Photoacoustic imaging in cancer detection, diagnosis, and treatment guidance

U-Net enhanced real-time LED-based photoacoustic imaging

Photoacoustic (PA) imaging is hybrid imaging modality with good optical contrast and spatial resolution. Portable, cost-effective, smaller footprint light emitting diodes (LEDs) are rapidly becoming important PA optical sources. However, the key challenge faced by the LED-based systems is the low light fluence that is generally compensated by high frame averaging, consequently reducing acquisition frame-rate. In this study, we present a simple deep learning U-Net framework that enhances the signal-to-noise ratio (SNR) and contrast of PA image obtained by averaging low number of frames. The SNR increased by approximately four-fold for both in-class in vitro phantoms (4.39 ± 2.55) and out-of-class in vivo models (4.27 ± 0.87). We also demonstrate the noise invariancy of the network and discuss the downsides (blurry outcome and failure to reduce the salt & pepper noise). Overall, the developed U-Net framework can provide a real-time image enhancement platform for clinically translatable low-cost and low-energy light source-based PA imaging systems.

Photoacoustic imaging in prostate cancer: A new paradigm for diagnosis and management

The global health issue of prostate cancer (PCa) requires better diagnosis and treatment. Photoacoustic imaging (PAI) may change PCa management. This review examines PAI's principles, diagnostic role, and therapeutic guidance. PAI uses optical light excitation and ultrasonic detection for high-resolution functional and molecular imaging. PAI uses endogenous and exogenous contrast agents to distinguish cancerous and benign prostate tissues with greater sensitivity and specificity than PSA testing and TRUS-guided biopsy. In addition to diagnosing, PAI can guide and monitor PCa therapy. Its real-time imaging allows precise biopsies and brachytherapy seed placement. Photoacoustic temperature imaging allows non-invasive monitoring of thermal therapies like cryotherapy, improving treatment precision and success. Transurethral illumination probes, innovative contrast agents, integration with other imaging modalities, and machine learning analysis are being developed to overcome depth and data complexity restrictions. PAI could become an essential tool for PCa diagnosis and therapeutic guidance as the field advances.

Laser-Synthesized Germanium Nanoparticles as Biodegradable Material for Near-Infrared Photoacoustic Imaging and Cancer Phototherapy

Biodegradable nanomaterials can significantly improve the safety profile of nanomedicine. Germanium nanoparticles (Ge NPs) with a safe biodegradation pathway are developed as efficient photothermal converters for biomedical applications. Ge NPs synthesized by femtosecond-laser ablation in liquids rapidly dissolve in physiological-like environment through the oxidation mechanism. The biodegradation of Ge nanoparticles is preserved in tumor cells in vitro and in normal tissues in mice with a half-life as short as 3.5 days. Biocompatibility of Ge NPs is confirmed in vivo by hematological, biochemical, and histological analyses. Strong optical absorption of Ge in the near-infrared spectral range enables photothermal treatment of engrafted tumors in vivo, following intravenous injection of Ge NPs. The photothermal therapy results in a 3.9-fold reduction of the EMT6/P adenocarcinoma tumor growth with significant prolongation of the mice survival. Excellent mass-extinction of Ge NPs (7.9 L g-1 cm-1 at 808 nm) enables photoacoustic imaging of bones and tumors, following intravenous and intratumoral administrations of the nanomaterial. As such, strongly absorbing near-infrared-light biodegradable Ge nanomaterial holds promise for advanced theranostics.

Multi-spectral photoacoustic imaging combined with acoustic radiation force impulse imaging for applications in tissue engineering

Tissue engineering is a dynamic field focusing on the creation of advanced scaffolds for tissue and organ regeneration. These scaffolds are customized to their specific applications and are often designed to be complex, large structures to mimic tissues and organs. This study addresses the critical challenge of effectively characterizing these thick, optically opaque scaffolds that traditional imaging methods fail to fully image due to their optical limitations. We introduce a novel multi-modal imaging approach combining ultrasound, photoacoustic, and acoustic radiation force impulse imaging. This combination leverages its acoustic-based detection to overcome the limitations posed by optical imaging techniques. Ultrasound imaging is employed to monitor the scaffold structure, photoacoustic imaging is employed to monitor cell proliferation, and acoustic radiation force impulse imaging is employed to evaluate the homogeneity of scaffold stiffness. We applied this integrated imaging system to analyze melanoma cell growth within silk fibroin protein scaffolds with varying pore sizes and therefore stiffness over different cell incubation periods. Among various materials, silk fibroin was chosen for its unique combination of features including biocompatibility, tunable mechanical properties, and structural porosity which supports extensive cell proliferation. The results provide a detailed mesoscale view of the scaffolds' internal structure, including cell penetration depth and biomechanical properties. Our findings demonstrate that the developed multimodal imaging technique offers comprehensive insights into the physical and biological dynamics of tissue-engineered scaffolds. As the field of tissue engineering continues to advance, the importance of non-ionizing and non-invasive imaging systems becomes increasingly evident, and by facilitating a deeper understanding and better characterization of scaffold architectures, such imaging systems are pivotal in driving the success of future tissue-engineering solutions.

Activity-Based Fluorescence Diagnostics for Cancer

Fluorescence imaging is one of the most promising approaches to achieve intraoperative assessment of the tumor/normal tissue margins during cancer surgery. This is critical to improve the patients' prognosis, and therefore various molecular fluorescence imaging probes have been developed for the identification of cancer lesions during surgery. Among them, "activatable" fluorescence probes that react with cancer-specific biomarker enzymes to generate fluorescence signals have great potential for high-contrast cancer imaging due to their low background fluorescence and high signal amplification by enzymatic turnover. Over the past two decades, activatable fluorescence probes employing various fluorescence control mechanisms have been developed worldwide for this purpose. Furthermore, new biomarker enzymatic activities for specific types of cancers have been identified, enabling visualization of various types of cancers with high sensitivity and specificity. This Review focuses on recent advances in the design, function and characteristics of activatable fluorescence probes that target cancer-specific enzymatic activities for cancer imaging and also discusses future prospects in the field of activity-based diagnostics for cancer.

Recent Progress in Peptide-Based Molecular Probes for Disease Bioimaging

Recent strides in molecular pathology have unveiled distinctive alterations at the molecular level throughout the onset and progression of diseases. Enhancing the in vivo visualization of these biomarkers is crucial for advancing disease classification, staging, and treatment strategies. Peptide-based molecular probes (PMPs) have emerged as versatile tools due to their exceptional ability to discern these molecular changes with unparalleled specificity and precision. In this Perspective, we first summarize the methodologies for crafting innovative functional peptides, emphasizing recent advancements in both peptide library technologies and computer-assisted peptide design approaches. Furthermore, we offer an overview of the latest advances in PMPs within the realm of biological imaging, showcasing their varied applications in diagnostic and therapeutic modalities. We also briefly address current challenges and potential future directions in this dynamic field.

Protocol to detect and quantify tumor hypoxia in mice using photoacoustic imaging

Photoacoustic imaging (PAI) with co-registered ultrasound (US) is a hybrid non-invasive imaging modality that enables visualization and quantification of tumor hypoxia in live animals. Here, using a breast tumor xenograft model as an example, we present a stepwise protocol describing animal preparation, positioning, instrument setup, and US-PAI image acquisition procedures. This protocol also guides through detailed data analysis, explains functional readouts obtained from PAI, and discusses the potential application of the technology to study the hypoxic tumor microenvironment. For complete details on the use and execution of this protocol, please refer to Dai et al.1.

