1
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Zhang J, Wiacek A, Feng Z, Ding K, Lediju Bell MA. Flexible array transducer for photoacoustic-guided interventions: phantom and ex vivo demonstrations. BIOMEDICAL OPTICS EXPRESS 2023; 14:4349-4368. [PMID: 37799699 PMCID: PMC10549736 DOI: 10.1364/boe.491406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 10/07/2023]
Abstract
Photoacoustic imaging has demonstrated recent promise for surgical guidance, enabling visualization of tool tips during surgical and non-surgical interventions. To receive photoacoustic signals, most conventional transducers are rigid, while a flexible array is able to deform and provide complete contact on surfaces with different geometries. In this work, we present photoacoustic images acquired with a flexible array transducer in multiple concave shapes in phantom and ex vivo bovine liver experiments targeted toward interventional photoacoustic applications. We validate our image reconstruction equations for known sensor geometries with simulated data, and we provide empirical elevation field-of-view, target position, and image quality measurements. The elevation field-of-view was 6.08 mm at a depth of 4 cm and greater than 13 mm at a depth of 5 cm. The target depth agreement with ground truth ranged 98.35-99.69%. The mean lateral and axial target sizes when imaging 600 μm-core-diameter optical fibers inserted within the phantoms ranged 0.98-2.14 mm and 1.61-2.24 mm, respectively. The mean ± one standard deviation of lateral and axial target sizes when surrounded by liver tissue were 1.80±0.48 mm and 2.17±0.24 mm, respectively. Contrast, signal-to-noise, and generalized contrast-to-noise ratios ranged 6.92-24.42 dB, 46.50-67.51 dB, and 0.76-1, respectively, within the elevational field-of-view. Results establish the feasibility of implementing photoacoustic-guided surgery with a flexible array transducer.
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Affiliation(s)
- Jiaxin Zhang
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Alycen Wiacek
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ziwei Feng
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Kai Ding
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD 21287, USA
| | - Muyinatu A. Lediju Bell
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Computer Science, Johns Hopkins University, Baltimore, MD 21218, USA
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2
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Gonzalez EA, Bell MAL. Photoacoustic Imaging and Characterization of Bone in Medicine: Overview, Applications, and Outlook. Annu Rev Biomed Eng 2023; 25:207-232. [PMID: 37000966 DOI: 10.1146/annurev-bioeng-081622-025405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Photoacoustic techniques have shown promise in identifying molecular changes in bone tissue and visualizing tissue microstructure. This capability represents significant advantages over gold standards (i.e., dual-energy X-ray absorptiometry) for bone evaluation without requiring ionizing radiation. Instead, photoacoustic imaging uses light to penetrate through bone, followed by acoustic pressure generation, resulting in highly sensitive optical absorption contrast in deep biological tissues. This review covers multiple bone-related photoacoustic imaging contributions to clinical applications, spanning bone cancer, joint pathologies, spinal disorders, osteoporosis, bone-related surgical guidance, consolidation monitoring, and transsphenoidal and transcranial imaging. We also present a summary of photoacoustic-based techniques for characterizing biomechanical properties of bone, including temperature, guided waves, spectral parameters, and spectroscopy. We conclude with a future outlook based on the current state of technological developments, recent achievements, and possible new directions.
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Affiliation(s)
- Eduardo A Gonzalez
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Muyinatu A Lediju Bell
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Electrical and Computer Engineering and Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA;
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3
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Swann R, Slikboer S, Genady A, Silva LR, Janzen N, Faraday A, Valliant JF, Sadeghi S. Tetrazine-Derived Near-Infrared Dye for Targeted Photoacoustic Imaging of Bone. J Med Chem 2023; 66:6025-6036. [PMID: 37129217 DOI: 10.1021/acs.jmedchem.2c01685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A near-infrared photoacoustic probe was used to image bone in vivo through active and bioorthogonal pretargeting strategies that utilized coupling between a tetrazine-derived cyanine dye and a trans-cyclooctene-modified bisphosphonate. In vitro hydroxyapatite binding of the probe via active and pretargeting strategies showed comparable increases in percent binding vs a nontargeted control. Intrafemoral injection of the bisphosphonate-dye conjugate showed retention out to 24 h post-injection, with a 14-fold increase in signal over background, while the nontargeted dye exhibited negligible binding to bone and signal washout by 4 h post-injection. Intravenous injection, using both active and pretargeting strategies, demonstrated bone accumulation as earlier as 4 h post-injection, where the signal was found to be 3.6- and 1.5-fold higher, respectively, than the signal from the nontargeted dye. The described bone-targeted dye enabled in vivo photoacoustic imaging, while the synthetic strategy provides a convenient building block for developing new targeted photoacoustic probes.
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Affiliation(s)
- Rowan Swann
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Samantha Slikboer
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Afaf Genady
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Luis Rafael Silva
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Nancy Janzen
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Amber Faraday
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - John F Valliant
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Saman Sadeghi
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
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4
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Losch MS, Kardux F, Dankelman J, Hendriks BHW. Diffuse reflectance spectroscopy of the spine: improved breach detection with angulated fibers. BIOMEDICAL OPTICS EXPRESS 2023; 14:739-750. [PMID: 36874502 PMCID: PMC9979673 DOI: 10.1364/boe.471725] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/07/2022] [Accepted: 12/14/2022] [Indexed: 06/18/2023]
Abstract
Accuracy in spinal fusion varies greatly depending on the experience of the physician. Real-time tissue feedback with diffuse reflectance spectroscopy has been shown to provide cortical breach detection using a conventional probe with two parallel fibers. In this study, Monte Carlo simulations and optical phantom experiments were conducted to investigate how angulation of the emitting fiber affects the probed volume to allow for the detection of acute breaches. Difference in intensity magnitude between cancellous and cortical spectra increased with the fiber angle, suggesting that outward angulated fibers are beneficial in acute breach scenarios. Proximity to the cortical bone could be detected best with fibers angulated at θ f = 45 ∘ for impending breaches between θ p = 0 ∘ and θ p = 45 ∘ . An orthopedic surgical device comprising a third fiber perpendicular to the device axis could thus cover the full impending breach range from θ p = 0 ∘ to θ p = 90 ∘ .
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Affiliation(s)
- Merle S. Losch
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Famke Kardux
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Jenny Dankelman
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Benno H. W. Hendriks
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
- Image Guided Therapy and Ultrasound Devices
and System Department, Philips Research,
Royal Philips NV, Eindhoven, The
Netherlands
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5
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Liu L, Zhao Y, Li A, Yu X, Xiao X, Liu S, Meng MQH. A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery. Front Bioeng Biotechnol 2022; 10:1000950. [PMID: 36185423 PMCID: PMC9520603 DOI: 10.3389/fbioe.2022.1000950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/15/2022] [Indexed: 12/02/2022] Open
Abstract
This article proposes a novel intra-operative navigation and sensing system that optimizes the functional accuracy of spinal pedicle screw implantation. It does so by incorporating radiation-free and multi-scale macroscopic 3D ultrasound (US) imaging and local tissue-awareness from in situ photoacoustic (PA) sensing at a clinically relevant mesoscopic scale. More specifically, 3D US imaging is employed for online status updates of spinal segment posture to determine the appropriate entry point and coarse drilling path once non-negligible or relative patient motion occurs between inter-vertebral segments in the intra-operative phase. Furthermore, a sophisticated sensor-enhanced drilling probe has been developed to facilitate fine-grained local navigation that integrates a PA endoscopic imaging component for in situ tissue sensing. The PA signals from a sideways direction to differentiate cancellous bone from harder cortical bone, or to indicate weakened osteoporotic bone within the vertebrae. In so doing it prevents cortical breaches, strengthens implant stability, and mitigates iatrogenic injuries of the neighboring artery and nerves. To optimize this PA-enhanced endoscopic probe design, the light absorption spectrum of cortical bone and cancellous bone are measured in vitro, and the associated PA signals are characterized. Ultimately, a pilot study is performed on an ex vivo bovine spine to validate our developed multi-scale navigation and sensing system. The experimental results demonstrate the clinical feasibility, and hence the great potential, for functionally accurate screw implantation in complex spinal stabilization interventions.
