Real-time intravascular photoacoustic-ultrasound imaging of lipid-laden plaque in human coronary artery at 16 frames per second

Enhanced dual-mode imaging: Superior photoacoustic and ultrasound endoscopy in live pigs using a transparent ultrasound transducer

Dual-mode photoacoustic/ultrasound endoscopy (ePAUS) is a promising tool for preclinical and clinical interventions. To be clinically useful, ePAUS must deliver high-performance ultrasound imaging comparable to commercial systems and maintain high photoacoustic imaging performance at long working distances. This requires a transducer with an intact physical aperture and coaxial alignment of acoustic and optical beams within the probe, a challenging integration task. We present a high-performance ePAUS probe with a miniaturized, optically transparent ultrasonic transducer (TUT) called ePAUS-TUT. The 1.8-mm-diameter probe, fitting into standard endoscopic channels, aligns acoustic and optical beams efficiently, achieving commercial-level ultrasound and high-resolution photoacoustic imaging over long distances. These imaging capabilities were validated through in vivo imaging of a rat's rectum and a pig's esophagus. The ePAUS-TUT system substantially enhances feasibility and potential for clinical applications.

Emerging Hybrid Intracoronary Imaging Technologies and Their Applications in Clinical Practice and Research

Intravascular ultrasound and optical coherence tomography are used with increasing frequency for the care of coronary patients and in research studies. These imaging tools can identify culprit lesions in acute coronary syndromes, assess coronary stenosis severity, guide percutaneous coronary intervention (PCI), and detect vulnerable plaques and patients. However, they have significant limitations that have stimulated the development of multimodality intracoronary imaging catheters, which provide improvements in assessing vessel wall pathology and guiding PCI. Prototypes combining 2 or even 3 imaging probes with complementary attributes have been developed, and several multimodality systems have already been used in patients, with near-infrared spectroscopy intravascular ultrasound-based studies showing promising results for the identification of high-risk plaques. Moreover, postmortem histology studies have documented that hybrid imaging catheters can enable more accurate characterization of plaque morphology than standalone imaging. This review describes the evolution in the field of hybrid intracoronary imaging; presents the available multimodality catheters; and discusses their potential role in PCI guidance, vulnerable plaque detection, and the assessment of endovascular devices and emerging pharmacotherapies targeting atherosclerosis.

Recent Advances in Photoacoustic Imaging: Current Status and Future Perspectives

Photoacoustic imaging (PAI) is an emerging hybrid imaging modality that combines high-contrast optical imaging with high-spatial-resolution ultrasound imaging. PAI can provide a high spatial resolution and significant imaging depth by utilizing the distinctive spectroscopic characteristics of tissue, which gives it a wide variety of applications in biomedicine and preclinical research. In addition, it is non-ionizing and non-invasive, and photoacoustic (PA) signals are generated by a short-pulse laser under thermal expansion. In this study, we describe the basic principles of PAI, recent advances in research in human and animal tissues, and future perspectives.

Innovations in Intracoronary Imaging: Present Clinical Practices and Future Outlooks

Engaging intracoronary imaging (IC) techniques such as intravascular ultrasound or optical coherence tomography enables the precise description of vessel architecture. These imaging modalities have well-established roles in providing guidance and optimizing percutaneous coronary intervention (PCI) outcomes. Furthermore, IC is increasingly recognized for its diagnostic capabilities, as it has the unique capacity to reveal vessel wall characteristics that may not be apparent through angiography alone. This manuscript thoroughly reviews the contemporary landscape of IC in clinical practice. Focused on current methodologies, the review explores the utility and advancements in IC techniques. Emphasizing their role in clarifying coronary pathophysiology, guiding PCI, and optimizing patient outcomes, the manuscript critically evaluates the strengths and limitations of each modality. Additionally, the integration of IC into routine clinical workflows and its impact on decision-making processes are discussed. By synthesizing the latest evidence, this review provides valuable insights for clinicians, researchers, and healthcare professionals involved in the dynamic field of interventional cardiology.

Dual-modal Photoacoustic and Ultrasound Imaging: from preclinical to clinical applications

Photoacoustic imaging is a novel biomedical imaging modality that has emerged over the recent decades. Due to the conversion of optical energy into the acoustic wave, photoacoustic imaging offers high-resolution imaging in depth beyond the optical diffusion limit. Photoacoustic imaging is frequently used in conjunction with ultrasound as a hybrid modality. The combination enables the acquisition of both optical and acoustic contrasts of tissue, providing functional, structural, molecular, and vascular information within the same field of view. In this review, we first described the principles of various photoacoustic and ultrasound imaging techniques and then classified the dual-modal imaging systems based on their preclinical and clinical imaging applications. The advantages of dual-modal imaging were thoroughly analyzed. Finally, the review ends with a critical discussion of existing developments and a look toward the future.

Correction of high-rate motion for photoacoustic microscopy by orthogonal cross-correlation

Photoacoustic imaging is a promising technology for in vivo imaging. However, its imaging performance can be hampered by motion artifacts, especially when dealing with high-rate motion. In this paper, we propose an orthogonal motion correction method that utilizes cross-correlation along orthogonal scan directions to extract accurate motion displacements from the photoacoustic data. The extracted displacements are then applied to remove artifacts and compensate for motion-induced distortions. Phantom experiments demonstrate that the proposed method can extract the motion information and the structural similarity index measurement after correction is increased by 26.5% and 11.2% compared to no correction and the previous correction method. Then the effectiveness of our method is evaluated in vivo imaging of a mouse brain. Our method shows a stable and effective performance under high-rate motion. The high accuracy of the motion correction method makes it valuable in improving the accuracy of photoacoustic imaging.

Photoacoustic imaging on its way toward clinical utility: a tutorial review focusing on practical application in medicine

Significance

Photoacoustic imaging (PAI) enables the visualization of optical contrast with ultrasonic imaging. It is a field of intense research, with great promise for clinical application. Understanding the principles of PAI is important for engineering research and image interpretation.