Nitric oxide nano-reactor DNMF/PLGA enables tumor vascular microenvironment and chemo-hyperthermia synergetic therapy

BACKGROUND

Breast cancer ranks first among malignant tumors, of which triple-negative breast cancer (TNBC) is characterized by its highly invasive behavior and the worst prognosis. Timely diagnosis and precise treatment of TNBC are substantially challenging. Abnormal tumor vessels play a crucial role in TNBC progression and treatment. Nitric oxide (NO) regulates angiogenesis and maintains vascular homeostasis, while effective NO delivery can normalize the tumor vasculature. Accordingly, we have proposed here a tumor vascular microenvironment remodeling strategy based on NO-induced vessel normalization and extracellular matrix collagen degradation with multimodality imaging-guided nanoparticles against TNBC called DNMF/PLGA.

RESULTS

Nanoparticles were synthesized using a chemotherapeutic agent doxorubicin (DOX), a NO donor L-arginine (L-Arg), ultrasmall spinel ferrites (MnFe2O4), and a poly (lactic-co-glycolic acid) (PLGA) shell. Nanoparticle distribution in the tumor was accurately monitored in real-time through highly enhanced magnetic resonance imaging and photoacoustic imaging. Near-infrared irradiation of tumor cells revealed that MnFe2O4 catalyzes the production of a large amount of reactive oxygen species (ROS) from H2O2, resulting in a cascade catalysis of L-Arg to trigger NO production in the presence of ROS. In addition, DOX activates niacinamide adenine dinucleotide phosphate oxidase to generate and supply H2O2. The generated NO improves the vascular endothelial cell integrity and pericellular contractility to promote vessel normalization and induces the activation of endogenous matrix metalloproteinases (mainly MMP-1 and MMP-2) so as to promote extravascular collagen degradation, thereby providing an auxiliary mechanism for efficient nanoparticle delivery and DOX penetration. Moreover, the chemotherapeutic effect of DOX and the photothermal effect of MnFe2O4 served as a chemo-hyperthermia synergistic therapy against TNBC.

CONCLUSION

The two therapeutic mechanisms, along with an auxiliary mechanism, were perfectly combined to enhance the therapeutic effects. Briefly, multimodality image-guided nanoparticles provide a reliable strategy for the potential application in the fight against TNBC.

Gene and Photothermal Combination Therapy: Principle, Materials, and Amplified Anticancer Intervention

Gene therapy (GT) and photothermal therapy (PTT) have emerged as promising alternatives to chemotherapy and radiotherapy for cancer treatment, offering noninvasiveness and reduced side effects. However, their efficacy as standalone treatments is limited. GT exhibits slow response rates, while PTT is confined to local tumor ablation. The convergence of GT and PTT, known as GT-PTT, facilitated by photothermal gene nanocarriers, has attracted considerable attention across various disciplines. In this integrated approach, GT reciprocates PTT by sensitizing cellular response to heat, while PTT benefits GT by improving gene translocation, unpacking, and expression. Consequently, this integration presents a unique opportunity for cancer therapy with rapid response and improved effectiveness. Extensive efforts over the past few years have been dedicated to the development of GT-PTT, resulting in notable achievements and rapid progress from the laboratory to potential clinical applications. This comprehensive review outlines recent advances in GT-PTT, including synergistic mechanisms, material systems, imaging-guided therapy, and anticancer applications. It also explores the challenges and future prospects in this nascent field. By presenting innovative ideas and insights into the implementation of GT-PTT for enhanced cancer therapy, this review aims to inspire further progress in this promising area of research.

Recent advances in cancer cell bionic nanoparticles for tumour therapy

Nanoparticle-based drug delivery systems have found extensive use in delivering oncology therapeutics; however, some delivery vehicles still exhibit rapid immune clearance, lack of biocompatibility and insufficient targeting. In recent years, bionanoparticles constructed from tumour cell membranes have gained momentum as tumour-targeting therapeutic agents. Cancer cell membrane-coated nanoparticles (CCMCNPs) typically consist of a drug-loaded nanoparticle core coated with cancer cell membrane. CCMCNPs retain homologous tumour cell surface antigens, receptors and proteins, and it has been shown that the modified nanoparticles exhibit better homologous targeting, immune escape and biocompatibility. CCMCNPs are now widely used in a variety of cancer treatments, including photothermal, photodynamic and sonodynamic therapies, chemotherapy, immunotherapy, chemodynamical therapy or other combination therapies. This article presents different therapeutic approaches using multimodal antitumour therapy-combination of two or more therapies that treat tumours synergistically-based on tumour cell membrane systems. The advantages of CCMCNPs in different cancer treatments in recent years are summarised, thus, providing new strategies for cancer treatment research.

Ultrasound-guided Photoacoustic image Annotation Toolkit in MATLAB (PHANTOM) for preclinical applications

Depth-dependent fluence-compensation in photoacoustic (PA) imaging is paramount for accurate quantification of chromophores from deep tissues. Here we present a user-friendly toolkit named PHANTOM (PHotoacoustic ANnotation TOolkit for MATLAB) that includes a graphical interface and assists in the segmentation of ultrasound-guided PA images. We modelled the light source configuration with Monte Carlo eXtreme and utilized 3D segmented tissues from ultrasound to generate fluence maps to depth compensate PA images. The methodology was used to analyze PA images of phantoms with varying blood oxygenation and results were validated with oxygen electrode measurements. Two preclinical models, a subcutaneous tumor and a calcified placenta, were imaged and fluence-compensated using the PHANTOM toolkit and the results were verified with immunohistochemistry. The PHANTOM toolkit provides scripts and auxiliary functions to enable biomedical researchers not specialized in optical imaging to apply fluence correction to PA images, enhancing accessibility of quantitative PAI for researchers in various fields.

In Vivo Photoacoustic Monitoring of Stem Cell Location and Apoptosis with Caspase-3-Responsive Nanosensors

Stem cell therapy has immense potential in a variety of regenerative medicine applications. However, clinical stem cell therapy is severely limited by challenges in assessing the location and functional status of implanted cells in vivo. Thus, there is a great need for longitudinal, noninvasive stem cell monitoring. Here we introduce a multidisciplinary approach combining nanosensor-augmented stem cell labeling with ultrasound guided photoacoustic (US/PA) imaging for the spatial tracking and functional assessment of transplanted stem cell fate. Specifically, our nanosensor incorporates a peptide sequence that is selectively cleaved by caspase-3, the primary effector enzyme in mammalian cell apoptosis; this cleavage event causes labeled cells to show enhanced optical absorption in the first near-infrared (NIR) window. Optimization of labeling protocols and spectral characterization of the nanosensor in vitro showed a 2.4-fold increase in PA signal from labeled cells during apoptosis while simultaneously permitting cell localization. We then successfully tracked the location and apoptotic status of mesenchymal stem cells in a mouse hindlimb ischemia model for 2 weeks in vivo, demonstrating a 4.8-fold increase in PA signal and spectral slope changes in the first NIR window under proapoptotic (ischemic) conditions. We conclude that our nanosensor allows longitudinal, noninvasive, and nonionizing monitoring of stem cell location and apoptosis, which is a significant improvement over current end-point monitoring methods such as biopsies and histological staining of excised tissue.

