unique capability of visualizing vascular structure and oxygenation levels aids in assessing diabetes mellitus comorbidities and thyroid function.

Conclusions

Despite extant challenges, PA imaging offers a promising noninvasive tool for precision disease diagnosis, long-term evaluation, and prognosis anticipation, making it a potentially significant imaging modality for clinical practice.

Dual-Scan Photoacoustic Tomography for the Imaging of Vascular Structure on Foot

Chronic leg ulcers are affecting approximately 6.5 million Americans, and they are associated with significant mortality, reduced quality of life, and high treatment costs. Since many chronic ulcers have underlying vascular insufficiency, accurate assessment of tissue perfusion is critical to treatment planning and monitoring. This study introduces a dual-scan photoacoustic (PA) tomography (PAT) system that can simultaneously image the dorsal and plantar sides of the foot to reduce imaging time. To account for the unique shape of the foot, the system employs height-adjustable and articulating baseball stages that can scan along the foot's contour. In vivo results from healthy volunteers demonstrate the system's ability to acquire clear images of foot vasculature, and results from patients indicate that the system can image patients with various ulcer conditions. We also investigated various PA features and examined their correlation with the foot condition. Our preliminary results indicate that vessel sharpness, occupancy, intensity, and density could all be used to assess tissue perfusion. This research demonstrated the potential of PAT for routine clinical tissue perfusion assessment.

Review of Three-Dimensional Handheld Photoacoustic and Ultrasound Imaging Systems and Their Applications

Photoacoustic (PA) imaging is a non-invasive biomedical imaging technique that combines the benefits of optics and acoustics to provide high-resolution structural and functional information. This review highlights the emergence of three-dimensional handheld PA imaging systems as a promising approach for various biomedical applications. These systems are classified into four techniques: direct imaging with 2D ultrasound (US) arrays, mechanical-scanning-based imaging with 1D US arrays, mirror-scanning-based imaging, and freehand-scanning-based imaging. A comprehensive overview of recent research in each imaging technique is provided, and potential solutions for system limitations are discussed. This review will serve as a valuable resource for researchers and practitioners interested in advancements and opportunities in three-dimensional handheld PA imaging technology.

Multispectral optoacoustic tomography for the non-invasive identification of patients with severe anemia in vivo

The immediate diagnosis of severe anemia is crucial for patient outcome. However, reliable non-invasive point-of-care diagnostic tools for e.g., ICU monitoring are currently lacking. Using an advanced Multispectral Optoacoustic Tomography (MSOT) research device, we first substantiated a strong positive correlation of MSOT-signal and absolute hemoglobin concentration ex vivo in blood samples. In a clinical exploratory proof-of-concept study, we then evaluated 19 patients with different severities of anemia and controls by non-invasive in vivo measurement of hemoglobin in the radial artery. Our approach proved excellent in identifying patients with severe anemia triggering RBC transfusion based on a strong positive correlation of MSOT-signal intensity and hemoglobin concentration for 700 nm single wavelength and HbR unmixed MSOT-parameter analysis. In conclusion, our study lays the foundation to further develop MSOT-based real-time quantitative perfusion analyses in follow-up preclinical and clinical imaging studies and as a promising diagnostic tool to improve patient care in the future. DRKS00021442.

Photoacoustic imaging to monitor outcomes during hyperbaric oxygen therapy: validation in a small cohort and case study in a bilateral chronic ischemic wound

Hyperbaric oxygen therapy (HBO2) is a common therapeutic modality that drives oxygen into hypoxic tissue to promote healing. Here, ten patients undergoing HBO2 underwent PA oximetry of the left radial artery and forearm pre- and post-HBO2; this cohort validated the use of PA imaging in HBO2. There was a significant increase in radial artery oxygenation after HBO2 (p = 0.002) in the validation cohort. We also include a case study: a non-diabetic male in his 50s (HB 010) presenting with bilateral ischemic and gangrenous wounds. HB 010 showed higher perfusion and oxygen saturation on the right foot than the left after HBO2 which correlated with independent surgical observations. Imaging assisted with limb salvage treatment. Hence, this work shows that PA imaging can measure changes in arterial oxygen saturation due to HBO2; it can also produce 3D maps of tissue oxygenation and evaluate response to therapy during HBO2.

Two-step proximal gradient descent algorithm for photoacoustic signal unmixing

Photoacoustic microscopy uses multiple wavelengths to measure concentrations of different absorbers. The speed of sound limits the shortest wavelength switching time to sub-microseconds, which is a bottleneck for high-speed broad-spectrum imaging. Via computational separation of overlapped signals, we can break the sound-speed limit on the wavelength switching time. This paper presents a new signal unmixing algorithm named two-step proximal gradient descent. It is advantageous in separating multiple wavelengths with long overlapping and high noise. In the simulation, we can unmix up to nine overlapped signals and successfully separate three overlapped signals with 12-ns delay and 15.9-dB signal-to-noise ratio. We apply this technique to separate three-wavelength photoacoustic images in microvessels. In vivo results show that the algorithm can successfully unmix overlapped multi-wavelength photoacoustic signals, and the unmixed data can improve accuracy in oxygen saturation imaging.