Aim

In this tutorial review, we lay out the imaging physics, instrumentation requirements, standardization, and some practical examples for (junior) researchers, who have an interest in developing PAI systems and applications for clinical translation or applying PAI in clinical research.

Approach

We discuss PAI principles and implementation in a shared context, emphasizing technical solutions that are amenable to broad clinical deployment, considering factors such as robustness, mobility, and cost in addition to image quality and quantification.

Results

Photoacoustics, capitalizing on endogenous contrast or administered contrast agents that are approved for human use, yields highly informative images in clinical settings, which can support diagnosis and interventions in the future.

Conclusion

PAI offers unique image contrast that has been demonstrated in a broad set of clinical scenarios. The transition of PAI from a "nice-to-have" to a "need-to-have" modality will require dedicated clinical studies that evaluate therapeutic decision-making based on PAI and consideration of the actual value for patients and clinicians, compared with the associated cost.

Intravascular Optical Coherence Tomography Utilizing a Miniature Piezoelectric-Driven Probe

Intravascular optical coherence tomography (IV-OCT) is crucial for evaluating lumen dimensions and guiding interventional procedures. However, traditional catheter-based IV-OCT faces challenges in achieving precise and full-field 360° imaging in tortuous vessels. Current IV-OCT catheters that employ proximal actuators and torque coils are susceptible to non-uniform rotational distortion (NURD) in tortuous vessels, while distal micromotor-driven catheters struggle with complete 360° imaging due to wiring artifacts. In this study, we developed a miniature optical scanning probe with an integrated piezoelectric-driven fiber optic slip ring (FOSR) to facilitate smooth navigation and precise imaging within tortuous vessels. The FOSR features a coil spring-wrapped optical lens serving as a rotor, enabling efficient 360° optical scanning. The structurally-and-functionally-integrated design significantly streamlines the probe (with a diameter of 0.85 mm and a length of 7 mm) while maintaining an excellent rotational speed of 10,000 rpm. High-precision 3D printing technology ensures accurate optical alignment of the fiber and lens inside the FOSR, with a maximum insertion loss variation of 2.67 dB during probe rotation. Finally, a vascular model demonstrated smooth probe insertion into the carotid artery, and imaging of oak leaf, metal rod phantoms, and ex vivo porcine vessels verified its capabilities for precise optical scanning, comprehensive 360° imaging, and artifact elimination. The FOSR probe exhibits small size, rapid rotation, and optical precision scanning, rendering it exceptionally promising for cutting-edge intravascular optical imaging techniques.

Diagnostics of atherosclerosis: Overview of the existing methods

Atherosclerosis was and remains an extremely common and serious health problem. Since the elderly are most at risk of cardiovascular risk, and the average life expectancy is increasing, the spread of atherosclerosis and its consequences increases as well. One of the features of atherosclerosis is its asymptomaticity. This factor makes it difficult to make a timely diagnosis. This entails the lack of timely treatment and even prevention. To date, in the arsenal of physicians, there is only a limited set of methods to suspect and fully diagnose atherosclerosis. In this review, we have tried to briefly describe the most common and effective methods for diagnosing atherosclerosis.

A high-sensitivity high-resolution intravascular photoacoustic catheter through mode cleaning in a graded-index fiber

Intravascular photoacoustic imaging has been developed to evaluate the possibility of plaque rupture in atherosclerosis by high spatial resolution imaging of lipid. However, the detection sensitivity and spatial resolution are compromised by the poor focusing caused by a multimode fiber. In this work, we report an intravascular photoacoustic catheter with mode self-cleaning in a graded-index fiber to improve the beam quality and the sensitivity for lipid detection. Compared with the higher-order modes in a step-index multimode fiber, the lower-order modes generated by the self-cleaning effect in the graded-index fiber greatly enhanced the photoacoustic spatial resolution and detection sensitivity. The dominant ringing artifact caused by laser absorption of the ultrasound transducer was further reduced by using stripe suppression. A lipid plaque mimicking phantom was imaged for evaluation. Lipid particles with a small diameter of 75.7 µm were clearly observed.

Longitudinal In Vivo Monitoring of Atheroprogression in Hypercholesterolemic Mice Using Photoacoustic Imaging

BACKGROUND AND AIM

 The ability to recognize and monitor atherosclerotic lesion development using noninvasive imaging is crucial in preventive cardiology. The aim of the present study was to establish a protocol for longitudinal monitoring of plaque lipid, collagen, and macrophage burden as well as of endothelial permeability.

METHODS AND RESULTS

 Photoacoustic signals derived from endogenous or exogenous dyes assessed in vivo, in plaques of albino Apoe-/- mice, correlated with lesion characteristics obtained after histomorphometric and immunofluorescence analyses, thus supporting the validity of our protocol. Using models of atheroprogression and regression, we could apply our imaging protocol to the longitudinal observation of atherosclerotic lesion characteristics in mice.

CONCLUSIONS

 The present study shows an innovative approach to assess arterial inflammation in a non-invasive fashion, applicable to longitudinal analyses of changes of atherosclerotic lesion composition. Such approach could prove important in the preclinical testing of therapeutic interventions in mice carrying pre-established lesions.

Optical-resolution functional gastrointestinal photoacoustic endoscopy based on optical heterodyne detection of ultrasound

Photoacoustic endoscopy shows promise in the detection of gastrointestinal cancer, inflammation, and other lesions. High-resolution endoscopic imaging of the hemodynamic response necessitates a small-sized, high-sensitivity ultrasound sensor. Here, we utilize a laser ultrasound sensor to develop a miniaturized, optical-resolution photoacoustic endoscope. The sensor can boost the acoustic response by a gain factor of ω_o/Ω (the frequency ratio of the signal light and measured ultrasound) by measuring the acoustically induced optical phase change. As a result, we achieve a noise-equivalent pressure density (NEPD) below 1.5 mPa·Hz^-1/2 over the measured range of 5 to 25 MHz. The heterodyne phase detection using dual-frequency laser beams of the sensor can offer resistance to thermal drift and vibrational perturbations. The endoscope is used to in vivo image a rat rectum and visualize the oxygen saturation changes during acute inflammation, which can hardly be observed with other imaging modalities.

