Video-Rate Dual-Modal Wide-Beam Harmonic Ultrasound and Photoacoustic Computed Tomography

Ultrasound-Based Micro-/Nanosystems for Biomedical Applications

Due to the intrinsic non-invasive nature, cost-effectiveness, high safety, and real-time capabilities, besides diagnostic imaging, ultrasound as a typical mechanical wave has been extensively developed as a physical tool for versatile biomedical applications. Especially, the prosperity of nanotechnology and nanomedicine invigorates the landscape of ultrasound-based medicine. The unprecedented surge in research enthusiasm and dedicated efforts have led to a mass of multifunctional micro-/nanosystems being applied in ultrasound biomedicine, facilitating precise diagnosis, effective treatment, and personalized theranostics. The effective deployment of versatile ultrasound-based micro-/nanosystems in biomedical applications is rooted in a profound understanding of the relationship among composition, structure, property, bioactivity, application, and performance. In this comprehensive review, we elaborate on the general principles regarding the design, synthesis, functionalization, and optimization of ultrasound-based micro-/nanosystems for abundant biomedical applications. In particular, recent advancements in ultrasound-based micro-/nanosystems for diagnostic imaging are meticulously summarized. Furthermore, we systematically elucidate state-of-the-art studies concerning recent progress in ultrasound-based micro-/nanosystems for therapeutic applications targeting various pathological abnormalities including cancer, bacterial infection, brain diseases, cardiovascular diseases, and metabolic diseases. Finally, we conclude and provide an outlook on this research field with an in-depth discussion of the challenges faced and future developments for further extensive clinical translation and application.

Simultaneous photoacoustic and ultrasound imaging: A review

Photoacoustic imaging (PAI) is an emerging biomedical imaging technique that combines the advantages of optical and ultrasound imaging, enabling the generation of images with both optical resolution and acoustic penetration depth. By leveraging similar signal acquisition and processing methods, the integration of photoacoustic and ultrasound imaging has introduced a novel hybrid imaging modality suitable for clinical applications. Photoacoustic-ultrasound imaging allows for non-invasive, high-resolution, and deep-penetrating imaging, providing a wealth of image information. In recent years, with the deepening research and the expanding biomedical application scenarios of photoacoustic-ultrasound bimodal systems, the immense potential of photoacoustic-ultrasound bimodal imaging in basic research and clinical applications has been demonstrated, with some research achievements already commercialized. In this review, we introduce the principles, technical advantages, and biomedical applications of photoacoustic-ultrasound bimodal imaging techniques, specifically focusing on tomographic, microscopic, and endoscopic imaging modalities. Furthermore, we discuss the future directions of photoacoustic-ultrasound bimodal imaging technology.

Application and prospects of AI-based radiomics in ultrasound diagnosis

Artificial intelligence (AI)-based radiomics has attracted considerable research attention in the field of medical imaging, including ultrasound diagnosis. Ultrasound imaging has unique advantages such as high temporal resolution, low cost, and no radiation exposure. This renders it a preferred imaging modality for several clinical scenarios. This review includes a detailed introduction to imaging modalities, including Brightness-mode ultrasound, color Doppler flow imaging, ultrasound elastography, contrast-enhanced ultrasound, and multi-modal fusion analysis. It provides an overview of the current status and prospects of AI-based radiomics in ultrasound diagnosis, highlighting the application of AI-based radiomics to static ultrasound images, dynamic ultrasound videos, and multi-modal ultrasound fusion analysis.