Thirty years of research on photoacoustic imaging in the field of cancer: A scientometric analysis of hotspots, bursts, and research trends

As a novel imaging modality based on photoacoustic effects, photoacoustic imaging (PAI) has shown great potential in biomedical applications, especially in the field of cancer. The purpose of our research was to identify collaborations between different institutions, authors, and countries, and to explore the hotspots and prospects of PAI research in the field of cancer. We downloaded publications on PAI research from the Science Citation Index-Expanded (SCI-E) of the Web of Science Core Collection database. Bibliometric analysis was performed using VOSviewer and CiteSpace software. A total of 2561 papers related to PAI research in the field of cancer were identified. A total of 10,105 authors participated in the PAI study, of which the majority (69.33%) authors participated in only 1 article. China (1638, 63.96%) was the country with the most articles in this field, and the Chinese Academy of Sciences (329, 12.85%) was the most productive institution. ACS Applied Materials & Interfaces (146, 5.70%) was the most productive journal and ACS Nano (7262 co-citations) was the most co-cited journal. Current hot topics of PAI research in the cancer field were the construction and development of multifunctional photoacoustic nanoprobes to achieve the integration of tumor detection and treatment. The application of photoacoustic imaging in the field of cancer is in the vigorous development stage and has a bright prospect. There was a wealth of cooperation between authors, countries, and institutions. Our findings can provide information about the future direction of funding agencies and research groups.

A flexible optoacoustic blood 'stethoscope' for noninvasive multiparametric cardiovascular monitoring

Quantitative and multiparametric blood analysis is of great clinical importance in cardiovascular disease diagnosis. Although there are various methods to extract blood information, they often require invasive procedures, lack continuity, involve bulky instruments, or have complicated testing procedures. Flexible sensors can realize on-skin assessment of several vital signals, but generally exhibit limited function to monitor blood characteristics. Here, we report a flexible optoacoustic blood 'stethoscope' for noninvasive, multiparametric, and continuous cardiovascular monitoring, without requiring complicated procedures. The optoacoustic blood 'stethoscope' features the light delivery elements to illuminate blood and the piezoelectric acoustic elements to capture light-induced acoustic waves. We show that the optoacoustic blood 'stethoscope' can adhere to the skin for continuous and non-invasive in-situ monitoring of multiple cardiovascular biomarkers, including hypoxia, intravascular exogenous agent concentration decay, and hemodynamics, which can be further visualized with a tailored 3D algorithm. Demonstrations on both in-vivo animal trials and human subjects highlight the optoacoustic blood 'stethoscope''s potential for cardiovascular disease diagnosis and prediction.

Niche preclinical and clinical applications of photoacoustic imaging with endogenous contrast

In the past decade, photoacoustic (PA) imaging has attracted a great deal of popularity as an emergent diagnostic technology owing to its successful demonstration in both preclinical and clinical arenas by various academic and industrial research groups. Such steady growth of PA imaging can mainly be attributed to its salient features, including being non-ionizing, cost-effective, easily deployable, and having sufficient axial, lateral, and temporal resolutions for resolving various tissue characteristics and assessing the therapeutic efficacy. In addition, PA imaging can easily be integrated with the ultrasound imaging systems, the combination of which confers the ability to co-register and cross-reference various features in the structural, functional, and molecular imaging regimes. PA imaging relies on either an endogenous source of contrast (e.g., hemoglobin) or those of an exogenous nature such as nano-sized tunable optical absorbers or dyes that may boost imaging contrast beyond that provided by the endogenous sources. In this review, we discuss the applications of PA imaging with endogenous contrast as they pertain to clinically relevant niches, including tissue characterization, cancer diagnostics/therapies (termed as theranostics), cardiovascular applications, and surgical applications. We believe that PA imaging's role as a facile indicator of several disease-relevant states will continue to expand and evolve as it is adopted by an increasing number of research laboratories and clinics worldwide.

Visual inertial odometry enabled 3D ultrasound and photoacoustic imaging

There is an increasing need for 3D ultrasound and photoacoustic (USPA) imaging technology for real-time monitoring of dynamic changes in vasculature or molecular markers in various malignancies. Current 3D USPA systems utilize expensive 3D transducer arrays, mechanical arms or limited-range linear stages to reconstruct the 3D volume of the object being imaged. In this study, we developed, characterized, and demonstrated an economical, portable, and clinically translatable handheld device for 3D USPA imaging. An off-the-shelf, low-cost visual odometry system (the Intel RealSense T265 camera equipped with simultaneous localization and mapping technology) to track free hand movements during imaging was attached to the USPA transducer. Specifically, we integrated the T265 camera into a commercially available USPA imaging probe to acquire 3D images and compared it to the reconstructed 3D volume acquired using a linear stage (ground truth). We were able to reliably detect 500 µm step sizes with 90.46% accuracy. Various users evaluated the potential of handheld scanning, and the volume calculated from the motion-compensated image was not significantly different from the ground truth. Overall, our results, for the first time, established the use of an off-the-shelf and low-cost visual odometry system for freehand 3D USPA imaging that can be seamlessly integrated into several photoacoustic imaging systems for various clinical applications.

Photoacoustic imaging for investigating tumor hypoxia: a strategic assessment

Hypoxia causes the expression of signaling molecules which regulate cell division, lead to angiogenesis, and further, in the tumor microenvironment, promote resistance to chemotherapy and radiotherapy, and induce metastasis. Photoacoustic imaging (PAI) takes advantage of unique absorption characteristics of chromophores in tissues and provides the opportunity to construct images with a high degree of spatial and temporal resolution. In this review, we discuss the physiologic characteristics of tumor hypoxia, and current applications of PAI using endogenous (label free imaging) and exogenous (organic and inorganic) contrast agents. Features of various methods in terms of their efficacy for determining physiologic and proteomic phenomena are analyzed. This review demonstrates that PAI has the potential to understand tumor growth and metastasis development through measurement of regulatory molecule concentrations, oxygen gradients, and vascular distribution.

Metal Nanoparticles as Novel Agents for Lung Cancer Diagnosis and Therapy

Lung cancer is one of the most common malignancies worldwide and contributes to most cancer-related morbidity and mortality cases. During the past decades, the rapid development of nanotechnology has provided opportunities and challenges for lung cancer diagnosis and therapeutics. As one of the most extensively studied nanostructures, metal nanoparticles obtain higher satisfaction in biomedical applications associated with lung cancer. Metal nanoparticles have enhanced almost all major imaging strategies and proved great potential as sensor for detecting cancer-specific biomarkers. Moreover, metal nanoparticles could also improve therapeutic efficiency via better drug delivery, improved radiotherapy, enhanced gene silencing, and facilitated photo-driven treatment. Herein, the recently advanced metal nanoparticles applied in lung cancer therapy and diagnosis are summarized. Future perspective on the direction of metal-based nanomedicine is also discussed. Stimulating more research interests to promote the development of metal nanoparticles in lung cancer is devoted.

Hybrid photoacoustic and fast super-resolution ultrasound imaging

The combination of photoacoustic (PA) imaging and ultrasound localization microscopy (ULM) with microbubbles has great potential in various fields such as oncology, neuroscience, nephrology, and immunology. Here we developed an interleaved PA/fast ULM imaging technique that enables super-resolution vascular and physiological imaging in less than 2 seconds per frame in vivo. By using sparsity-constrained (SC) optimization, we accelerated the frame rate of ULM up to 37 times with synthetic data and 28 times with in vivo data. This allows for the development of a 3D dual imaging sequence with a commonly used linear array imaging system, without the need for complicated motion correction. Using the dual imaging scheme, we demonstrated two in vivo scenarios challenging to image with either technique alone: the visualization of a dye-labeled mouse lymph node showing nearby microvasculature, and a mouse kidney microangiography with tissue oxygenation. This technique offers a powerful tool for mapping tissue physiological conditions and tracking the contrast agent biodistribution non-invasively.