Survival intravascular photoacoustic imaging of lipid-rich plaque in cholesterol fed rabbits

Intravascular photoacoustic (IVPA) imaging is a promising modality for quantitative assessment of lipid-laden atherosclerotic plaques. Yet, survival IVPA imaging of the same plaque in the same animal is not demonstrated. Here, using a sheathed IVUS/PA catheter of 0.9 mm in diameter, we demonstrate MRI-guided survival IVPA imaging of same plaque in an aorta of a well-established rabbit model mimicking atherosclerosis in human patients. The IVUS/PA results were confirmed by histology. These advances open the opportunity to evaluate the effectiveness of a therapy that aims to reduce the size of atherosclerotic plaques and demonstrates the potential of translating the IVPA catheter into clinic for detection of lipid-rich plaques that are at high risk for thrombosis.

Real-Time Detection and 3D Localization of Coronary Atherosclerosis Using a Microwave Imaging Technique: A Simulation Study

Obtaining the exact position of accumulated calcium on the inner walls of coronary arteries is critical for successful angioplasty procedures. For the first time to our knowledge, in this work, we present a high accuracy imaging of the inner coronary artery using microwaves for precise calcium identification. Specifically, a cylindrical catheter radiating microwave signals is designed. The catheter has multiple dipole-like antennas placed around it to enable a 360° field-of-view around the catheter. In addition, to resolve image ambiguity, a metallic rod is inserted along the axis of the plastic catheter. The reconstructed images using data obtained from simulations show successful detection and 3D localization of the accumulated calcium on the inner walls of the coronary artery in the presence of blood flow. Considering the space and shape limitations, and the highly lossy biological tissue environment, the presented imaging approach is promising and offers a potential solution for accurate localization of coronary atherosclerosis during angioplasty or other related procedures.

High-resolution label-free mapping of murine kidney vasculature by raster-scanning optoacoustic mesoscopy: an ex vivo study

BACKGROUND

Chronic kidney disease (CKD) is a global burden affecting both children and adults. Novel imaging modalities hold great promise to visualize and quantify structural, functional, and molecular organ damage. The aim of the study was to visualize and quantify murine renal vasculature using label-free raster scanning optoacoustic mesoscopy (RSOM) in explanted organs from mice with renal injury.

MATERIAL AND METHODS

For the experiments, freshly bisected kidneys of alpha 8 integrin knock-out (KO) and wildtype mice (WT) were used. A total of n=7 female (n=4 KO, n=3 WT) and n=6 male animals (n=2 KO, n=4 WT) aged 6 weeks were examined with RSOM optoacoustic imaging systems (RSOM Explorer P50 at SWL 532nm and/or ms-P50 imaging system at 532 nm, 555 nm, 579 nm, and 606 nm). Images were reconstructed using a dedicated software, analyzed for size and vascular area and compared to standard histologic sections.

RESULTS

RSOM enabled mapping of murine kidney size and vascular area, revealing differences between kidney sizes of male (m) and female (f) mice (merged frequencies (MF) f vs. m: 52.42±6.24 mm² vs. 69.18±15.96 mm², p=0.0156) and absolute vascular area (MF f vs. m: 35.67±4.22 mm² vs. 49.07±13.48 mm², p=0.0036). Without respect to sex, the absolute kidney area was found to be smaller in knock-out (KO) than in wildtype (WT) mice (WT vs. KO: MF: p=0.0255) and showed a similar trend for the relative vessel area (WT vs. KO: MF p=0.0031). Also the absolute vessel areas of KO compared to WT were found significantly different (MF p=0.0089). A significant decrease in absolute vessel area was found in KO compared to WT male mice (MF WT vs. KO: 54.37±9.35 mm² vs. 34.93±13.82 mm², p=0.0232). In addition, multispectral RSOM allowed visualization of oxygenated and deoxygenated parenchymal regions by spectral unmixing.

CONCLUSION

This study demonstrates the capability of RSOM for label-free visualization of differences in vascular morphology in ex vivo murine renal tissue at high resolution. Due to its scalability optoacoustic imaging provides an emerging modality with potential for further preclinical and clinical imaging applications.

Intra-instrument channel workable, optical-resolution photoacoustic and ultrasonic mini-probe system for gastrointestinal endoscopy

There has been a long-standing expectation that the optical-resolution embodiment of photoacoustic tomography could have a substantial impact on gastrointestinal endoscopy by enabling microscopic visualization of the vasculature based on the endogenous contrast mechanism. Although multiple studies have demonstrated the in vivo imaging capability of a developed imaging device over the last decade, the implementation of such an endoscopic system that can be applied immediately when necessary via the instrument channel of a video endoscope has been a challenge. In this study, we developed a 3.38-mm diameter catheter-based, integrated optical-resolution photoacoustic and ultrasonic mini-probe system and successfully demonstrated its intra-instrument channel workability for the standard 3.7-mm diameter instrument channel of a clinical video endoscope based on a swine model. Through the instrument channel, we acquired the first in vivo dual-mode photoacoustic and ultrasonic endoscopic images from the esophagogastric junction of a swine. Further, in a rat colorectum in vivo imaging experiment, we visualized hierarchically developed mesh-like capillary networks with a hole size as small as ~50 µm, which suggests the potential level of image details that could be photoacoustically provided in clinical settings in the future.

Advances in Endoscopic Photoacoustic Imaging

Photoacoustic (PA) imaging is able to provide extremely high molecular contrast while maintaining the superior imaging depth of ultrasound (US) imaging. Conventional microscopic PA imaging has limited access to deeper tissue due to strong light scattering and attenuation. Endoscopic PA technology enables direct delivery of excitation light into the interior of a hollow organ or cavity of the body for functional and molecular PA imaging of target tissue. Various endoscopic PA probes have been developed for different applications, including the intravascular imaging of lipids in atherosclerotic plaque and endoscopic imaging of colon cancer. In this paper, the authors review representative probe configurations and corresponding preclinical applications. In addition, the potential challenges and future directions of endoscopic PA imaging are discussed.