Super-Low-Dose Functional and Molecular Photoacoustic Microscopy

Photoacoustic microscopy can image many biological molecules and nano-agents in vivo via low-scattering ultrasonic sensing. Insufficient sensitivity is a long-standing obstacle for imaging low-absorbing chromophores with less photobleaching or toxicity, reduced perturbation to delicate organs, and more choices of low-power lasers. Here, the photoacoustic probe design is collaboratively optimized and a spectral-spatial filter is implemented. A multi-spectral super-low-dose photoacoustic microscopy (SLD-PAM) is presented that improves the sensitivity by ≈33 times. SLD-PAM can visualize microvessels and quantify oxygen saturation in vivo with ≈1% of the maximum permissible exposure, dramatically reducing potential phototoxicity or perturbation to normal tissue function, especially in imaging of delicate tissues, such as the eye and the brain. Capitalizing on the high sensitivity, direct imaging of deoxyhemoglobin concentration is achieved without spectral unmixing, avoiding wavelength-dependent errors and computational noises. With reduced laser power, SLD-PAM can reduce photobleaching by ≈85%. It is also demonstrated that SLD-PAM achieves similar molecular imaging quality using 80% fewer contrast agents. Therefore, SLD-PAM enables the use of a broader range of low-absorbing nano-agents, small molecules, and genetically encoded biomarkers, as well as more types of low-power light sources in wide spectra. It is believed that SLD-PAM offers a powerful tool for anatomical, functional, and molecular imaging.

An ultrasound-activatable platinum prodrug for sono-sensitized chemotherapy

Despite the great success achieved by photoactivated chemotherapy, eradicating deep tumors using external sources with high tissue penetration depth remains a challenge. Here, we present cyaninplatin, a paradigm of Pt(IV) anticancer prodrug that can be activated by ultrasound in a precise and spatiotemporally controllable manner. Upon sono-activation, mitochondria-accumulated cyaninplatin exhibits strengthened mitochondrial DNA damage and cell killing efficiency, and the prodrug overcomes drug resistance as a consequence of combined effects from released Pt(II) chemotherapeutics, the depletion of intracellular reductants, and the burst of reactive oxygen species, which gives rise to a therapeutic approach, namely sono-sensitized chemotherapy (SSCT). Guided by high-resolution ultrasound, optical, and photoacoustic imaging modalities, cyaninplatin realizes the overall theranostics of tumors in vivo with superior efficacy and biosafety. This work highlights the practical utility of ultrasound to precisely activate Pt(IV) anticancer prodrugs for the eradication of deep tumor lesions and broadens the biomedical uses of Pt coordination complexes.

Simultaneous dual-modal photoacoustic and harmonic ultrasound microscopy with an optimized acoustic combiner

Simultaneous photoacoustic (PA) and ultrasound (US) imaging provides rich optical and acoustic contrasts with high sensitivity, specificity, and resolution, making it a promising tool for diagnosing and assessing various diseases. However, the resolution and penetration depth tend to be contradictory due to the increased attenuation of high-frequency ultrasound. To address this issue, we present simultaneous dual-modal PA/US microscopy with an optimized acoustic combiner that can maintain high resolution while improving the penetration of ultrasound imaging. A low-frequency ultrasound transducer is used for acoustic transmission, and a high-frequency transducer is used for PA and US detection. An acoustic beam combiner is utilized to merge the transmitting and receiving acoustic beams with a predetermined ratio. By combining the two different transducers, harmonic US imaging and high-frequency photoacoustic microscopy are implemented. In vivo experiments on the mouse brain demonstrate the simultaneous PA and US imaging ability. The harmonic US imaging of the mouse eye reveals finer iris and lens boundary structures than conventional US imaging, providing a high-resolution anatomical reference for co-registered PA imaging.

Array-based high-intensity focused ultrasound therapy system integrated with real-time ultrasound and photoacoustic imaging

High-intensity focused ultrasound (HIFU) is a promising non-invasive therapeutic technique in clinical applications. Challenges in stimulation or ablation HIFU therapy are to accurately target the treatment spot, flexibly deliver or fast-move focus points in the treatment region, and monitor therapy progress in real-time. In this paper, we develop an array-based HIFU system integrated with real-time ultrasound (US) and photoacoustic (PA) imaging. The array-based HIFU transducer can be dynamically focused in a lateral range of ∼16 mm and an axial range of ∼40 mm via electronically adjusting the excitation phase map. To monitor the HIFU therapy progress in real-time, sequential HIFU transmission, PA imaging, PA thermometry, and US imaging are implemented to display the dual-modal images and record the local temperature changes. Co-registered dual-modal images show structural and functional information and thus can guide the HIFU therapy for precise positioning and dosage control. Besides therapy, the multi-element HIFU transducer can also be used to acquire US images to precisely align the imaging coordinates with the HIFU coordinates. Phantom experiments validate the precise and dynamic steering capability of HIFU ablation. We also show that dual-modal imaging can guide HIFU in the designated region and monitor the temperature in biological tissue in real-time.