Use of photoacoustic imaging for monitoring vascular disrupting cancer treatments

Vascular disrupting agents disrupt tumor vessels, blocking the nutritional and oxygen supply tumors need to thrive. This is achieved by damaging the endothelium lining of blood vessels, resulting in red blood cells (RBCs) entering the tumor parenchyma. RBCs present in the extracellular matrix are exposed to external stressors resulting in biochemical and physiological changes. The detection of these changes can be used to monitor the efficacy of cancer treatments. Spectroscopic photoacoustic (PA) imaging is an ideal candidate for probing RBCs due to their high optical absorption relative to surrounding tissue. The goal of this work is to use PA imaging to monitor the efficacy of the vascular disrupting agent 5,6-Dimethylxanthenone-4-acetic acid (DMXAA) through quantitative analysis. Then, 4T1 breast cancer cells were injected subcutaneously into the left hind leg of eight BALB/c mice. After 10 days, half of the mice were treated with 15 mg/kg of DMXAA and the other half were injected with saline. All mice were imaged using the VevoLAZR X PA system before treatment, 24 and 72 hours after treatment. The imaging was done at six wavelengths and linear spectral unmixing was applied to the PA images to quantify three forms of hemoglobin (oxy, deoxy and met-hemoglobin). After imaging, tumors were histologically processed and H&E and TUNEL staining were used to detect the tissue damage induced by the DMXAA treatment. The total hemoglobin concentration remained unchanged after treatment for the saline treated mice. For DMXAA treated mice, a 10% increase of deoxyhemoglobin concentration was detected 24 hours after treatment and a 22.6% decrease in total hemoglobin concentration was observed by 72 hours. A decrease in the PA spectral slope parameters was measured 24 hours after treatment. This suggests that DMXAA induces vascular damage, causing red blood cells to extravasate. Furthermore, H&E staining of the tumor showed areas of bleeding with erythrocyte deposition. These observations are further supported by the increase in TUNEL staining in DMXAA treated tumors, revealing increased cell death due to vascular disruption. This study demonstrates the capability of PA imaging to monitor tumor vessel disruption by the vascular disrupting agent DMXAA.

Titanium-Based Nanoarchitectures for Sonodynamic Therapy-Involved Multimodal Treatments

Sonodynamic therapy (SDT) has considerably revolutionized the healthcare sector as a viable noninvasive therapeutic procedure. It employs a combination of low-intensity ultrasound and chemical entities, known as a sonosensitizer, to produce cytotoxic reactive oxygen species (ROS) for cancer and antimicrobial therapies. With nanotechnology, several unique nanoplatforms are introduced as a sonosensitizers, including, titanium-based nanomaterials, thanks to their high biocompatibility, catalytic efficiency, and customizable physicochemical features. Additionally, developing titanium-based sonosensitizers facilitates the integration of SDT with other treatment modalities (for example, chemotherapy, chemodynamic therapy, photodynamic therapy, photothermal therapy, and immunotherapy), hence increasing overall therapeutic results. This review summarizes the most recent developments in cancer therapy and tissue engineering using titanium nanoplatforms mediated SDT. The synthesis strategies and biosafety aspects of Titanium-based nanoplatforms for SDT are also discussed. Finally, various challenges and prospects for its further development and potential clinical translation are highlighted.

Reaching new lights: a review on photo-controlled nanomedicines and their in vivo evaluation

The selective and efficient delivery of bioactive molecules to sites of interest remains a formidable challenge in medicine. In recent years, it has been shown that stimuli-responsive drug delivery systems display several advantages over traditional drug administration such as an improved pharmacokinetic profile and the desirable ability to gain control over release. Light emerged as one of the most powerful stimuli due to its high biocompatibility, spatio-temporal control, and non-invasiveness. On the road to clinical translation, various chemical systems of high complexity have been reported with the aim to improve efficacy, safety, and versatility of drug delivery under complex biological conditions. For future research on the chemical design of such photo-controlled nanomedicines, it is essential to gain an understanding of their in vivo translation and efficiency. Here, we discuss photo-controlled nanomedicines that have been evaluated in vivo and provide an overview of the state-of-the-art that should guide future research design.

Modeling of Rapid Pam Systems Based on Electrothermal Micromirror for High-Resolution Facial Angiography

In this paper, a portable photoacoustic microscopy (PAM) system is proposed based on a large stroke electrothermal micromirror to achieve high resolution and fast imaging. The crucial micromirror in the system realizes a precise and efficient 2-axis control. Two different designs of electrothermal actuators with "O" and "Z" shape are evenly located around the four directions of mirror plate. With a symmetrical structure, the actuator realized single direction drive only. The finite element modelling of both two proposed micromirror has realized a large displacement over 550 μm and the scan angle over ±30.43° at 0-10 V DC excitation. In addition, the steady-state and transient-state response show a high linearity and quick response respectively, which can contribute to a fast and stable imaging. Using the Linescan model, the system achieves an effective imaging area of 1 mm × 3 mm in 14 s and 1 mm × 4 mm in 12 s for the "O" and "Z" types, respectively. The proposed PAM systems have advantages in image resolution and control accuracy, indicating a significant potential in the field of facial angiography.

An aminopeptidase N-based color-convertible fluorescent nano-probe for cancer diagnosis

Specific cancer diagnosis at an early stage plays a significant role in preventing cancer metastasis and reducing cancer mortality. Thus, exploring specific and sensitive fluorescent probes to realize early cancer diagnosis is an urgent need in clinic. Aminopeptidase N (APN/CD13), overexpressed in numerous malignant tumors, is an important tumor biomarker associated with cancer progression, invasion, and metastasis. In this study, a novel fluorescent molecule APN-SUB, capable of monitoring APN in real time, is encapsulated in a pH-responsive block copolymer (termed APN-SUB nanoprobe) for cancer diagnosis. APN-SUB contains a fluorophore center and a trigger moiety (leucine group), which is covalently conjugated on the fluorophore with an amide bond. The hydrolysis of the amide bond in APN-SUB activated by APN leads to a red shift of maximum fluorescence emission wavelength from 495 nm to 600 nm, realizing dual-color transformation from green to red. Moreover, the APN-SUB nanoprobe with pH-responsiveness is prepared to improve the accumulation and the release rate in the tumor region. It is worth noting that the APN-SUB nanoprobe exhibits good performance for APN imaging, namely, superior limit of detection (0.14 nU mL^-1), excellent selectivity and strong photostability. More importantly, the APN-SUB nanoprobe can be successfully employed as a color-convertible fluorescent probe for cancer diagnosis by tracking the activity of APN with high specificity and sensitivity in vivo, demonstrating its potential value for cancer diagnosis.

Chemosensor with Ultra-High Fluorescence Enhancement for Assisting in Diagnosis and Resection of Ovarian Cancer

Fluorescence imaging-guided diagnostics is one of the most promising approaches for facile detection of tumors in situ owing to its simple operation and non-invasiveness. As a crucial biomarker for primary ovarian cancers, β-galactosidase (β-gal) has been demonstrated to be the significant molecular target for visualization of ovarian tumors. Herein, a membrane-permeable fluorescent chemosensor (namely, LAN-βgal) was synthesized for β-gal-specific detection using the d-galactose residue as a specific recognition unit and LAN-OH (Φ_F = 0.47) as a fluorophore. After β-gal was digested, the fluorescence of the initially quenched LAN-βgal (Φ_F < 0.001) was enhanced by up to more than 2000-fold, which exceeded the fluorescence enhancement of other previously reported probes. We also demonstrated that the chemosensor LAN-βgal could visualize endogenous β-gal and distinguish ovarian cancer cells from normal ovarian cells. Further, the chemosensor LAN-βgal was successfully applied to visualize the back tumor-bearing mouse model and peritoneal metastatic ovarian cancer model in vivo. More importantly, through in situ spraying, the proposed chemosensor was successfully employed to assist in the surgical resection of ovarian cancer tumors due to its high tumor-to-normal (T/N) tissue fluorescence ratio of 218. To the best of our knowledge, this is the highest T/N tissue fluorescence ratio ever reported. We believe that the LAN-βgal chemosensor can be utilized as a new tool for the clinical diagnosis and treatment of ovarian cancer.