Video-rate dual-modal photoacoustic and fluorescence imaging through a multimode fibre towards forward-viewing endomicroscopy

Multimode fibres (MMFs) are becoming increasingly attractive in optical endoscopy as they promise to enable unparallelled miniaturisation, spatial resolution and cost. However, high-speed imaging with wavefront shaping has been challenging. Here, we report the development of a video-rate dual-modal photoacoustic (PA) and fluorescence microscopy probe with a high-speed digital micromirror device (DMD) towards forward-viewing endomicroscopy. Optimal DMD patterns were obtained using a real-valued intensity transmission matrix algorithm to raster-scan a 1.5  μ m-diameter focused beam at the distal fibre tip for imaging. The PA imaging speed and spatial resolution were varied from  ∼ 2 to 57 frames per second and from 1.7 to 3  μ m, respectively. Further, high-fidelity PA images of carbon fibres and mouse red blood cells were acquired at unprecedented speed. The capability of dual-modal imaging was demonstrated with phantoms. We anticipate that with further miniaturisation of the ultrasound detector, this probe could be integrated into medical needles to guide minimally invasive procedures.

Three-Dimensional Intravascular Ultrasound Imaging Using a Miniature Helical Ultrasonic Motor

Existing 3-D intravascular ultrasound (IVUS) systems that combine two electromagnetic (EM) motors to drive catheters are bulky and require considerable efforts to eliminate EM interference (EMI). Here, we propose a new scanning method to realize 3-D IVUS imaging using a helical ultrasonic motor to overcome the aforementioned issues. The ultrasonic motor with compact dimensions (7-mm outer diameter and 30-mm longitudinal length), lightweight (20.5 g), and free of EMI exhibits a great application potential in mobile imaging devices. In particular, it can simultaneously perform rotary and linear motions, facilitating precise 3-D scanning of an imaging catheter. Experimental results show that the signal-to-noise ratio (SNR) of raw images obtained using the ultrasonic motor is 5.3 dB better than that of an EM motor. Moreover, the proposed imaging device exhibits the maximum rotary speed of 12.3 r/s and the positioning accuracy of 2.6 [Formula: see text] at a driving voltage of 240 V_p-p. The 3-D wire phantom imaging and 3-D tube phantom imaging are performed to evaluate the performance of the imaging device. Finally, the in vitro imaging of a porcine coronary artery demonstrates that the layered architecture of the vessel can be precisely identified while significantly increasing the SNR of the raw images.

SVD-based filtering to detect intraplaque hemorrhage using single wavelength photoacoustic imaging

SIGNIFICANCE

Intraplaque hemorrhage (IPH) is an important indicator of plaque vulnerability. Early detection could aid the prevention of stroke.

AIM

We aim to detect IPH with single wavelength PA imaging in vivo and to improve image quality.

APPROACH

We developed a singular value decomposition (SVD)-based filter to detect the nonstationary and stationary components in ultrasound data. A PA mask was created to detect stationary (IPH) sources. The method was tested ex vivo using phantoms and in vivo in patients.

RESULTS

The flow and IPH channels were successfully separated in the phantom data. We can also detect the PA signals from IPH and reject signals from the carotid lumen in vivo. Generalized contrast-to-noise ratio improved in both ex vivo and in vivo in US imaging.

CONCLUSIONS

SVD-based filtering can successfully detect IPH using a single laser wavelength, opening up opportunities for more economical and cost-effective laser sources.

Multifocus Thermal Strain Imaging Using a Curved Linear Array Transducer for Identification of Lipids in Deep Tissue

Thermal strain imaging (TSI) is an ultrasound-based imaging technique intended primarily for diseases in which lipid accumulation is the main biomarker. The goal of the research described here was to successfully implement TSI on a single, commercially available curved linear array transducer for heating and imaging of organs at a deeper depth. For an effective temperature rise of the tissue over a large area, which is key to TSI performance, an innovative multifocus beamforming approach was applied. This yielded a heating area from 32 to 96 mm in the axial direction and -7 to +7 mm in the lateral direction. The pressure fields generated from simulation were in agreement with pressure fields measured with the hydrophone. TSI with safe acoustic power identified with high contrast a rubber inclusion and liposuction fat tissue embedded in a gelatin block.

Recent Advances in Transducers for Intravascular Ultrasound (IVUS) Imaging

As a well-known medical imaging methodology, intravascular ultrasound (IVUS) imaging plays a critical role in diagnosis, treatment guidance and post-treatment assessment of coronary artery diseases. By cannulating a miniature ultrasound transducer mounted catheter into an artery, the vessel lumen opening, vessel wall morphology and other associated blood and vessel properties can be precisely assessed in IVUS imaging. Ultrasound transducer, as the key component of an IVUS system, is critical in determining the IVUS imaging performance. In recent years, a wide range of achievements in ultrasound transducers have been reported for IVUS imaging applications. Herein, a comprehensive review is given on recent advances in ultrasound transducers for IVUS imaging. Firstly, a fundamental understanding of IVUS imaging principle, evaluation parameters and IVUS catheter are summarized. Secondly, three different types of ultrasound transducers (piezoelectric ultrasound transducer, piezoelectric micromachined ultrasound transducer and capacitive micromachined ultrasound transducer) for IVUS imaging are presented. Particularly, the recent advances in piezoelectric ultrasound transducer for IVUS imaging are extensively examined according to their different working mechanisms, configurations and materials adopted. Thirdly, IVUS-based multimodality intravascular imaging of atherosclerotic plaque is discussed. Finally, summary and perspectives on the future studies are highlighted for IVUS imaging applications.