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Affiliation(s)
- Li Liu
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
- *Correspondence: Li Liu, ; Siyu Liu,
| | - Yongjian Zhao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ang Li
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xianghu Yu
- Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Xiao Xiao
- Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Siyu Liu
- School of Science, Nanjing University of Science and Technology, Nanjing, China
- *Correspondence: Li Liu, ; Siyu Liu,
| | - Max Q.-H. Meng
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China
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6
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Gubbi MR, Gonzalez EA, Bell MAL. Theoretical Framework to Predict Generalized Contrast-to-Noise Ratios of Photoacoustic Images With Applications to Computer Vision. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:2098-2114. [PMID: 35446763 DOI: 10.1109/tuffc.2022.3169082] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The successful integration of computer vision, robotic actuation, and photoacoustic imaging to find and follow targets of interest during surgical and interventional procedures requires accurate photoacoustic target detectability. This detectability has traditionally been assessed with image quality metrics, such as contrast, contrast-to-noise ratio, and signal-to-noise ratio (SNR). However, predicting target tracking performance expectations when using these traditional metrics is difficult due to unbounded values and sensitivity to image manipulation techniques like thresholding. The generalized contrast-to-noise ratio (gCNR) is a recently introduced alternative target detectability metric, with previous work dedicated to empirical demonstrations of applicability to photoacoustic images. In this article, we present theoretical approaches to model and predict the gCNR of photoacoustic images with an associated theoretical framework to analyze relationships between imaging system parameters and computer vision task performance. Our theoretical gCNR predictions are validated with histogram-based gCNR measurements from simulated, experimental phantom, ex vivo, and in vivo datasets. The mean absolute errors between predicted and measured gCNR values ranged from 3.2 ×10-3 to 2.3 ×10-2 for each dataset, with channel SNRs ranging -40 to 40 dB and laser energies ranging 0.07 [Formula: see text] to 68 mJ. Relationships among gCNR, laser energy, target and background image parameters, target segmentation, and threshold levels were also investigated. Results provide a promising foundation to enable predictions of photoacoustic gCNR and visual servoing segmentation accuracy. The efficiency of precursory surgical and interventional tasks (e.g., energy selection for photoacoustic-guided surgeries) may also be improved with the proposed framework.
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7
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Recent advances in aggregation-induced emission luminogens in photoacoustic imaging. Eur J Nucl Med Mol Imaging 2022; 49:2560-2583. [PMID: 35277741 DOI: 10.1007/s00259-022-05726-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/13/2022] [Indexed: 12/14/2022]
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8
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Atria PJ, Bordin D, Marti F, Nayak VV, Conejo J, Benalcázar Jalkh E, Witek L, Sampaio CS. 3D
‐printed resins for provisional dental restorations: Comparison of mechanical and biological properties. J ESTHET RESTOR DENT 2022; 34:804-815. [DOI: 10.1111/jerd.12888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Pablo J. Atria
- Department of Biomaterials, College of Dentistry Universidad de los Andes Santiago Chile
- NYU Grossman School of Medicine New York University New York New York USA
| | - Dimorvan Bordin
- College of Dentistry University of Guarulhos, Universus Veritas UNG Guarulhos Brazil
| | - Felipe Marti
- Department of Implantology, College of Dentistry Universidad Mayor Santiago Chile
| | | | - Julian Conejo
- Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine Philadelphia Pennsylvania USA
| | - Ernesto Benalcázar Jalkh
- Department of Biomaterials New York University College of Dentistry New York New York USA
- Department of Prosthodontics and Periodontology University of São Paulo, Bauru School of Dentistry Bauru Brazil
| | - Lukasz Witek
- Department of Biomaterials New York University College of Dentistry New York New York USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering New York University Brooklyn New York USA
| | - Camila S. Sampaio
- Department of Biomaterials, College of Dentistry Universidad de los Andes Santiago Chile
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9
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Piezoelectric and Opto-Acoustic Material Properties of Bone. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1364:319-346. [DOI: 10.1007/978-3-030-91979-5_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Fisher C, Harty J, Yee A, Li CL, Komolibus K, Grygoryev K, Lu H, Burke R, Wilson BC, Andersson-Engels S. Perspective on the integration of optical sensing into orthopedic surgical devices. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:010601. [PMID: 34984863 PMCID: PMC8727454 DOI: 10.1117/1.jbo.27.1.010601] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/23/2021] [Indexed: 06/14/2023]
Abstract
SIGNIFICANCE Orthopedic surgery currently comprises over 1.5 million cases annually in the United States alone and is growing rapidly with aging populations. Emerging optical sensing techniques promise fewer side effects with new, more effective approaches aimed at improving patient outcomes following orthopedic surgery. AIM The aim of this perspective paper is to outline potential applications where fiberoptic-based approaches can complement ongoing development of minimally invasive surgical procedures for use in orthopedic applications. APPROACH Several procedures involving orthopedic and spinal surgery, along with the clinical challenge associated with each, are considered. The current and potential applications of optical sensing within these procedures are discussed and future opportunities, challenges, and competing technologies are presented for each surgical application. RESULTS Strong research efforts involving sensor miniaturization and integration of optics into existing surgical devices, including K-wires and cranial perforators, provided the impetus for this perspective analysis. These advances have made it possible to envision a next-generation set of devices that can be rigorously evaluated in controlled clinical trials to become routine tools for orthopedic surgery. CONCLUSIONS Integration of optical devices into surgical drills and burrs to discern bone/tissue interfaces could be used to reduce complication rates across a spectrum of orthopedic surgery procedures or to aid less-experienced surgeons in complex techniques, such as laminoplasty or osteotomy. These developments present both opportunities and challenges for the biomedical optics community.