Signal restoration algorithm for photoacoustic imaging systems

In a photoacoustic (PA) imaging system, the detectors are bandwidth-limited. Therefore, they capture PA signals with some unwanted ripples. This limitation degrades the resolution/contrast and induces sidelobes and artifacts in the reconstructed images along the axial direction. To compensate for the limited bandwidth effect, we present a PA signal restoration algorithm, where a mask is designed to extract the signals at the absorber positions and remove the unwanted ripples. This restoration improves the axial resolution and contrast in the reconstructed image. The restored PA signals can be considered as the input of the conventional reconstruction algorithms (e.g., Delay-and-sum (DAS) and Delay-multiply-and-sum (DMAS)). To compare the performance of the proposed method, DAS and DMAS reconstruction algorithms were performed with both the initial and restored PA signals on numerical and experimental studies (numerical targets, tungsten wires, and human forearm). The results show that, compared with the initial PA signals, the restored PA signals can improve the axial resolution and contrast by 45% and 16.1 dB, respectively, and suppress background artifacts by 80%.

Switchable preamplifier for dual modal photoacoustic and ultrasound imaging

Photoacoustic (PA) imaging is a high-fidelity biomedical imaging technique based on the principle of molecular-specific optical absorption of biological tissue constitute. Because PA imaging shares the same basic principle as that of ultrasound (US) imaging, the use of PA/US dual-modal imaging can be achieved using a single system. However, because PA imaging is limited to a shallower depth than US imaging due to the optical extinction in biological tissue, the PA signal yields a lower signal-to-noise ratio (SNR) than US images. To selectively amplify the PA signal, we propose a switchable preamplifier for acoustic-resolution PA microscopy implemented on an application-specific integrated circuit. Using the preamplifier, we measured the increments in the SNR with both carbon lead and wire phantoms. Furthermore, in vivo whole-body PA/US imaging of a mouse with a preamplifier showed enhancement of SNR in deep tissues, unveiling deeply located organs and vascular networks. By selectively amplifying the PA signal range to a level similar to that of the US signal without contrast agent administration, our switchable amplifier strengthens the mutual complement between PA/US imaging. PA/US imaging is impending toward clinical translation, and we anticipate that this study will help mitigate the imbalance of image depth between the two imaging modalities.

Adaptive dual-speed ultrasound and photoacoustic computed tomography

Full-ring dual-modal ultrasound and photoacoustic computed tomography has unique advantages of nearly isotropic spatial resolution, complementary contrast, deep penetration, and full-view detection. However, the imaging quality may be deteriorated by the inaccurate sound speed estimation. Automatic determining and compensation for sound speed has been a long-standing problem in image reconstruction. Here, we present new adaptive dual-speed ultrasound and photoacoustic computed tomography (ADS-USPACT) to address this challenge. The system features full-view coverage (360°), high-speed dual-modal imaging (10-Hz), automated dual sound speed correction, and synergistic high imaging quality. To correct the sound speed, we develop a two-compartment method that can automatically segment the sample boundary and search for the optimal sound speed based on the rich ultrasonic pulse-echo signals. The method does not require the operator's intervention. We validate this technique in numerical simulation, phantom study, and in vivo experiments. The ADS-USPACT represents significant progress in dual-modal imaging.

Targeted Multifunctional Nanoplatform for Imaging-Guided Precision Diagnosis and Photothermal/Photodynamic Therapy of Orthotopic Hepatocellular Carcinoma

Background

Effective theranostic of hepatocellular carcinoma (HCC) in an early-stage is imminently demanded to improve its poor prognosis. Combination of the near-infrared (NIR) photoacoustic imaging (PAI) and fluorescence imaging (FLI) can provide high temporospatial resolution, outstanding optical contrast, and deep penetration and thus is promising for accurate and sensitive HCC diagnosis.