Photoacoustic-fluorescence microendoscopy in vivo

A miniature endoscope capable of imaging multiple tissue contrasts in high resolution is highly attractive, because it can provide complementary and detailed tissue information of internal organs. Here we present a photoacoustic (PA)-fluorescence (FL) endoscope for optical-resolution PA microscopy (PAM) and FL microscopy (FLM). The endoscope with a diameter of 2.8 mm achieves high lateral resolutions of 5.5 and 6.3 µm for PAM and FLM modes, respectively. In vivo imaging of zebrafish larvae and a mouse ear is conducted, and high-quality images are obtained. Additionally, in vivo endoscopic imaging of a rat rectum is demonstrated, showing the endoscopic imaging capability of our endoscope. By providing dual contrasts with high resolution, the endoscope may open up new opportunities for clinical endoscopic imaging applications.

Optoacoustic Imaging in Inflammation

Optoacoustic or photoacoustic imaging (OAI/PAI) is a technology which enables non-invasive visualization of laser-illuminated tissue by the detection of acoustic signals. The combination of "light in" and "sound out" offers unprecedented scalability with a high penetration depth and resolution. The wide range of biomedical applications makes this technology a versatile tool for preclinical and clinical research. Particularly when imaging inflammation, the technology offers advantages over current clinical methods to diagnose, stage, and monitor physiological and pathophysiological processes. This review discusses the clinical perspective of using OAI in the context of imaging inflammation as well as in current and emerging translational applications.

Gold Nanoparticles in Cancer Theranostics

Conventional cancer treatments, such as surgical resection, radiotherapy, and chemotherapy, have achieved significant progress in cancer therapy. Nevertheless, some limitations (such as toxic side effects) are still existing for conventional therapies, which motivate efforts toward developing novel theranostic avenues. Owning many merits such as easy surface modification, unique optical properties, and high biocompatibility, gold nanoparticles (AuNPs and GNPs) have been engineered to serve as targeted delivery vehicles, molecular probes, sensors, and so on. Their small size and surface characteristics enable them to extravasate and access the tumor microenvironment (TME), which is a promising solution to realize highly effective treatments. Moreover, stimuli-responsive properties (respond to hypoxia and acidic pH) of nanoparticles to TME enable GNPs’ unrivaled control for effective transport of therapeutic cargos. In this review article, we primarily introduce the basic properties of GNPs, further discuss the recent progress in gold nanoparticles for cancer theranostics, with an additional concern about TME stimuli-responsive studies.

Near-infrared double-illumination optical-resolution photoacoustic microscopy

Label-free chemical bond imaging is of great importance in biology and medicine. Photoacoustic imaging at the third near-infrared windows (1600-1870 nm, near-infrared-III) provides a stable molecular vibrational imaging tool for lipid-rich tissue owing to the first overtone transition of the CH bond at 1.7 μm. However, lacking high-energy pulsed laser sources at 1.7 μm and the strong water absorption significantly limit the signal-to-noise ratio of the lipid imaging, especially for thin lipid tissues. To circumvent this barrier, we develop near-infrared-III double-illumination optical-resolution photoacoustic microscopy (DIOR-PAM) for improving the sensitivity of label-free lipid imaging. Using the same laser, DIOR-PAM can enhance the sensitivity by nearly 100%, which we prove in the Monte Carlo simulation. We experimentally demonstrated 50% ~ 100% sensitivity enhancements on nonbiological and biological lipid-rich samples.

Photoacoustic Tomography Opening New Paradigms in Biomedical Imaging

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

Single-shot hybrid photoacoustic-fluorescent microendoscopy through a multimode fiber with wavefront shaping

We present a minimally-invasive endoscope based on a multimode fiber that combines photoacoustic and fluorescence sensing. From the measurement of a transmission matrix during a prior calibration step, a focused spot is produced and raster-scanned over a sample at the distal tip of the fiber by use of a fast spatial light modulator. An ultra-sensitive fiber-optic ultrasound sensor for photoacoustic detection placed next to the fiber is combined with a photodetector to obtain both fluorescence and photoacoustic images with a distal imaging tip no larger than 250 µm. The high signal-to-noise ratio provided by wavefront shaping based focusing and the ultra-sensitive ultrasound sensor enables imaging with a single laser shot per pixel, demonstrating fast two-dimensional hybrid in vitro imaging of red blood cells and fluorescent beads.

Highly sensitive lipid detection and localization in atherosclerotic plaque with a dual-frequency intravascular photoacoustic/ultrasound catheter

Intravascular photoacoustic/ultrasound (IVPA/US) is an emerging hybrid imaging modality that provides specific lipid detection and localization, while maintaining co-registered artery morphology, for diagnosis of vulnerable plaque in cardiovascular disease. However, current IVPA/US approaches based on a single-element transducer exhibit compromised performance for lipid detection due to the relatively low contrast of lipid absorption and conflicting detection bands for photoacoustic and ultrasound signals. Here, we present a dual-frequency IVPA/US catheter for highly sensitive detection and precision localization of lipids. The low frequency transducer provides enhanced photoacoustic sensitivity, while the high frequency transducer maintains state-of-the-art spatial resolution for ultrasound imaging. The boosted capability of IVPA/US imaging enables a multi-scale analysis of lipid distribution in swine with coronary atherosclerosis. The dual-frequency IVPA/US catheter has a diameter of 1 mm and flexibility to easily adapt to current catheterization procedures and is a significant step toward clinical diagnosis of vulnerable plaque.

In-vivo hemodynamic imaging of acute prenatal ethanol exposure in fetal brain by photoacoustic tomography

Prenatal ethanol exposure (PEE) can lead to structural and functional abnormalities in fetal brain. Although neural developmental deficits due to PEE have been recognized, the immediate effects of PEE on fetal brain vasculature and hemodynamics remain poorly understood. One of the major obstacles that preclude the rapid advancement of studies on fetal vascular dynamics is the limitation of the imaging techniques. Thus, a technique for noninvasive in-vivo imaging of fetal vasculature and hemodynamics is desirable. In this study, we explored the dynamic changes of the vessel dimeter, density and oxygen saturation in fetal brain after acute maternal ethanol exposure in the second-trimester equivalent murine model using a real-time photoacoustic tomography system we developed for imaging embryo of small animals. The results indicate a significant decrease in fetal brain vessel diameter, perfusion and oxygen saturation. This work demonstrated that PAT can provide high-resolution noninvasive imaging ability to monitor fetal vascular dynamics.