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Affiliation(s)
- Carl Fisher
- Biophotonics@Tyndall, IPIC, Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, Ireland
| | - James Harty
- Cork University Hospital and South Infirmary Victoria University Hospital, Department of Orthopaedic Surgery, Cork, Ireland
| | - Albert Yee
- University of Toronto, Sunnybrook Research Institute, Department of Surgery, Holland Bone and Joint Program, Division of Orthopaedic Surgery, Sunnybrook Health Sciences; Orthopaedic Biomechanics Laboratory, Physical Sciences Platform, Toronto, Canada
| | - Celina L. Li
- Biophotonics@Tyndall, IPIC, Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, Ireland
| | - Katarzyna Komolibus
- Biophotonics@Tyndall, IPIC, Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, Ireland
| | - Konstantin Grygoryev
- Biophotonics@Tyndall, IPIC, Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, Ireland
| | - Huihui Lu
- Biophotonics@Tyndall, IPIC, Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, Ireland
| | - Ray Burke
- Biophotonics@Tyndall, IPIC, Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, Ireland
| | - Brian C. Wilson
- University of Toronto, Princess Margaret Cancer Centre/University Health Network, Department of Medical Biophysics, Toronto, Canada
| | - Stefan Andersson-Engels
- Biophotonics@Tyndall, IPIC, Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, Ireland
- University College Cork, Department of Physics, Cork, Ireland
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11
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Cai Q, Li Z, Li B, Jiang J, Li X, Meng W, Zhu S. Precise Diagnosis and Therapy of Bone Cancer Using Near-Infrared Lights. Front Bioeng Biotechnol 2021; 9:771153. [PMID: 34869286 PMCID: PMC8636834 DOI: 10.3389/fbioe.2021.771153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Bone is a preferred site for both primary and metastasis tumors. Current diagnosis of osteopathia typically relies on noninvasive skeleton radiography technology. However, due to the limited resolution of ionizing radiation, accurate diagnosis and effective identification impairment areas are still lacking. Near-infrared (NIR) bioimaging, especially in the NIR-II (1000-1700 nm) regions, can provide high sensitivity and spatiotemporal resolution bioimaging compared to the conventional radiography. Thus, NIR bioimaging affords intraoperative visualization and imaging-guided surgery, aiming to overcome challenges associated with theranostics of osteopathia and bone tumors. The present review aimed to summarize the latest evidence on the use of NIR probes for the targeting bone imaging. We further highlight the recent advances in bone photoX (X presents thermal, dynamic, and immuno) therapy through NIR probes, in particular combination with other customized therapeutic agents could provide high-efficiency treatment for bone tumors.
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Affiliation(s)
- Qing Cai
- Hospital of Stomatology, Jilin University, Changchun, China
| | - Zuntai Li
- Hospital of Stomatology, Jilin University, Changchun, China
| | - Baosheng Li
- Hospital of Stomatology, Jilin University, Changchun, China
| | - Jiayang Jiang
- Hospital of Stomatology, Jilin University, Changchun, China
| | - Xiaoyu Li
- Hospital of Stomatology, Jilin University, Changchun, China
| | - Weiyan Meng
- Hospital of Stomatology, Jilin University, Changchun, China
| | - Shoujun Zhu
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, China
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12
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Privitera L, Paraboschi I, Dixit D, Arthurs OJ, Giuliani S. Image-guided surgery and novel intraoperative devices for enhanced visualisation in general and paediatric surgery: a review. Innov Surg Sci 2021; 6:161-172. [PMID: 35937852 PMCID: PMC9294338 DOI: 10.1515/iss-2021-0028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 12/17/2021] [Indexed: 12/27/2022] Open
Abstract
Fluorescence guided surgery, augmented reality, and intra-operative imaging devices are rapidly pervading the field of surgical interventions, equipping the surgeon with powerful tools capable of enhancing the surgical visualisation of anatomical normal and pathological structures. There is a wide range of possibilities in the adult population to use these novel technologies and devices in the guidance for surgical procedures and minimally invasive surgeries. Their applications and their use have also been increasingly growing in the field of paediatric surgery, where the detailed visualisation of small anatomical structures could reduce procedure time, minimising surgical complications and ultimately improve the outcome of surgery. This review aims to illustrate the mechanisms underlying these innovations and their main applications in the clinical setting.
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Affiliation(s)
- Laura Privitera
- Wellcome/EPSRC Centre for Interventional & Surgical Sciences, London, UK,Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Irene Paraboschi
- Wellcome/EPSRC Centre for Interventional & Surgical Sciences, London, UK,Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Divyansh Dixit
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Owen J Arthurs
- Department of Clinical Radiology, NHS Foundation Trust, Great Ormond Street Hospital for Children, London, UK,NIHR GOSH Biomedical Research Centre, NHS Foundation Trust, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Stefano Giuliani
- Wellcome/EPSRC Centre for Interventional & Surgical Sciences, London, UK,Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, UK,Department of Specialist Neonatal and Paediatric Surgery, NHS Foundation Trust, Great Ormond Street Hospital for Children, London, UK
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13
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Gonzalez EA, Jain A, Bell MAL. Combined Ultrasound and Photoacoustic Image Guidance of Spinal Pedicle Cannulation Demonstrated With Intact ex vivo Specimens. IEEE Trans Biomed Eng 2021; 68:2479-2489. [PMID: 33347403 PMCID: PMC8345233 DOI: 10.1109/tbme.2020.3046370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Spinal fusion surgeries require accurate placement of pedicle screws in anatomic corridors without breaching bone boundaries. We are developing a combined ultrasound and photoacoustic image guidance system to avoid pedicle screw misplacement and accidental bone breaches, which can lead to nerve damage. METHODS Pedicle cannulation was performed on a human cadaver, with co-registered photoacoustic and ultrasound images acquired at various time points during the procedure. Bony landmarks obtained from coherence-based ultrasound images of lumbar vertebrae were registered to post-operative CT images. Registration methods were additionally tested on an ex vivo caprine vertebra. RESULTS Locally weighted short-lag spatial coherence (LW-SLSC) ultrasound imaging enhanced the visualization of bony structures with generalized contrast-to-noise ratios (gCNRs) of 0.99 and 0.98-1.00 in the caprine and human vertebrae, respectively. Short-lag spatial coherence (SLSC) and amplitude-based delay-and-sum (DAS) ultrasound imaging generally produced lower gCNRs of 0.98 and 0.84, respectively, in the caprine vertebra and 0.84-0.93 and 0.34-0.99, respectively, in the human vertebrae. The mean ± standard deviation of the area of -6 dB contours created from DAS photoacoustic images acquired with an optical fiber inserted in prepared pedicle holes (i.e., fiber surrounded by cancellous bone) and holes created after intentional breaches (i.e., fiber exposed to cortical bone) was 10.06 ±5.22 mm 2 and 2.47 ±0.96 mm 2, respectively (p 0.01). CONCLUSIONS Coherence-based LW-SLSC and SLSC beamforming improved visualization of bony anatomical landmarks for ultrasound-to-CT registration, while amplitude-based DAS beamforming successfully distinguished photoacoustic signals within the pedicle from less desirable signals characteristic of impending bone breaches. SIGNIFICANCE These results are promising to improve visual registration of ultrasound and photoacoustic images with CT images, as well as to assist surgeons with identifying and avoiding impending bone breaches during pedicle cannulation in spinal fusion surgeries.