A jointed feature fusion framework for photoacoustic image reconstruction

The standard reconstruction of Photoacoustic (PA) computed tomography (PACT) image could cause the artifacts due to interferences or ill-posed setup. Recently, deep learning has been used to reconstruct the PA image with ill-posed conditions. In this paper, we propose a jointed feature fusion framework (JEFF-Net) based on deep learning to reconstruct the PA image using limited-view data. The cross-domain features from limited-view position-wise data and the reconstructed image are fused by a backtracked supervision. A quarter position-wise data (32 channels) is fed into model, which outputs another 3-quarters-view data (96 channels). Moreover, two novel losses are designed to restrain the artifacts by sufficiently manipulating superposed data. The experimental results have demonstrated the superior performance and quantitative evaluations show that our proposed method outperformed the ground-truth in some metrics by 135% (SSIM for simulation) and 40% (gCNR for in-vivo) improvement.

In situ synthesized nanozyme for photoacoustic-imaging-guided photothermal therapy and tumor hypoxia relief

Nanozymes have attracted extensive research interest due to their ideal enzymatic catalytic performance; however, uncontrollable activities and nonspecific accumulation limit their further clinical application. To overcome these obstacles, we proposed in situ synthesized nanozyme, and realized the concept through an intelligent nanosystem (ISSzyme) based on Prussian blue (PB) precursor. PB nanozyme was synthesized at the tumor sites through the interaction of ISSzyme with glutathione, which was demonstrated by comparing with conventional PB nanozyme. ISSzyme is capable of tumor-specific photoacoustic imaging (PAI) and photothermal therapy (PTT), reducing the false-positive signals of PAI and the treatment side effects of PTT. ISSzyme has catalase-like activities, resulting in tumor hypoxia relief and metastasis inhibition. More importantly, the in situ synthesized PB nanozyme has the favorable property of minimal liver accumulation. Considering the above advantages, ISSzyme is expected to shed light on the design of the next-generation artificial enzymes, with many new biomedical applications.

Optimizing Axial and Peripheral Substitutions in Si-Centered Naphthalocyanine Dyes for Enhancing Aqueous Solubility and Photoacoustic Signal Intensity

Photoacoustic imaging using external contrast agents is emerging as a powerful modality for real-time molecular imaging of deep-seated tumors. There are several chromophores, such as indocyanine green and IRDye800, that can potentially be used for photoacoustic imaging; however, their use is limited due to several drawbacks, particularly photostability. There is, therefore, an urgent need to design agents to enhance contrast in photoacoustic imaging. Naphthalocyanine dyes have been demonstrated for their use as photoacoustic contrast agents; however, their low solubility in aqueous solvents and high aggregation propensity limit their application. In this study, we report the synthesis and characterization of silicon-centered naphthalocyanine dyes with high aqueous solubility and near infra-red (NIR) absorption in the range of 850-920 nm which make them ideal candidates for photoacoustic imaging. A series of Silicon-centered naphthalocyanine dyes were developed with varying axial and peripheral substitutions, all in an attempt to enhance their aqueous solubility and improve photophysical properties. We demonstrate that axial incorporation of charged ammonium mesylate group enhances water solubility. Moreover, the incorporation of peripheral 2-methoxyethoxy groups at the α-position modulates the electronic properties by altering the π-electron delocalization and enhancing photoacoustic signal amplitude. In addition, all the dyes were synthesized to incorporate an N-hydroxysuccinimidyl group to enable further bioconjugation. In summary, we report the synthesis of water-soluble silicon-centered naphthalocyanine dyes with a high photoacoustic signal amplitude that can potentially be used as contrast agents for molecular photoacoustic imaging.

Photoacoustic signal enhancement in dual-contrast gastrin-releasing peptide receptor-targeted nanobubbles

Translatable imaging agents are a crucial element of successful molecular imaging. Photoacoustic molecular imaging relies on optical absorbing materials to generate a sufficient signal. However, few materials approved for human use can generate adequate photoacoustic responses. Here we report a new nanoengineering approach to further improve photoacoustic response from biocompatible materials. Our study shows that when optical absorbers are incorporated into the shell of a gaseous nanobubble, their photoacoustic signal can be significantly enhanced compared to the original form. As an example, we constructed nanobubbles using biocompatible indocyanine green (ICG) and biodegradable poly(lactic-co-glycolic acid) (PLGA). We demonstrated that these ICG nanobubbles generate a strong ultrasound signal and almost four-fold photoacoustic signal compared to the same concentration of ICG solution; our theoretical calculations corroborate this effect and elucidate the origin of the photoacoustic enhancement. To demonstrate their molecular imaging performance, we conjugated gastrin-releasing peptide receptor (GRPR) targeting ligands with the ICG nanobubbles. Our dual photoacoustic/ultrasound molecular imaging shows a more than three-fold enhancement in targeting specificity of the GRPR-targeted ICG nanobubbles, compared to untargeted nanobubbles or prostate cancer cells not expressing GRPR, in a prostate cancer xenograft mouse model in vivo.

An Investigation of Signal Preprocessing for Photoacoustic Tomography

Photoacoustic tomography (PAT) is increasingly being used for high-resolution biological imaging at depth. Signal-to-noise ratios and resolution are the main factors that determine image quality. Various reconstruction algorithms have been proposed and applied to reduce noise and enhance resolution, but the efficacy of signal preprocessing methods which also affect image quality, are seldom discussed. We, therefore, compared common preprocessing techniques, namely bandpass filters, wavelet denoising, empirical mode decomposition, and singular value decomposition. Each was compared with and without accounting for sensor directivity. The denoising performance was evaluated with the contrast-to-noise ratio (CNR), and the resolution was calculated as the full width at half maximum (FWHM) in both the lateral and axial directions. In the phantom experiment, counting in directivity was found to significantly reduce noise, outperforming other methods. Irrespective of directivity, the best performing methods for denoising were bandpass, unfiltered, SVD, wavelet, and EMD, in that order. Only bandpass filtering consistently yielded improvements. Significant improvements in the lateral resolution were observed using directivity in two out of three acquisitions. This study investigated the advantages and disadvantages of different preprocessing methods and may help to determine better practices in PAT reconstruction.

Recent Advances in Flexible Ultrasonic Transducers: From Materials Optimization to Imaging Applications

Ultrasonic (US) transducers have been widely used in the field of ultrasonic and photoacoustic imaging system in recent years, to convert acoustic and electrical signals into each other. As the core part of imaging systems, US transducers have been extensively studied and achieved remarkable progress recently. Imaging systems employing conventional rigid US transducers impose certain constraints, such as not being able to conform to complex surfaces and comfortably come into contact with skin and the sample, and meet the applications of continuous monitoring and diagnosis. To overcome these drawbacks, significant effort has been made in transforming the rigid US transducers to become flexible and wearable. Flexible US transducers ensure self-alignment to complex surfaces and maximize the transferred US energy, resulting in high quality detection performance. The advancement in flexible US transducers has further extended the application range of imaging systems. This review is intended to summarize the most recent advances in flexible US transducers, including advanced functional materials optimization, representative US transducers designs and practical applications in imaging systems. Additionally, the potential challenges and future directions of the development of flexible US transducers are also discussed.