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

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

Transcranial photoacoustic imaging of NMDA-evoked focal circuit dynamics in the rat hippocampus

OBJECTIVE

We report the transcranial functional photoacoustic (fPA) neuroimaging of N-methyl-D-aspartate (NMDA) evoked neural activity in the rat hippocampus. Concurrent quantitative electroencephalography (qEEG) and microdialysis were used to record real-time circuit dynamics and excitatory neurotransmitter concentrations, respectively.

APPROACH

We hypothesized that location-specific fPA voltage-sensitive dye (VSD) contrast would identify neural activity changes in the hippocampus which correlate with NMDA-evoked excitatory neurotransmission.

MAIN RESULTS

Transcranial fPA VSD imaging at the contralateral side of the microdialysis probe provided NMDA-evoked VSD responses with positive correlation to extracellular glutamate concentration changes. qEEG validated a wide range of glutamatergic excitation, which culminated in focal seizure activity after a high NMDA dose. We conclude that transcranial fPA VSD imaging can distinguish focal glutamate loads in the rat hippocampus, based on the VSD redistribution mechanism which is sensitive to the electrophysiologic membrane potential.

SIGNIFICANCE

Our results suggest the future utility of this emerging technology in both laboratory and clinical sciences as an innovative functional neuroimaging modality.

Sensitivity Enhanced Photoacoustic Imaging Using a High-Frequency PZT Transducer with an Integrated Front-End Amplifier

Photoacoustic (PA) imaging is a hybrid imaging technique that can provide both structural and functional information of biological tissues. Due to limited permissible laser energy deposited on tissues, highly sensitive PA imaging is required. Here, we developed a 20 MHz lead zirconium titanate (PZT) transducer (1.5 mm × 3 mm) with front-end amplifier circuits for local signal processing to achieve sensitivity enhanced PA imaging. The electrical and acoustic performance was characterized. Experiments on phantoms and chicken breast tissue were conducted to validate the imaging performance. The fabricated prototype shows a bandwidth of 63% and achieves a noise equivalent pressure (NEP) of 0.24 mPa/√Hz and a receiving sensitivity of 62.1 μV/Pa at 20 MHz without degradation of the bandwidth. PA imaging of wire phantoms demonstrates that the prototype is capable of improving the detection sensitivity by 10 dB compared with the traditional transducer without integrated amplifier. In addition, in vitro experiments on chicken breast tissue show that structures could be imaged with enhanced contrast using the prototype and the imaging depth range was improved by 1 mm. These results demonstrate that the transducer with an integrated front-end amplifier enables highly sensitive PA imaging with improved penetration depth. The proposed method holds the potential for visualization of deep tissue structures and enhanced detection of weak physiological changes.

Multimodal intravascular imaging technology for characterization of atherosclerosis

Early detection of vulnerable plaques is the critical step in the prevention of acute coronary events. Morphology, composition, and mechanical property of a coronary artery have been demonstrated to be the key characteristics for the identification of vulnerable plaques. Several intravascular multimodal imaging technologies providing co-registered simultaneous images have been developed and applied in clinical studies to improve the characterization of atherosclerosis. In this paper, the authors review the present system and probe designs of representative intravascular multimodal techniques. In addition, the scientific innovations, potential limitations, and future directions of these technologies are also discussed.

Minimally invasive photoacoustic imaging: Current status and future perspectives

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

Ultrafine intravascular photoacoustic endoscope with a 0.7 mm diameter probe

Intravascular photoacoustic (IVPA) imaging, benefiting from high optical contrast, large imaging depth and absorption specificity, is of great potential for lipid-rich plaque detection. However, the diameters of reported IVPA endoscopes are too big to intervene into the coronary artery branches. Here, by designing an ultracompact house embedded with a side-fire fiber and a miniature single-element ultrasound transducer, we developed an ultrafine IVPA endoscope with a diameter of 0.7 mm aiming at coronary artery branches atherosclerotic plaque detection. The reliability and feasibility of the ultrafine IVPA endoscope was demonstrated by imaging a stent with a 1.6 mm inner diameter. Furthermore, the photoacoustic imaging and ultrasound imaging of a mouse thoracic aorta with an inner diameter of 1.15 mm was conducted to verify the clinical potentiality of the endoscope, and the PA images have good consistency with histological staining results. To the best of our knowledge, this is the first time we have achieved the IVPA imaging in fine vessel by the 0.7 mm diameter ultrafine photoacoustic endoscope, which paved a way for the translation of the IVPA endoscope to clinical application.

A new approach to the diagnosis and treatment of atherosclerosis: the era of the liposome

The consequences of atherosclerotic cardiovascular disease (ASCVD) include myocardial infarction, ischemic stroke, and angina pectoris, which are major causes of mortality and morbidity worldwide. Despite current therapeutic strategies to reduce risk, patients still experience the consequences of ASCVD. Consequently, a current goal is to enhance visualization of early atherosclerotic lesions to improve residual ASCVD risk. The uses of liposomes, in the context of ASCVD, can include as contrast agents for imaging techniques, as well as for the delivery of antiatherosclerotic drugs, genes, and cells to established sites of plaque. Additionally, liposomes have a role as vaccine adjuvants against mediators of atherosclerosis. Here. we review the scientific and clinical evidence relating to the use of liposomes in the diagnosis and management of ASCVD.