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14
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Wiacek A, Lediju Bell MA. Photoacoustic-guided surgery from head to toe [Invited]. BIOMEDICAL OPTICS EXPRESS 2021; 12:2079-2117. [PMID: 33996218 PMCID: PMC8086464 DOI: 10.1364/boe.417984] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 05/04/2023]
Abstract
Photoacoustic imaging-the combination of optics and acoustics to visualize differences in optical absorption - has recently demonstrated strong viability as a promising method to provide critical guidance of multiple surgeries and procedures. Benefits include its potential to assist with tumor resection, identify hemorrhaged and ablated tissue, visualize metal implants (e.g., needle tips, tool tips, brachytherapy seeds), track catheter tips, and avoid accidental injury to critical subsurface anatomy (e.g., major vessels and nerves hidden by tissue during surgery). These benefits are significant because they reduce surgical error, associated surgery-related complications (e.g., cancer recurrence, paralysis, excessive bleeding), and accidental patient death in the operating room. This invited review covers multiple aspects of the use of photoacoustic imaging to guide both surgical and related non-surgical interventions. Applicable organ systems span structures within the head to contents of the toes, with an eye toward surgical and interventional translation for the benefit of patients and for use in operating rooms and interventional suites worldwide. We additionally include a critical discussion of complete systems and tools needed to maximize the success of surgical and interventional applications of photoacoustic-based technology, spanning light delivery, acoustic detection, and robotic methods. Multiple enabling hardware and software integration components are also discussed, concluding with a summary and future outlook based on the current state of technological developments, recent achievements, and possible new directions.
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Affiliation(s)
- Alycen Wiacek
- Department of Electrical and Computer Engineering, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
| | - Muyinatu A. Lediju Bell
- Department of Electrical and Computer Engineering, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Biomedical Engineering, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Computer Science, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
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15
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Huang J, Wiacek A, Kempski KM, Palmer T, Izzi J, Beck S, Lediju Bell MA. Empirical assessment of laser safety for photoacoustic-guided liver surgeries. BIOMEDICAL OPTICS EXPRESS 2021; 12:1205-1216. [PMID: 33796347 PMCID: PMC7984790 DOI: 10.1364/boe.415054] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 05/03/2023]
Abstract
Photoacoustic imaging is a promising technique to provide guidance during multiple surgeries and procedures. One challenge with this technique is that major blood vessels in the liver are difficult to differentiate from surrounding tissue within current safety limits, which only exist for human skin and eyes. In this paper, we investigate the safety of raising this limit for liver tissue excited with a 750 nm laser wavelength and approximately 30 mJ laser energy (corresponding to approximately 150 mJ/cm2 fluence). Laparotomies were performed on six swine to empirically investigate potential laser-related liver damage. Laser energy was applied for temporal durations of 1 minute, 10 minutes, and 20 minutes. Lasered liver lobes were excised either immediately after laser application (3 swine) or six weeks after surgery (3 swine). Cell damage was assessed using liver damage blood biomarkers and histopathology analyses of 41 tissue samples total. The biomarkers were generally normal over a 6 week post-surgical in vivo study period. Histopathology revealed no cell death, although additional pathology was present (i.e., hemorrhage, inflammation, fibrosis) due to handling, sample resection, and fibrous adhesions as a result of the laparotomy. These results support a new protocol for studying laser-related liver damage, indicating the potential to raise the safety limit for liver photoacoustic imaging to approximately 150 mJ/cm2 with a laser wavelength of 750 nm and for imaging durations up to 10 minutes without causing cell death. This investigation and protocol may be applied to other tissues and extended to additional wavelengths and energies, which is overall promising for introducing new tissue-specific laser safety limits for photoacoustic-guided surgery.
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Affiliation(s)
- Jiaqi Huang
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
| | - Alycen Wiacek
- Department of Electrical and Computer
Engineering, Johns Hopkins University,
Baltimore, MD 21218, USA
| | - Kelley M. Kempski
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
| | - Theron Palmer
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
| | - Jessica Izzi
- Department of Molecular and Comparative
Pathobiology, Johns Hopkins University,
Baltimore, MD 21218, USA
| | - Sarah Beck
- Department of Molecular and Comparative
Pathobiology, Johns Hopkins University,
Baltimore, MD 21218, USA
| | - Muyinatu A. Lediju Bell
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
- Department of Electrical and Computer
Engineering, Johns Hopkins University,
Baltimore, MD 21218, USA
- Department of Computer Science,
Johns Hopkins University, Baltimore, MD
21218, USA
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16
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Ravina K, Lin L, Liu CY, Thomas D, Hasson D, Wang LV, Russin JJ. Prospects of Photo- and Thermoacoustic Imaging in Neurosurgery. Neurosurgery 2020; 87:11-24. [PMID: 31620798 DOI: 10.1093/neuros/nyz420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/25/2019] [Indexed: 12/25/2022] Open
Abstract
The evolution of neurosurgery has been, and continues to be, closely associated with innovations in technology. Modern neurosurgery is wed to imaging technology and the future promises even more dependence on anatomic and, perhaps more importantly, functional imaging. The photoacoustic phenomenon was described nearly 140 yr ago; however, biomedical applications for this technology have only recently received significant attention. Light-based photoacoustic and microwave-based thermoacoustic technologies represent novel biomedical imaging modalities with broad application potential within and beyond neurosurgery. These technologies offer excellent imaging resolution while generally considered safer, more portable, versatile, and convenient than current imaging technologies. In this review, we summarize the current state of knowledge regarding photoacoustic and thermoacoustic imaging and their potential impact on the field of neurosurgery.
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Affiliation(s)
- Kristine Ravina
- Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Li Lin
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, Department of Electrical Engineering, California Institute of Technology, Pasadena, California.,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri
| | - Charles Y Liu
- Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Biology and Biological Engineering, California Institute of Technology, Pasadena, California.,Tianqiao and Chrissy Chen Brain-machine Interface Center, California Institute of Technology, Pasadena, California
| | - Debi Thomas
- Department of Surgery, University of California Davis, Davis, California
| | - Denise Hasson
- Division of Critical Care Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Lihong V Wang
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, Department of Electrical Engineering, California Institute of Technology, Pasadena, California
| | - Jonathan J Russin
- Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
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17
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Humbert J, Will O, Peñate-Medina T, Peñate-Medina O, Jansen O, Both M, Glüer CC. Comparison of photoacoustic and fluorescence tomography for the in vivo imaging of ICG-labelled liposomes in the medullary cavity in mice. PHOTOACOUSTICS 2020; 20:100210. [PMID: 33101928 PMCID: PMC7569329 DOI: 10.1016/j.pacs.2020.100210] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 08/26/2020] [Accepted: 09/13/2020] [Indexed: 05/20/2023]
Abstract
Few reports quantitatively compare the performance of photoacoustic tomography (PAT) versus fluorescence molecular tomography (FMT) in vivo. We compared both modalities for the detection of signals from injected ICG liposomes in the tibial medullary space of 10 BALB/c mice in vivo and ex vivo. Signals significantly correlated between modalities (R² = 0.69) and within each modality in vivo versus ex vivo (PAT: R² = 0.70, FMT: R² = 0.76). Phantom studies showed that signals at 4 mm depth are detected down to 3.3 ng ICG by PAT and 33 ng by FMT, with a nominal spatial resolution below 0.5 mm in PAT and limited to 1 mm in FMT. Our study demonstrates comparable in vivo sensitivity, but superior ex vivo sensitivity and in vivo resolution for our ICG liposomes of the VevoLAZR versus the FMT2500. PAT provides a useful new tool for the high-resolution imaging of bone marrow signals, for example for monitoring drug delivery.