Laser-activated nanoparticles for ultrasound/photoacoustic imaging-guided prostate cancer treatment

Prostate cancer (PCa) is the most common malignant tumor in men. Prostate-specific membrane antigen (PSMA), which is overexpressed on the surface of Prostate cancer cells, may serve as a potential therapeutic target. Recently, image-guided and targeted therapy for prostate cancers has attracted much attention by using Prostate-specific membrane antigen targeting nanoparticle. In this study, we produced PSMA-targeted light-responsive nanosystems. These nanosystems of liquid perfluorocarbon cores and polymer shells were loaded with the photosensitizer IR780 and therapeutic drugs paclitaxel. The liquid perfluorocarbon (PFP) in nanoparticles can perform ultrasound-enhanced imaging by liquid-gas transition and promote the deliver and release of paclitaxel. IR780 can perform photothermal therapy (PTT) guided by photoacoustic (PA) imaging. Combination treatment with photothermal therapy and chemotherapy exhibited excellent inhibition of cell proliferation in vitro and a significant therapeutic effect in vivo. In conclusion, we successfully formulated PSMA-targeted nanosystems with precision targeting and ultrasound/PA dual-modality imaging for anti-tumor effects.

Theoretical and experimental comparison of the performance of gold, titanium, and platinum nanodiscs as contrast agents for photoacoustic imaging

Exogenous contrast agents in photoacoustic imaging help improve spatial resolution and penetration depth and enable targeted molecular imaging. To screen efficient photoacoustic signaling materials as contrast agents, we propose a light absorption-weighted figure of merit (FOM) that can be calculated using material data from the literature and numerically simulated light absorption cross-sections. The calculated light absorption-weighted FOM shows that a Ti nanodisc has a photoacoustic conversion performance similar to that of an Au nanodisc and better than that of a Pt nanodisc. The photoacoustic imaging results of Ti, Au, and Pt nanodiscs, which are physically synthesized with identical shapes and dimensions, experimentally demonstrated that the Ti nanodisc could be a highly efficient contrast agent.

Nanodiscs with different materials but the same shape and size were synthesized, and their performance as photoacoustic imaging contrast agents was compared both theoretically and experimentally.

Multicomponent carrier-free nanodrugs for cancer treatment

Nanocarriers can be used to deliver insoluble anticancer drugs to optimize therapeutic efficacy. However, the potential toxicity of nanocarriers cannot be ignored. Carrier-free nanodrugs are emerging safe drug delivery systems, which are composed of multiple components, such as drugs, bioactive molecules and functional ingredients, avoiding the usage of inert carrier materials and offering advantages that include high drug loading, low toxicity, synergistic therapy, versatile design, and easy surface functionalization. Therefore, how to design multicomponent carrier-free nanodrugs is becoming a priority. In this review, the common strategies for rapid construction of multicomponent carrier-free nanodrugs are briefly explored from the perspective of methodology. The properties of organic-organic, organic-inorganic and inorganic-inorganic multiple carrier-free nanosystems are analyzed according to wettability and in-depth understanding is provided. Further advances in the applications of multiple carrier-free nanodrugs are outlined in anticipation of grasping the intrinsic nature for the design and development of carrier-free nanodrugs.

A Comprehensive Review on Photoacoustic-Based Devices for Biomedical Applications

The photoacoustic effect is an emerging technology that has sparked significant interest in the research field since an acoustic wave can be produced simply by the incidence of light on a material or tissue. This phenomenon has been extensively investigated, not only to perform photoacoustic imaging but also to develop highly miniaturized ultrasound probes that can provide biologically meaningful information. Therefore, this review aims to outline the materials and their fabrication process that can be employed as photoacoustic targets, both biological and non-biological, and report the main components' features to achieve a certain performance. When designing a device, it is of utmost importance to model it at an early stage for a deeper understanding and to ease the optimization process. As such, throughout this article, the different methods already implemented to model the photoacoustic effect are introduced, as well as the advantages and drawbacks inherent in each approach. However, some remaining challenges are still faced when developing such a system regarding its fabrication, modeling, and characterization, which are also discussed.

Small Animal In Situ Drug Delivery Effects via Transdermal Microneedles Array versus Intravenous Injection: A Pilot Observation Based on Photoacoustic Tomography

Intravenous injection is a rapid, low-cost, and direct method that is commonly used to deliver multifarious biotherapeutics and vaccines. However, intravenous injection often causes trauma or tissue injury that requires professional operation. Transdermal drug delivery overcomes the aforementioned defects, and the microneedles (MNs) array is one of the most promising transdermal drug delivery platforms. Timely, precise, and non-invasive monitoring and evaluation of the effects of MNs in transdermal administration is significant to the research of drug efficiency response to specific diseases. In this sense, photoacoustic computed tomography (PACT), which provides wavelength-selective and deep-penetrating optical contrast, could be a promising imaging tool for in situ evaluation of the treatment effects. In this work, we propose the use of PACT to non-invasively assess the effects of real-time drug delivery in glioma tumors through transdermal administration with degradable indocyanine green-loaded hyaluronic acid MNs (ICG-HA-MNs). The outcome is systematically and quantitatively compared with that via intravenous injection. It is found that the photoacoustic signals of ICG in the tumor site express a faster elevation and shorter duration time in the intravenous injection group; by contrast, the photoacoustic signals demonstrate a lower intensity but prolonged duration time in the MNs group. The observed phenomenon indicates faster response but shorter drug duration for intravenous injection, which is in contrast with the lower loading but prolonged performance for transdermal drug delivery with MNs. These results exhibit good consistency with the earlier, common-sense findings reported from other aspects, confirming that PACT can serve as a potential imaging tool to precisely, non-invasively, and quickly evaluate in situ drug delivery effects and provide constructive guidance for the design and fabrication of microneedles.

Ultrasound-enhanced Unet model for quantitative photoacoustic tomography of ovarian lesions

Quantitative photoacoustic tomography (QPAT) is a valuable tool in characterizing ovarian lesions for accurate diagnosis. However, accurately reconstructing a lesion's optical absorption distributions from photoacoustic signals measured with multiple wavelengths is challenging because it involves an ill-posed inverse problem with three unknowns: the Grüneisen parameter ( Γ ) , the absorption distribution, and the optical fluence ( ϕ ) . Here, we propose a novel ultrasound-enhanced Unet model (US-Unet) that reconstructs optical absorption distribution from PAT data. A pre-trained ResNet-18 extracts the US features typically identified as morphologies of suspicious ovarian lesions, and a Unet is implemented to reconstruct optical absorption coefficient maps, using the initial pressure and US features extracted by ResNet-18. To test this US-Unet model, we calculated the blood oxygenation saturation values and total hemoglobin concentrations from 655 regions of interest (ROIs) (421 benign, 200 malignant, and 34 borderline ROIs) obtained from clinical images of 35 patients with ovarian/adnexal lesions. A logistic regression model was used to compute the ROC, the area under the ROC curve (AUC) was 0.94, and the accuracy was 0.89. To the best of our knowledge, this is the first study to reconstruct quantitative PAT with PA signals and US-based structural features.