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

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

Review of the state of the art in cardiovascular endoscopy imaging of atherosclerosis using photoacoustic techniques with pulsed and continuous-wave optical excitations

Intravascular photoacoustics (IV-PA) is an emerging atherosclerosis imaging modality that provides chemical-specific optical information of arterial walls with acoustic depth penetration and resolution. As lipid composition of atherosclerotic plaques is considered to be one of the primary indicators for plaque vulnerability, many IV-PA applications are calibrated so as to target plaque necrotic cores. Based on the mode of optical excitation and the corresponding signal processing technique, IV-PA is categorized into two different modalities. The pulse-based IV-PA has been the universal IV-PA imaging mode with its high peak power and straightforward time-domain signal processing technique. As an alternative, the low power continuous-wave (CW)-based IV-PA has been under intense development as a radar-like frequency-domain signal processing modality. The two state-of-the-art types of IV-PA are reviewed in terms of their physics and imaging capabilities, with major emphasis on frequency-swept CW-based IV-PA that has been recently introduced in the field.

High-resolution photoacoustic endoscope through beam self-cleaning in a graded index fiber

Intravascular photoacoustic imaging can potentially improve the identification of lipid-laden atherosclerotic plaque. Most intravascular photoacoustic endoscopes use multimode fibers, which do not allow tight focusing of photons. Recent experiments on pulse propagation in multimode graded-index fibers have shown a nonlinear improvement in beam quality. Here, we harness this nonlinear phenomenon for fiber-delivery of nanosecond laser pulses. We built a photoacoustic catheter 1.4 mm outer diameter, offering a lateral resolution as fine as 30 μm within a depth range of 2.5 mm. Such resolution is one order of magnitude better than current multimode fiber-based intravascular photoacoustic catheters. At the same time, the delivered pulse energy can reach as high as 20 μJ, which is two orders of magnitude higher than that of an optical resolution photoacoustic endoscope built with a single mode fiber. These improvements are expected to promote the biomedical application of photoacoustic endoscopes which require both high resolution and high pulse energy.

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

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

Cardiovascular optoacoustics: From mice to men - A review

Imaging has become an indispensable tool in the research and clinical management of cardiovascular disease (CVD). An array of imaging technologies is considered for CVD diagnostics and therapeutic assessment, ranging from ultrasonography, X-ray computed tomography and magnetic resonance imaging to nuclear and optical imaging methods. Each method has different operational characteristics and assesses different aspects of CVD pathophysiology; nevertheless, more information is desirable for achieving a comprehensive view of the disease. Optoacoustic (photoacoustic) imaging is an emerging modality promising to offer novel information on CVD parameters by allowing high-resolution imaging of optical contrast several centimeters deep inside tissue. Implemented with illumination at several wavelengths, multi-spectral optoacoustic tomography (MSOT) in particular, is sensitive to oxygenated and deoxygenated hemoglobin, water and lipids allowing imaging of the vasculature, tissue oxygen saturation and metabolic or inflammatory parameters. Progress with fast-tuning lasers, parallel detection and advanced image reconstruction and data-processing algorithms have recently transformed optoacoustics from a laboratory tool to a promising modality for small animal and clinical imaging. We review progress with optoacoustic CVD imaging, highlight the research and diagnostic potential and current applications and discuss the advantages, limitations and possibilities for integration into clinical routine.

Comparative Quantification of Arterial Lipid by Intravascular Photoacoustic-Ultrasound Imaging and Near-Infrared Spectroscopy-Intravascular Ultrasound

Intravascular photoacoustic-ultrasound (IVPA-US) imaging and near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) are two hybrid modalities that detect arterial lipid, with comparison necessary to understand the relative advantages of each. We performed in vivo and ex vivo IVPA-US imaging of the iliac arteries of Ossabaw swine with metabolic syndrome (MetS) and lean swine to investigate sensitivity for early-stage atherosclerosis. We repeated imaging ex vivo with NIRS-IVUS for comparison to IVPA-US and histology. Both modalities showed significantly greater lipid in MetS vs. lean swine, but only IVPA-US localized the lipid as perivascular. To investigate late-stage atherosclerosis, we performed ex vivo IVPA-US imaging of a human coronary artery with comparison to NIRS-IVUS and histology. Two advanced fibroatheromas were identified, with agreement between IVPA-measured lipid area and NIRS-derived lipid content. As confirmed histologically, IVPA-US has sensitivity to detect lipid content similar to NIRS-IVUS and provides additional depth resolution, enabling quantification and localization of lipid cores within plaques.

Optoacoustic mesoscopy for biomedicine

Fuelled by innovation, optical microscopy plays a critical role in the life sciences and medicine, from basic discovery to clinical diagnostics. However, optical microscopy is limited by typical penetration depths of a few hundred micrometres for in vivo interrogations in the visible spectrum. Optoacoustic microscopy complements optical microscopy by imaging the absorption of light, but it is similarly limited by penetration depth. In this Review, we summarize progress in the development and applicability of optoacoustic mesoscopy (OPAM); that is, optoacoustic imaging with acoustic resolution and wide-bandwidth ultrasound detection. OPAM extends the capabilities of optical imaging beyond the depths accessible to optical and optoacoustic microscopy, and thus enables new applications. We explain the operational principles of OPAM, its placement as a bridge between optoacoustic microscopy and optoacoustic macroscopy, and its performance in the label-free visualization of tissue pathophysiology, such as inflammation, oxygenation, vascularization and angiogenesis. We also review emerging applications of OPAM in clinical and biological imaging.

Optimized light delivery probe using ball lenses for co-registered photoacoustic and ultrasound endo-cavity subsurface imaging

An optimized hand-held photoacoustic and ultrasound probe suitable for endo-cavity tumor subsurface imaging was designed and evaluated. Compared to previous designs, the prototype probe, consisting of four 1 mm multi-mode optical fibers attached with 1.5 mm diameter ball-shaped fiber tips sandwiched between a transvaginal ultrasound transducer and a custom-made sheath, demonstrated a higher light output and better beam homogeneity on tissue subsurface. The output power and fluence profile were simulated for different design parameters. A camera recorded fluence profiles through calibrated intralipid solution at various imaging depths. The light delivery efficiency was experimentally compared with and without the ball lenses, based on ex-vivo imaging of human colorectal cancer and in-vivo imaging of a palmar vein proximal to the human wrist. The simulations and experiments demonstrated that ball-shaped fiber tip design can achieve homogeneous fluence distribution on tissue subsurface with acceptable light output efficiency, suggesting its clinical potential for in-vivo endo-cavity imaging.