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Key Words
- % ID, percent initial dose
- % PA signal, percent photoacoustic signal
- BMD, bone mineral density
- Bone
- DXA, dual-energy x-ray absorptiometry
- FLI, fluorescence imaging
- FMT, fluorescence molecular tomography
- Fluorescence imaging
- Hb, deoxygenated hemoglobin
- HbO2, oxygenated hemoglobin
- ICG, indocyanine green
- In vivo imaging
- LDF, laser-doppler flowmetry
- Liposomes
- M, mean
- Medullary space
- NIR, near-infrared
- PAI, photoacoustic imaging
- PAT, photoacoustic tomography
- Photoacoustic imaging
- QUS, quantitative ultrasound
- RFU, relative fluorescence units
- SD, standard deviation
- SEM, standard error of the mean
- Tibia
- US, ultrasound
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Affiliation(s)
- Jana Humbert
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Am Botanischen Garten 14, 24118 Kiel, Germany
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Corresponding author at: Molecular Imaging North Competence Center (MOIN CC), Am Botanischen Garten 14, 24118 Kiel, Germany.
| | - Olga Will
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Am Botanischen Garten 14, 24118 Kiel, Germany
| | - Tuula Peñate-Medina
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Am Botanischen Garten 14, 24118 Kiel, Germany
| | - Oula Peñate-Medina
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Am Botanischen Garten 14, 24118 Kiel, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Claus-Christian Glüer
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Am Botanischen Garten 14, 24118 Kiel, Germany
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18
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Li D, Liu Q, Qi Q, Shi H, Hsu EC, Chen W, Yuan W, Wu Y, Lin S, Zeng Y, Xiao Z, Xu L, Zhang Y, Stoyanova T, Jia W, Cheng Z. Gold Nanoclusters for NIR-II Fluorescence Imaging of Bones. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2020; 16:e2003851. [PMID: 33000882 DOI: 10.1002/smll.202003851] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/20/2020] [Indexed: 05/25/2023]
Abstract
Fluorescence imaging in the second near-infrared window (NIR-II, 1000-1700 nm) holds great promise for deep tissue visualization. Development of novel clinical translatable NIR-II probes is crucial for realizing the medical applications of NIR-II fluorescence imaging. Herein, the glutathione-capped gold nanoclusters (AuNCs, specifically Au25 (SG)18 ) demonstrate highly efficient binding capability to hydroxyapatite in vitro for the first time. Further in vivo NIR-II fluorescence imaging of AuNCs indicate that they accumulate in bone tissues with high contrast and signal-background ratio. AuNCs are also mainly and quickly excreted from body through renal system, showing excellent ribs and thoracic vertebra imaging because of no background signal in liver and spleen. The deep tissue penetration capability and high resolution of AuNCs in NIR-II imaging render their great potential for fluorescence-guided surgery like spinal pedicle screw implantation. Overall, AuNCs are highly promising and clinical translatable NIR-II imaging probe for visualizing bone and bone related abnormalities.
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Affiliation(s)
- Deling Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Qiang Liu
- College of Chemistry and Environmental Protection Engineering, Southwest Minzu University, Chengdu, Sichuan, 610041, China
| | - Qingrong Qi
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
- West China School of Pharmacy, Sichuan University, Chengdu, 610041, China
| | - Hui Shi
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
| | - En-Chi Hsu
- Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, Palo Alto, CA, 94304, USA
| | - Weiyu Chen
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
| | - Wenli Yuan
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
| | - Yifan Wu
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
| | - Sien Lin
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, 94305, USA
| | - Yitian Zeng
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, 94305, USA
| | - Zunyu Xiao
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
| | - Lingyun Xu
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
| | - Yanrong Zhang
- Department of Materials Science and Engineering, Stanford University, Palo Alto, CA, 94304, USA
| | - Tanya Stoyanova
- Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, Palo Alto, CA, 94304, USA
| | - Wang Jia
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Zhen Cheng
- Molecular Imaging Program at Stanford (MIPS), Bio-X Program, and Department of Radiology, Stanford University, Palo Alto, CA, 94305, USA
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19
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Feasibility Study of Precise Balloon Catheter Tracking and Visualization with Fast Photoacoustic Microscopy. SENSORS 2020; 20:s20195585. [PMID: 33003536 PMCID: PMC7582572 DOI: 10.3390/s20195585] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 12/14/2022]
Abstract
Correct guiding of the catheter is a critical issue in almost all balloon catheter applications, including arterial stenosis expansion, coronary arterial diseases, and gastrointestinal tracking. To achieve safe and precise guiding of the balloon catheter, a novel imaging method with high-resolution, sufficient depth of penetration, and real-time display is required. Here, we present a new balloon catheter guiding method using fast photoacoustic microscopy (PAM) technique for precise balloon catheter tracking and visualization as a feasibility study. We implemented ex vivo and in vivo experiments with three different medium conditions of balloon catheter: no air, air, and water. Acquired cross-sectional, maximum amplitude projection (MAP), and volumetric 3D PAM images demonstrated its capability as a new imaging guiding tool for balloon catheter tracking and visualization.
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20
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Lediju Bell MA. Photoacoustic imaging for surgical guidance: Principles, applications, and outlook. JOURNAL OF APPLIED PHYSICS 2020; 128:060904. [PMID: 32817994 PMCID: PMC7428347 DOI: 10.1063/5.0018190] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/30/2020] [Indexed: 05/08/2023]
Abstract
Minimally invasive surgeries often require complicated maneuvers and delicate hand-eye coordination and ideally would incorporate "x-ray vision" to see beyond tool tips and underneath tissues prior to making incisions. Photoacoustic imaging has the potential to offer this feature but not with ionizing x-rays. Instead, optical fibers and acoustic receivers enable photoacoustic sensing of major structures-such as blood vessels and nerves-that are otherwise hidden from view. This imaging process is initiated by transmitting laser pulses that illuminate regions of interest, causing thermal expansion and the generation of sound waves that are detectable with conventional ultrasound transducers. The recorded signals are then converted to images through the beamforming process. Photoacoustic imaging may be implemented to both target and avoid blood-rich surgical contents (and in some cases simultaneously or independently visualize optical fiber tips or metallic surgical tool tips) in order to prevent accidental injury and assist device operators during minimally invasive surgeries and interventional procedures. Novel light delivery systems, counterintuitive findings, and robotic integration methods introduced by the Photoacoustic & Ultrasonic Systems Engineering Lab are summarized in this invited Perspective, setting the foundation and rationale for the subsequent discussion of the author's views on possible future directions for this exciting frontier known as photoacoustic-guided surgery.