Recent advances in near-infrared-II hollow nanoplatforms for photothermal-based cancer treatment

Near-infrared-II (NIR-II, 1000–1700 nm) light-triggered photothermal therapy (PTT) has been regarded as a promising candidate for cancer treatment, but PTT alone often fails to achieve satisfactory curative outcomes. Hollow nanoplatforms prove to be attractive in the biomedical field owing to the merits including good biocompatibility, intrinsic physical-chemical nature and unique hollow structures, etc. On one hand, hollow nanoplatforms themselves can be NIR-II photothermal agents (PTAs), the cavities of which are able to carry diverse therapeutic units to realize multi-modal therapies. On the other hand, NIR-II PTAs are capable of decorating on the surface to combine with the functions of components encapsulated inside the hollow nanoplatforms for synergistic cancer treatment. Notably, PTAs generally can serve as good photoacoustic imaging (PAI) contrast agents (CAs), which means such kind of hollow nanoplatforms are also expected to be multifunctional all-in-one nanotheranostics. In this review, the recent advances of NIR-II hollow nanoplatforms for single-modal PTT, dual-modal PTT/photodynamic therapy (PDT), PTT/chemotherapy, PTT/catalytic therapy and PTT/gas therapy as well as multi-modal PTT/chemodynamic therapy (CDT)/chemotherapy, PTT/chemo/gene therapy and PTT/PDT/CDT/starvation therapy (ST)/immunotherapy are summarized for the first time. Before these, the typical synthetic strategies for hollow structures are presented, and lastly, potential challenges and perspectives related to these novel paradigms for future research and clinical translation are discussed.

Biomedical Application of Photoacoustics: A Plethora of Opportunities

The photoacoustic (PA) technique is a non-invasive, non-ionizing hybrid technique that exploits laser irradiation for sample excitation and acquires an ultrasound signal generated due to thermoelastic expansion of the sample. Being a hybrid technique, PA possesses the inherent advantages of conventional optical (high resolution) and ultrasonic (high depth of penetration in biological tissue) techniques and eliminates some of the major limitations of these conventional techniques. Hence, PA has been employed for different biomedical applications. In this review, we first discuss the basic physics of PA. Then, we discuss different aspects of PA techniques, which includes PA imaging and also PA frequency spectral analysis. The theory of PA signal generation, detection and analysis is also detailed in this work. Later, we also discuss the major biomedical application area of PA technique.

Dual-targeting nanozyme for tumor activatable photo-chemodynamic theranostics

Abstract

Tumor phototheranostics holds a great promise on account of its high spatiotemporal resolution, tumor-specificity, and noninvasiveness. However, physical limitation of light penetration and “always on” properties of conventional photothermal-conversion agents usually cause difficulty in accurate diagnosis and completely elimination of tumor. Meanwhile, nanozymes mediated Fenton reactions can well utilize the tumor microenvironment (TME) to generate hydroxyl radicals for chemodynamic therapy (CDT), but limited by the concentration of H₂O₂ in TME and the delivery efficiency of nanozymes. To overcome these problems, a dual-targeting nanozyme (FTRNPs) is developed for tumor-specific in situ theranostics, based upon the assembling of ultrasmall Fe₃O₄ nanoparticles, 3,3’,5,5’-tetrameth-ylbenzidine (TMB) and the RGD peptide. The FTRNPs after H₂O₂ treatment exhibits superior photothermal stability and high photothermal conversion efficiency (η = 50.9%). FTRNPs shows extraordinary accumulation and retention in the tumor site by biological/physical dual-targeting, which is 3.54-fold higher than that without active targeting. Cascade-dual-response to TME for nanozymes mediated Fenton reactions and TMB oxidation further improves the accuracy of both photoacoustic imaging and photothermal therapy (PTT). The tumor inhibition rate of photo-chemodynamic therapy is ~ 97.76%, which is ~ 4-fold higher than that of PTT or CDT only. Thus, the combination of CDT and PTT to construct “turn on” nanoplatform is of great significance to overcome their respective limitations. Considering its optimized “all-in-one” performance, this new nanoplatform is expected to provide an advanced theranostic strategy for the future treatment of cancers.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12951-022-01662-9.

Multifunctional nanotheranostics for near infrared optical imaging-guided treatment of brain tumors

Malignant brain tumors, a heterogeneous group of primary and metastatic neoplasms in the central nervous system (CNS), are notorious for their highly invasive and devastating characteristics, dismal prognosis and low survival rate. Recently, near-infrared (NIR) optical imaging modalities including fluorescence imaging (FLI) and photoacoustic imaging (PAI) have displayed bright prospect in innovation of brain tumor diagnoses, due to their merits, like noninvasiveness, high spatiotemporal resolution, good sensitivity and large penetration depth. Importantly, these imaging techniques have been widely used to vividly guide diverse brain tumor therapies in a real-time manner with high accuracy and efficiency. Herein, we provide a systematic summary of the state-of-the-art NIR contrast agents (CAs) for brain tumors single-modal imaging (e.g., FLI and PAI), dual-modal imaging (e.g., FLI/PAI, FLI/magnetic resonance imaging (MRI) and PAI/MRI) and triple-modal imaging (e.g., MRI/FLI/PAI and MRI/PAI/computed tomography (CT) imaging). In addition, we update the most recent progress on the NIR optical imaging-guided therapies, like single-modal (e.g., photothermal therapy (PTT), chemotherapy, surgery, photodynamic therapy (PDT), gene therapy and gas therapy), dual-modal (e.g., PTT/chemotherapy, PTT/surgery, PTT/PDT, PDT/chemotherapy, PTT/chemodynamic therapy (CDT) and PTT/gene therapy) and triple-modal (e.g., PTT/PDT/chemotherapy, PTT/PDT/surgery, PTT/PDT/gene therapy and PTT/gene/chemotherapy). Finally, we discuss the opportunities and challenges of the CAs and nanotheranostics for future clinic translation.

Photoacoustic imaging for microcirculation

Microcirculation facilitates the blood-tissue exchange of nutrients and regulates blood perfusion. It is, therefore, essential in maintaining tissue health. Aberrations in microcirculation are potentially indicative of underlying cardiovascular and metabolic pathologies. Thus, quantitative information about it is of great clinical relevance. Photoacoustic imaging (PAI) is a capable technique that relies on the generation of imaging contrast via the absorption of light and can image at micron-scale resolution. PAI is especially desirable to map microvasculature as hemoglobin strongly absorbs light and can generate a photoacoustic signal. This paper reviews the current state of the art for imaging microvascular networks using photoacoustic imaging. We further describe how quantitative information about blood dynamics such as the total hemoglobin concentration, oxygen saturation, and blood flow rate is obtained using PAI. We also discuss its importance in understanding key pathophysiological processes in neurovascular, cardiovascular, ophthalmic, and cancer research fields. We then discuss the current challenges and limitations of PAI and the approaches that can help overcome these limitations. Finally, we provide the reader with an overview of future trends in the field of PAI for imaging microcirculation.

Validation of photoacoustic/ultrasound dual imaging in evaluating blood oxygen saturation

Photoacoustic imaging (PAI) was performed to evaluate oxygen saturation (sO₂) of blood-mimicking phantoms, femoral arteries in beagles, and radial arteries in humans at various sO₂ plateaus. The accuracy (root mean square error, RMSE) of PAI sO₂ compared with reference sO₂ was calculated. In blood-mimicking phantoms, PAI achieved an accuracy of 1.49% and a mean absolute error (MAE) of 1.09% within 25 mm depth, and good linearity (R = 0.968; p < 0.001) was obtained between PAI sO₂ and reference sO₂. In canine femoral arteries, PAI achieved an accuracy of 2.16% and an MAE of 1.58% within 8 mm depth (R = 0.965; p < 0.001). In human radial arteries, PAI achieved an accuracy of 3.97% and an MAE of 3.28% in depth from 4 to 14 mm (R = 0.892; p < 0.001). For PAI sO₂ evaluation at different depths in healthy volunteers, the RMSE accuracy of PAI sO₂ increased from 2.66% to 24.96% with depth increasing from 4 to 14 mm. Through the multiscale method, we confirmed the feasibility of the hand-held photoacoustic/ultrasound (PA/US) in evaluating sO₂. These results demonstrate the potential clinical value of PAI in evaluating blood sO₂. Consequently, protocols for verifying the feasibility of medical devices based on PAI may be established.