An FPGA-Based Backend System for Intravascular Photoacoustic and Ultrasound Imaging

The integration of intravascular ultrasound (IVUS) and intravascular photoacoustic (IVPA) imaging produces an imaging modality with high sensitivity and specificity which is particularly needed in interventional cardiology. Conventional side-looking IVUS imaging with a single-element ultrasound (US) transducer lacks forward-viewing capability, which limits the application of this imaging mode in intravascular intervention guidance, Doppler-based flow measurement, and visualization of nearly, or totally blocked arteries. For both side-looking and forward-looking imaging, the necessity to mechanically scan the US transducer limits the imaging frame rate, and therefore, array-based solutions are desired. In this paper, we present a low-cost, compact, high-speed, and programmable imaging system based on a field-programmable gate array suitable for dual-mode forward-looking IVUS/IVPA imaging. The system has 16 US transmit and receive channels and functions in multiple modes including interleaved photoacoustic (PA) and US imaging, hardware-based high-frame-rate US imaging, software-driven US imaging, and velocity measurement. The system is implemented in the register-transfer level, and the central system controller is implemented as a finite-state machine. The system was tested with a capacitive micromachined ultrasonic transducer array. A 170-frames-per-second (FPS) US imaging frame rate is achieved in the hardware-based high-frame-rate US imaging mode while the interleaved PA and US imaging mode operates at a 60-FPS US and a laser-limited 20-FPS PA imaging frame rate. The performance of the system benefits from the flexibility and efficiency provided by the low-level implementation. The resulting system provides a convenient backend platform for research and clinical IVPA and IVUS imaging.

Exogenous imaging contrast and therapeutic agents for intravascular photoacoustic imaging and image-guided therapy

Intravascular photoacoustic (IVPA) imaging has been developed in recent years as a viable imaging modality for the assessment of atherosclerotic plaques. Exogenous imaging contrast and therapeutic agents further enhance this imaging modality and provide significant benefits. Imaging contrast agents can significantly increase photoacoustic signal, resulting in enhanced plaque detection and characterization. The ability to use these particles to molecularly target markers of disease progression makes it possible to determine patient-specific levels of risk and plan treatments accordingly. With improved diagnosis, clinicians will be able to use therapeutic agents that are synergistic with IVPA imaging to treat atherosclerotic patients. Pre-clinical and clinical studies with relevance to IVPA imaging have shown promise in the area of diagnosis and therapeutics. In this review, we present a variety of imaging contrast agents that are either designed for or are compatible with IVPA imaging, cover uses of therapeutic agents that compliment this imaging modality, and discuss future directions of research in the field.

Intravascular Photothermal Strain Imaging for Lipid Detection

Cardiovascular disease (CVD) is one of the major threats to humanity, accounting for one-third of the world's deaths. For patients with high-risk CVD, plaque rupture can lead to critical condition. It is therefore important to determine the stability of the plaque and classify the patient's risk level. Lipid content is an important determinant of plaque stability. However, conventional intravascular imaging methods have limitations in finding lipids. Therefore, new intravascular imaging techniques for plaque risk assessment are urgently needed. In this study, a novel photothermal strain imaging (pTSI) was applied to an intravascular imaging system for detecting lipids in plaques. As a combination of thermal strain imaging and laser-induced heating, pTSI differentiates lipids from other tissues based on changes in ultrasound (US) velocity with temperature change. We designed an optical pathway to an intravascular ultrasound catheter to deliver 1210-nm laser and US simultaneously. To establish the feasibility of the intravascular pTSI system, we experimented with a tissue-mimicking phantom made of fat and gelatin. Due to the difference in the strain during laser heating, we can clearly distinguish fat and gelatin in the phantom. The result demonstrates that pTSI could be used with conventional intravascular imaging methods to detect the plaque lipid.

Scanning Acoustic Microscopy and Time-Resolved Fluorescence Spectroscopy for Characterization of Atherosclerotic Plaques

Atherosclerotic plaques constitute the primary cause of heart attack and stroke. However, we still lack a clear identification of the plaques. Here, we evaluate the feasibility of scanning acoustic microscopy (SAM) and time-resolved fluorescence spectroscopy (TRFS) in atherosclerotic plaque characterization. We perform dual-modality microscopic imaging of the human carotid atherosclerotic plaques. We first show that the acoustic impedance values are statistically higher in calcified regions compared with the collagen-rich areas. We then use CdTe/CdS quantum dots for imaging the atherosclerotic plaques by TRFS and show that fluorescence lifetime values of the quantum dots in collagen-rich areas are notably different from the ones in calcified areas. In summary, both modalities are successful in differentiating the calcified regions from the collagen-rich areas within the plaques indicating that these techniques are confirmatory and may be combined to characterize atherosclerotic plaques in the future.

Optical Ultrasound Generation and Detection for Intravascular Imaging: A Review

Combined ultrasound and photoacoustic imaging has attracted significant interests for intravascular imaging such as atheromatous plaque detection, with ultrasound imaging providing spatial location and morphology and photoacoustic imaging highlighting molecular composition of the plaque. Conventional ultrasound imaging systems utilize piezoelectric ultrasound transducers, which suffer from limited frequency bandwidths and reduced sensitivity with miniature transducer elements. Recent advances on optical methods for both ultrasound generation and detection have shown great promise, as they provide efficient and ultrabroadband ultrasound generation and sensitive and ultrabroadband ultrasound detection. As such, all-optical ultrasound imaging has a great potential to become a next generation ultrasound imaging method. In this paper, we review recent developments on optical ultrasound transmitters, detectors, and all-optical ultrasound imaging systems, with a particular focus on fiber-based probes for intravascular imaging. We further discuss our thoughts on future directions on developing combined all-optical photoacoustic and ultrasound imaging systems for intravascular imaging.