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Affiliation(s)
- Muyinatu A. Lediju Bell
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA
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21
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Gonzalez EA, Bell MAL. GPU implementation of photoacoustic short-lag spatial coherence imaging for improved image-guided interventions. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-19. [PMID: 32713168 PMCID: PMC7381831 DOI: 10.1117/1.jbo.25.7.077002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/29/2020] [Indexed: 05/04/2023]
Abstract
SIGNIFICANCE Photoacoustic-based visual servoing is a promising technique for surgical tool tip tracking and automated visualization of photoacoustic targets during interventional procedures. However, one outstanding challenge has been the reliability of obtaining segmentations using low-energy light sources that operate within existing laser safety limits. AIM We developed the first known graphical processing unit (GPU)-based real-time implementation of short-lag spatial coherence (SLSC) beamforming for photoacoustic imaging and applied this real-time algorithm to improve signal segmentation during photoacoustic-based visual servoing with low-energy lasers. APPROACH A 1-mm-core-diameter optical fiber was inserted into ex vivo bovine tissue. Photoacoustic-based visual servoing was implemented as the fiber was manually displaced by a translation stage, which provided ground truth measurements of the fiber displacement. GPU-SLSC results were compared with a central processing unit (CPU)-SLSC approach and an amplitude-based delay-and-sum (DAS) beamforming approach. Performance was additionally evaluated with in vivo cardiac data. RESULTS The GPU-SLSC implementation achieved frame rates up to 41.2 Hz, representing a factor of 348 speedup when compared with offline CPU-SLSC. In addition, GPU-SLSC successfully recovered low-energy signals (i.e., ≤268 μJ) with mean ± standard deviation of signal-to-noise ratios of 11.2 ± 2.4 (compared with 3.5 ± 0.8 with conventional DAS beamforming). When energies were lower than the safety limit for skin (i.e., 394.6 μJ for 900-nm wavelength laser light), the median and interquartile range (IQR) of visual servoing tracking errors obtained with GPU-SLSC were 0.64 and 0.52 mm, respectively (which were lower than the median and IQR obtained with DAS by 1.39 and 8.45 mm, respectively). GPU-SLSC additionally reduced the percentage of failed segmentations when applied to in vivo cardiac data. CONCLUSIONS Results are promising for the use of low-energy, miniaturized lasers to perform GPU-SLSC photoacoustic-based visual servoing in the operating room with laser pulse repetition frequencies as high as 41.2 Hz.
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Affiliation(s)
- Eduardo A. Gonzalez
- Johns Hopkins University, School of Medicine, Department of Biomedical Engineering, Baltimore, Maryland, United States
| | - Muyinatu A. Lediju Bell
- Johns Hopkins University, School of Medicine, Department of Biomedical Engineering, Baltimore, Maryland, United States
- Johns Hopkins University, Whiting School of Engineering, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
- Johns Hopkins University, Whiting School of Engineering, Department of Computer Science, Baltimore, Maryland, United States
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22
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Kubelick KP, Emelianov SY. In vivo photoacoustic guidance of stem cell injection and delivery for regenerative spinal cord therapies. NEUROPHOTONICS 2020; 7:030501. [PMID: 32743015 PMCID: PMC7388074 DOI: 10.1117/1.nph.7.3.030501] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 07/14/2020] [Indexed: 05/16/2023]
Abstract
Significance: Stem cell therapies are of interest for treating a variety of neurodegenerative diseases and injuries of the spinal cord. However, the lack of techniques for longitudinal monitoring of stem cell therapy progression is inhibiting clinical translation. Aim: The goal of this study is to demonstrate an intraoperative imaging approach to guide stem cell injection to the spinal cord in vivo. Results may ultimately support the development of an imaging tool that spans intra- or postoperative environments to guide therapy throughout treatment. Approach: Stem cells were labeled with Prussian blue nanocubes (PBNCs) to facilitate combined ultrasound and photoacoustic (US/PA) imaging to visualize stem cell injection and delivery to the spinal cord in vivo. US/PA results were confirmed by magnetic resonance imaging (MRI) and histology. Results: Real-time intraoperative US/PA image-guided injection of PBNC-labeled stem cells and three-dimensional volumetric images of injection provided feedback necessary for successful delivery of therapeutics into the spinal cord. Postoperative MRI confirmed delivery of PBNC-labeled stem cells. Conclusions: The nanoparticle-augmented US/PA approach successfully detected injection and delivery of stem cells into the spinal cord, confirmed by MRI. Our work demonstrated in vivo feasibility, which is a critical step toward the development of a US/PA/MRI platform to monitor regenerative spinal cord therapies.
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Affiliation(s)
- Kelsey P. Kubelick
- Georgia Institute of Technology, Emory University School of Medicine, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Georgia Institute of Technology, School of Electrical and Computer Engineering, Atlanta, Georgia, United States
| | - Stanislav Y. Emelianov
- Georgia Institute of Technology, Emory University School of Medicine, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Georgia Institute of Technology, School of Electrical and Computer Engineering, Atlanta, Georgia, United States
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23
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Graham M, Assis F, Allman D, Wiacek A, Gonzalez E, Gubbi M, Dong J, Hou H, Beck S, Chrispin J, Bell MAL. In Vivo Demonstration of Photoacoustic Image Guidance and Robotic Visual Servoing for Cardiac Catheter-Based Interventions. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:1015-1029. [PMID: 31502964 DOI: 10.1109/tmi.2019.2939568] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Cardiac interventional procedures are often performed under fluoroscopic guidance, exposing both the patient and operators to ionizing radiation. To reduce this risk of radiation exposure, we are exploring the use of photoacoustic imaging paired with robotic visual servoing for cardiac catheter visualization and surgical guidance. A cardiac catheterization procedure was performed on two in vivo swine after inserting an optical fiber into the cardiac catheter to produce photoacoustic signals from the tip of the fiber-catheter pair. A combination of photoacoustic imaging and robotic visual servoing was employed to visualize and maintain constant sight of the catheter tip in order to guide the catheter through the femoral or jugular vein, toward the heart. Fluoroscopy provided initial ground truth estimates for 1D validation of the catheter tip positions, and these estimates were refined using a 3D electromagnetic-based cardiac mapping system as the ground truth. The 1D and 3D root mean square errors ranged 0.25-2.28 mm and 1.24-1.54 mm, respectively. The catheter tip was additionally visualized at three locations within the heart: (1) inside the right atrium, (2) in contact with the right ventricular outflow tract, and (3) inside the right ventricle. Lasered regions of cardiac tissue were resected for histopathological analysis, which revealed no laser-related tissue damage, despite the use of 2.98 mJ per pulse at the fiber tip (379.2 mJ/cm2 fluence). In addition, there was a 19 dB difference in photoacoustic signal contrast when visualizing the catheter tip pre- and post-endocardial tissue contact, which is promising for contact confirmation during cardiac interventional procedures (e.g., cardiac radiofrequency ablation). These results are additionally promising for the use of photoacoustic imaging to guide cardiac interventions by providing depth information and enhanced visualization of catheter tip locations within blood vessels and within the beating heart.
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24
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Abstract
Photoacoustic imaging has demonstrated its potential for diagnosis over the last few decades. In recent years, its unique imaging capabilities, such as detecting structural, functional and molecular information in deep regions with optical contrast and ultrasound resolution, have opened up many opportunities for photoacoustic imaging to be used during image-guided interventions. Numerous studies have investigated the capability of photoacoustic imaging to guide various interventions such as drug delivery, therapies, surgeries, and biopsies. These studies have demonstrated that photoacoustic imaging can guide these interventions effectively and non-invasively in real-time. In this minireview, we will elucidate the potential of photoacoustic imaging in guiding active and passive drug deliveries, photothermal therapy, and other surgeries and therapies using endogenous and exogenous contrast agents including organic, inorganic, and hybrid nanoparticles, as well as needle-based biopsy procedures. The advantages of photoacoustic imaging in guided interventions will be discussed. It will, therefore, show that photoacoustic imaging has great potential in real-time interventions due to its advantages over current imaging modalities like computed tomography, magnetic resonance imaging, and ultrasound imaging.