A Novel Matching Layer Design for Improving the Performance of Transparent Ultrasound Transducers

Transparent ultrasound transducer (TUT) technology allows easy co-alignment of optical and acoustic beams in the development of compact photoacoustic imaging (PAI) devices with minimum acoustic coupling. However, TUTs suffer from narrow bandwidth and low pulse-echo sensitivity due to the lack of suitable transparent acoustic matching and backing layers. Here, we studied translucent glass beads (GB) in transparent epoxy as an acoustic matching layer for the transparent lithium niobate piezoelectric material-based TUTs (LN-TUTs). The acoustic and optical properties of various volume fractions of GB matching layers were studied using theoretical calculations, simulations, and experiments. These results demonstrated that the GB matching layer has significantly enhanced the pulse-echo sensitivity and bandwidth of the TUTs. Moreover, the GB matching layer served as a light diffuser to help achieve uniform optical fluence on the tissue surface and also improved the photoacoustic (PA) signal bandwidth. The proposed GB matching layer fabrication is low cost, easy to manufacture using conventional ultrasound transducer fabrication tools, acoustically compatible with soft tissue, and minimizes the use of the acoustic coupling medium.

Dual-wavelength photoacoustic atlas method to estimate fractional methylene blue and hemoglobin contents

SIGNIFICANCE

Methylene blue (MB) is an exogenous contrast agent that has the potential to assist with visualization and penetration challenges in photoacoustic imaging. However, monitoring the local concentration between MB and endogenous chromophores is critical for avoiding unnecessary MB accumulations that could lead to adverse effects such as hemolysis when exposed to increased dose and photodamage when exposed to high laser energies.

AIM

We developed a modified version of a previously proposed acoustic-based atlas method to estimate concentration levels from a mixture of two photoacoustic-sensitive materials after two laser wavelength emissions.

APPROACH

Photoacoustic data were acquired from mixtures of 100-μM MB and either human or porcine blood (Hb) injected in a plastisol phantom, using laser wavelengths of 710 and 870 nm. An algorithm to perform linear regression of the acoustic frequency response from an atlas composed of pure concentrations was designed to assess the concentration levels from photoacoustic samples obtained from 11 known MB/Hb volume mixtures. The mean absolute error (MAE), coefficient of determination (i.e., R2), and Spearman's correlation coefficient (i.e., ρ) between the estimated results and ground-truth labels were calculated to assess the algorithm performance, linearity, and monotonicity, respectively.

RESULTS

The overall MAE, R2, and ρ were 12.68%, 0.80, and 0.89, respectively, for the human Hb dataset and 9.92%, 0.86, and 0.93, respectively, for the porcine Hb dataset. In addition, a similarly linear relationship was observed between the acoustic frequency response at 2.3 MHz and 870-nm laser wavelength and the ground-truth concentrations, with R2 and | ρ | values of 0.76 and 0.88, respectively.

CONCLUSIONS

Contrast agent concentration monitoring is feasible with the proposed approach. The potential for minimal data acquisition times with only two wavelength emissions is advantageous toward real-time implementation in the operating room.

Elevational Synthetic Aperture Focusing for Three-Dimensional Photoacoustic Imaging Using a Clinical One-Dimensional Array Transducer

OBJECTIVE

Two-dimensional (2D) photoacoustic (PA) imaging based on array transducers provide high spatial resolution in the lateral direction by adopting receive dynamic focusing. However, the quality of PA image is often deteriorated by poor elevational resolution which is achieved by an acoustic lens. To overcome this limitation, we present a three-dimensional (3D) image reconstruction method using a commercial one-dimensional (1D) array transducer.

METHODS

In the method, the elevational resolution is improved by applying synthetic aperture focusing (SAF) technique along the elevational direction. For this, a commercially available 1D array transducer with an acoustic lens is modeled and appropriate synthetic focusing delay that can minimize the effect of the acoustic lens is derived by mathematical analysis.

RESULTS

From the simulation and experiment results, it was demonstrated that the proposed method can enhance the image quality of PA imaging, i.e., elevational resolution and signal-to-noise ratio (SNR).

CONCLUSION

3D PA images with improved elevational resolution were achieved using a clinical 1D array transducer.

SIGNIFICANCE

The presented method may be useful for clinical application such as detecting microcalcification, imaging of tumor vasculature and guidance of biopsy in real time.

MRI Information-Based Correction and Restoration of Photoacoustic Tomography

As an emerging molecular imaging modality, Photoacoustic Tomography (PAT) is capable of mapping tissue physiological metabolism and exogenous contrast agent information with high specificity. Due to its ultrasonic detection mechanism, the precise localization of targeted lesions has long been a challenge for PAT imaging. The poor soft-tissue contrast of the PAT image makes this process difficult and inaccurate. To meet this challenge, in this study, we first make use of the rich and clear structural information brought about by another advanced imaging modality, Magnetic Resonance Imaging (MRI), to assist organ segmentation and correct for the light fluence attenuation of PAT. We demonstrate improved feature visibility and enhanced localization of endogenous and exogenous agents in the fluence corrected PAT images. Compared with PAT-based methods, the contrast-to-noise ratio (CNR) of our MRI-assisted method increases by 29.1% in live animal experiments. Furthermore, we show that the co-registered MRI image can also be incorporated into PAT image restoration, and achieves improved anatomical landscape and soft-tissue contrast (CNR increased by 25.36%) while preserving similar spatial resolution. This PAT-MRI combination provides excellent structural, functional and molecular images of the subject, and may enable more comprehensive analysis of various preclinical research applications.

Fast Fourier Transform-weighted Photoacoustic Imaging by In Vivo Magnetic Alignment of Hybrid Nanorods

Photoacoustic (PA) imaging uses photon-phonon conversion for high-resolution tomography of biological tissues and functions. Exogenous contrast agents are often added to improve the image quality, but the interference from endogenous molecules diminishes the imaging sensitivity and specificity. We report a background-free PA imaging technique based on the active modulation of PA signals via magnetic alignment of Fe₃O₄@Au hybrid nanorods. Switching the field direction creates enhanced and deactivated PA imaging modalities, enabling a simple pixel subtraction to effectively minimize background noises. Under an alternating magnetic field, the nanorods exhibit PA signals of coherently periodic changes that can be converted into a sharp peak in a frequency domain via the fast Fourier transform. Automatic pixel-wise screening of nanorod signals performed using a computational algorithm across a time-sequence set of PA images regenerates a background-free PA image with significantly improved contrast, specificity, and fidelity.

Dual-Wavelength Photoacoustic Computed Tomography with Piezoelectric Ring-Array Transducer for Imaging of Indocyanine Green Liposomes Aggregation in Tumors

Recently, indocyanine green (ICG), as an FDA-approved dye, has been widely used for phototherapy. It is essential to obtain information on the migration and aggregation of ICG in deep tissues. However, existing fluorescence imaging platforms are not able to obtain the structural information of the tissues. Here, we prepared ICG liposomes (ICG-Lips) and built a dual-wavelength photoacoustic computed tomography (PACT) system with piezoelectric ring-array transducer to image the aggregation of ICG-Lips in tumors to guide phototherapy. Visible 780 nm light excited the photoacoustic (PA) effects of the ICG-Lips and near-infrared 1064 nm light provided the imaging of the surrounding tissues. The aggregation of ICG-Lips within the tumor and the surrounding tissues was visualized by PACT in real time. This work indicates that PACT with piezoelectric ring-array transducer has great potential in the real-time monitoring of in vivo drug distribution.