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Affiliation(s)
- Madhumithra S Karthikesh
- Bioengineering Program and Institute for Bioengineering Research, University of Kansas, Lawrence, KS 66045, USA
| | - Xinmai Yang
- Bioengineering Program and Institute for Bioengineering Research, University of Kansas, Lawrence, KS 66045, USA
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS 66045, USA
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25
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Nyström NN, Yip LCM, Carson JJL, Scholl TJ, Ronald JA. Development of a Human Photoacoustic Imaging Reporter Gene Using the Clinical Dye Indocyanine Green. Radiol Imaging Cancer 2019; 1:e190035. [PMID: 33778683 DOI: 10.1148/rycan.2019190035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 09/17/2019] [Accepted: 10/08/2019] [Indexed: 12/12/2022]
Abstract
Purpose To develop a photoacoustic imaging (PAI) reporter gene that has high translational potential. Previous research has shown that human organic anion-transporting polypeptide 1b3 (OATP1B3) promotes the uptake of the near-infrared fluorescent dye indocyanine green (ICG). In this study, the authors have established OATP1B3 and ICG as a reporter gene-probe pair for in vivo PAI. Materials and Methods Human breast cancer cells were engineered to express OATP1B3. Control cells (not expressing OATP1B3) or OATP1B3-expressing cells were incubated with or without ICG, placed in a breast-mimicking phantom, and imaged with PAI. Control (n = 6) or OATP1B3-expressing (n = 5) cells were then implanted orthotopically into female mice. Full-spectrum PAI was performed before and 24 hours after ICG administration. One-way analysis of variance was performed, followed by Tukey posthoc multiple comparisons, to assess statistical significance. Results OATP1B3-expressing cells incubated with ICG exhibited a 2.7-fold increase in contrast-to-noise ratio relative to all other controls in vitro (P < .05). In mice, PAI signals after ICG administration were increased 2.3-fold in OATP1B3 tumors relative to those in controls (P < .05). Conclusion OATP1B3 operates as an in vivo PAI reporter gene based on its ability to promote the cellular uptake of ICG. Benefits include the human derivation of OATP1B3, combined with the use of wavelengths in the near-infrared region, high extinction coefficient, low quantum yield, and clinical approval of ICG. The authors posit that this system will be useful for localized monitoring of emerging gene- and cell-based therapies in clinical applications.© RSNA, 2019Keywords: Animal Studies, Molecular Imaging, Molecular Imaging-Clinical Translation, Molecular Imaging-Reporter Gene Imaging, Optical ImagingSupplemental material is available for this article.
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Affiliation(s)
- Nivin N Nyström
- Department of Medical Biophysics, University of Western Ontario, 1151 Richmond St N, Room 2241A, London, ON, Canada N6A 3K7 (N.N.N., L.C.M.Y., J.J.L.C., T.J.S., J.A.R.); Imaging Research Laboratories, Robarts Research Institute, London, Canada (N.N.N., T.J.S., J.A.R.); Lawson Health Research Institute, London, Canada (L.C.M.Y., J.J.L.C., J.A.R.); and Ontario Institute for Cancer Research, Toronto, Canada (T.J.S.)
| | - Lawrence C M Yip
- Department of Medical Biophysics, University of Western Ontario, 1151 Richmond St N, Room 2241A, London, ON, Canada N6A 3K7 (N.N.N., L.C.M.Y., J.J.L.C., T.J.S., J.A.R.); Imaging Research Laboratories, Robarts Research Institute, London, Canada (N.N.N., T.J.S., J.A.R.); Lawson Health Research Institute, London, Canada (L.C.M.Y., J.J.L.C., J.A.R.); and Ontario Institute for Cancer Research, Toronto, Canada (T.J.S.)
| | - Jeffrey J L Carson
- Department of Medical Biophysics, University of Western Ontario, 1151 Richmond St N, Room 2241A, London, ON, Canada N6A 3K7 (N.N.N., L.C.M.Y., J.J.L.C., T.J.S., J.A.R.); Imaging Research Laboratories, Robarts Research Institute, London, Canada (N.N.N., T.J.S., J.A.R.); Lawson Health Research Institute, London, Canada (L.C.M.Y., J.J.L.C., J.A.R.); and Ontario Institute for Cancer Research, Toronto, Canada (T.J.S.)
| | - Timothy J Scholl
- Department of Medical Biophysics, University of Western Ontario, 1151 Richmond St N, Room 2241A, London, ON, Canada N6A 3K7 (N.N.N., L.C.M.Y., J.J.L.C., T.J.S., J.A.R.); Imaging Research Laboratories, Robarts Research Institute, London, Canada (N.N.N., T.J.S., J.A.R.); Lawson Health Research Institute, London, Canada (L.C.M.Y., J.J.L.C., J.A.R.); and Ontario Institute for Cancer Research, Toronto, Canada (T.J.S.)
| | - John A Ronald
- Department of Medical Biophysics, University of Western Ontario, 1151 Richmond St N, Room 2241A, London, ON, Canada N6A 3K7 (N.N.N., L.C.M.Y., J.J.L.C., T.J.S., J.A.R.); Imaging Research Laboratories, Robarts Research Institute, London, Canada (N.N.N., T.J.S., J.A.R.); Lawson Health Research Institute, London, Canada (L.C.M.Y., J.J.L.C., J.A.R.); and Ontario Institute for Cancer Research, Toronto, Canada (T.J.S.)
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van Soest G, Desjardins A. Interventional photoacoustics: using light to sound out the path to safe, effective interventions. Phys Med Biol 2019; 64:220401. [DOI: 10.1088/1361-6560/ab50d8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kempski KM, Wiacek A, Graham M, González E, Goodson B, Allman D, Palmer J, Hou H, Beck S, He J, Bell MAL. In vivo photoacoustic imaging of major blood vessels in the pancreas and liver during surgery. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-12. [PMID: 31411010 PMCID: PMC7006046 DOI: 10.1117/1.jbo.24.12.121905] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/22/2019] [Indexed: 05/07/2023]
Abstract
Abdominal surgeries carry considerable risk of gastrointestinal and intra-abdominal hemorrhage, which could possibly cause patient death. Photoacoustic imaging is one solution to overcome this challenge by providing visualization of major blood vessels during surgery. We investigate the feasibility of in vivo blood vessel visualization for photoacoustic-guided liver and pancreas surgeries. In vivo photoacoustic imaging of major blood vessels in these two abdominal organs was successfully achieved after a laparotomy was performed on two swine. Three-dimensional photoacoustic imaging with a robot-controlled ultrasound (US) probe and color Doppler imaging were used to confirm vessel locations. Blood vessels in the in vivo liver were visualized with energies of 20 to 40 mJ, resulting in 10 to 15 dB vessel contrast. Similarly, an energy of 36 mJ was sufficient to visualize vessels in the pancreas with up to 17.3 dB contrast. We observed that photoacoustic signals were more focused when the light source encountered a major vessel in the liver. This observation can be used to distinguish major blood vessels in the image plane from the more diffuse signals associated with smaller blood vessels in the surrounding tissue. A postsurgery histopathological analysis was performed on resected pancreatic and liver tissues to explore possible laser-related damage. Results are generally promising for photoacoustic-guided abdominal surgery when the US probe is fixed and the light source is used to interrogate the surgical workspace. These findings are additionally applicable to other procedures that may benefit from photoacoustic-guided interventional imaging of the liver and pancreas (e.g., biopsy and guidance of radiofrequency ablation lesions in the liver).
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Affiliation(s)
- Kelley M. Kempski
- University of Delaware, Department of Biomedical Engineering, Newark, Delaware, United States
| | - Alycen Wiacek
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
| | - Michelle Graham
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
| | - Eduardo González
- Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Maryland, United States
| | - Bria Goodson
- Delta State University, Department of Biology, Cleveland, Mississippi, United States
| | - Derek Allman
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
| | - Jasmin Palmer
- Massachusetts Institute of Technology, Department of Mechanical Engineering, Cambridge, Massachusetts, United States
| | - Huayu Hou
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
| | - Sarah Beck
- Johns Hopkins Medicine, Department of Molecular and Comparative Pathobiology, Baltimore, Maryland, United States
| | - Jin He
- Johns Hopkins Medicine, Department of Surgery, Baltimore, Maryland, United States
- Johns Hopkins Medicine, Department of Oncology, Baltimore, Maryland, United States
| | - Muyinatu A. Lediju Bell
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
- Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Maryland, United States
- Johns Hopkins University, Department of Computer Science, Baltimore, Maryland, United States
- Address all correspondence to Muyinatu A. Lediju Bell, E-mail:
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28
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Cho N, Shokeen M. Changing landscape of optical imaging in skeletal metastases. J Bone Oncol 2019; 17:100249. [PMID: 31316892 PMCID: PMC6611980 DOI: 10.1016/j.jbo.2019.100249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 02/08/2023] Open
Abstract
Optical imaging is an emerging strategy for in vitro and in vivo visualization of the molecular mechanisms of cancer over time. An increasing number of optical imaging contrast agents and techniques have been developed in recent years specifically for bone research and skeletal metastases. Visualizing molecular processes in relation to bone remodeling in metastasized cancers provides valuable information for understanding disease mechanisms and monitoring expression of primary molecular targets and therapeutic efficacy. This review is intended to provide an overview of tumor-specific and non-specific contrast agents in the first near-infrared window (NIR-I) window from 650 nm to 950 nm that can be used to study functional and structural aspects of skeletal remodeling of cancer in preclinical animal models. Near-infrared (NIR) optical imaging techniques, specifically NIR spectroscopy and photoacoustic imaging, and their use in skeletal metastases will also be discussed. Perspectives on the promises and challenges facing this exciting field are then given.
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Affiliation(s)
- Nicholas Cho
- Department of Radiology, Washington University School of Medicine, 4515 McKinley Ave, St. Louis, MO 63110, United States.,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 63110, United States
| | - Monica Shokeen
- Department of Radiology, Washington University School of Medicine, 4515 McKinley Ave, St. Louis, MO 63110, United States.,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 63110, United States.,Alvin J. Siteman Cancer Center at Washington University School of Medicine and Barnes Jewish Hospital, St. Louis, MO 63110, United States
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Upputuri PK, Pramanik M. Photoacoustic imaging in the second near-infrared window: a review. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-20. [PMID: 30968648 PMCID: PMC6990072 DOI: 10.1117/1.jbo.24.4.040901] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 03/18/2019] [Indexed: 05/04/2023]
Abstract
Photoacoustic (PA) imaging is an emerging medical imaging modality that combines optical excitation and ultrasound detection. Because ultrasound scatters much less than light in biological tissues, PA generates high-resolution images at centimeters depth. In recent years, wavelengths in the second near-infrared (NIR-II) window (1000 to 1700 nm) have been increasingly explored due to its potential for preclinical and clinical applications. In contrast to the conventional PA imaging in the visible (400 to 700 nm) and the first NIR-I (700 to 1000 nm) window, PA imaging in the NIR-II window offers numerous advantages, including high spatial resolution, deeper penetration depth, reduced optical absorption, and tissue scattering. Moreover, the second window allows a fivefold higher light excitation energy density compared to the visible window for enhancing the imaging depth significantly. We highlight the importance of the second window for PA imaging and discuss the various NIR-II PA imaging systems and contrast agents with strong absorption in the NIR-II spectral region. Numerous applications of NIR-II PA imaging, including whole-body animal imaging and human imaging, are also discussed.
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Affiliation(s)
- Paul Kumar Upputuri
- Nanyang Technological University, School of Chemical and Biomedical Engineering, Singapore
| | - Manojit Pramanik
- Nanyang Technological University, School of Chemical and Biomedical Engineering, Singapore
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Han SH. Review of Photoacoustic Imaging for Imaging-Guided Spinal Surgery. Neurospine 2018; 15:306-322. [PMID: 30531652 PMCID: PMC6347351 DOI: 10.14245/ns.1836206.103] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/10/2018] [Indexed: 12/23/2022] Open
Abstract
This review introduces the current technique of photoacoustic imaging as it is applied in imaging-guided surgery (IGS), which provides the surgeon with image visualization and analysis capabilities during surgery. Numerous imaging techniques have been developed to help surgeons perform complex operations more safely and quickly. Although surgeons typically use these kinds of images to visualize targets hidden by bone and other tissues, it is nonetheless more difficult to perform surgery with static reference images (e.g., computed tomography scans and magnetic resonance images) of internal structures. Photoacoustic imaging could enable real-time visualization of regions of interest during surgery. Several researchers have shown that photoacoustic imaging has potential for the noninvasive diagnosis of various types of tissues, including bone. Previous studies of the surgical application of photoacoustic imaging have focused on cancer surgery, but photoacoustic imaging has also recently attracted interest for spinal surgery, because it could be useful for avoiding pedicle breaches and for choosing an appropriate starting point before drilling or pedicle probe insertion. This review describes the current instruments and clinical applications of photoacoustic imaging. Its primary objective is to provide a comprehensive overview of photoacoustic IGS in spinal surgery.
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Affiliation(s)
- Seung Hee Han
- Division of Biophotonics, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
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31
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Lediju Bell MA, Shubert J. Photoacoustic-based visual servoing of a needle tip. Sci Rep 2018; 8:15519. [PMID: 30341371 PMCID: PMC6195562 DOI: 10.1038/s41598-018-33931-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/08/2018] [Indexed: 12/15/2022] Open
Abstract
In intraoperative settings, the presence of acoustic clutter and reflection artifacts from metallic surgical tools often reduces the effectiveness of ultrasound imaging and complicates the localization of surgical tool tips. We propose an alternative approach for tool tracking and navigation in these challenging acoustic environments by augmenting ultrasound systems with a light source (to perform photoacoustic imaging) and a robot (to autonomously and robustly follow a surgical tool regardless of the tissue medium). The robotically controlled ultrasound probe continuously visualizes the location of the tool tip by segmenting and tracking photoacoustic signals generated from an optical fiber inside the tool. System validation in the presence of fat, muscle, brain, skull, and liver tissue with and without the presence of an additional clutter layer resulted in mean signal tracking errors <2 mm, mean probe centering errors <1 mm, and successful recovery from ultrasound perturbations, representing either patient motion or switching from photoacoustic images to ultrasound images to search for a target of interest. A detailed analysis of channel SNR in controlled experiments with and without significant acoustic clutter revealed that the detection of a needle tip is possible with photoacoustic imaging, particularly in cases where ultrasound imaging traditionally fails. Results show promise for guiding surgeries and procedures in acoustically challenging environments with this novel robotic and photoacoustic system combination.
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Affiliation(s)
- Muyinatu A Lediju Bell
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, MD, 21218, USA. .,Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD, 21218, USA. .,Johns Hopkins University, Department of Computer Science, Baltimore, MD, 21218, USA.
| | - Joshua Shubert
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, MD, 21218, USA
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