Methods

A versatile CXCR4-targeted Indocyanine green (ICG)/Platinum (Pt)-doped polydopamine melanin-mimic nanoparticle (designated ICG/Pt@PDA-CXCR4, referred to as IPP-c) is synthesized as an HCC-specific contrast agent for high-resolution precise diagnostic PAI/FLI and optical imaging-guided targeted photothermal therapy (PTT)/photodynamic therapy (PDT) of orthotopic small hepatocellular carcinoma (SHCC).

Results

The multifunctional targeted nanoparticle yields superior HCC specificity, high imaging contrast in both PAI and FLI, good stability, reliable biocompatibility, effective singlet oxygen generation and superior photothermal conversion efficiency (PCE, 58.7%) upon 808-nm laser irradiation. The targeting ability of IPP-c was validated in in vitro experiments on selectively killing the CXCR4-overexpressing HCC cells. Moreover, we test the efficient dual-modal optical precision diagnosis properties of IPP-c via in vivo experiments on targeted particle accumulation in an early-stage SHCC mouse model (tumor diameter about 1.2 mm). Then, under the guidance of real-time optical imaging, effective and mini-invasive PTT/PDT of orthotopic SHCCs were demonstrated without damaging adjacent liver tissues or other major organs.

Conclusion

This study presented a multifunctional CXCR4-targeted nanoparticle to conduct effective and mini-invasive phototherapeutics of orthotopic SHCCs via the real-time quantitative guidance by optical imaging, which provided a new perception for building a versatile targeted nanoplatform for phototheranostics of early-stage HCC.

Video-rate full-ring ultrasound and photoacoustic computed tomography with real-time sound speed optimization

Full-ring dual-modal ultrasound and photoacoustic imaging provide complementary contrasts, high spatial resolution, full view angle and are more desirable in pre-clinical and clinical applications. However, two long-standing challenges exist in achieving high-quality video-rate dual-modal imaging. One is the increased data processing burden from the dense acquisition. Another one is the object-dependent speed of sound variation, which may cause blurry, splitting artifacts, and low imaging contrast. Here, we develop a video-rate full-ring ultrasound and photoacoustic computed tomography (VF-USPACT) with real-time optimization of the speed of sound. We improve the imaging speed by selective and parallel image reconstruction. We determine the optimal sound speed via co-registered ultrasound imaging. Equipped with a 256-channel ultrasound array, the dual-modal system can optimize the sound speed and reconstruct dual-modal images at 10 Hz in real-time. The optimized sound speed can effectively enhance the imaging quality under various sample sizes, types, or physiological states. In animal and human imaging, the system shows co-registered dual contrasts, high spatial resolution (140 µm), single-pulse photoacoustic imaging (< 50 µs), deep penetration (> 20 mm), full view, and adaptive sound speed correction. We believe VF-USPACT can advance many real-time biomedical imaging applications, such as vascular disease diagnosing, cancer screening, or neuroimaging.

Handheld volumetric photoacoustic/ultrasound imaging using an internal scanning mechanism

Photoacoustic/ultrasound (PA/US) dual-modality imaging has been evolving rapidly for the last two decades. Handheld PA/US probes with different implementations have attracted particular attention due to their convenience and high applicability. However, developing a volumetric dual-modality PA/US imaging probe with a compact design remains a challenge. Here, we develop a handheld volumetric PA/US imaging probe with a special light-ultrasound coupling design and an internal scanning mechanism. A coaxial design for the excitation and detection paths in a customized 3D-printed housing with a size of 110 × 90 × 64 mm³ is proposed to optimize the signal-to-noise ratio (SNR) of the handheld probe for deep tissue imaging. Two parallel and synchronously rotational acoustic reflectors allow for volumetric imaging with an effective field of view (FOV) of more than 30 mm × 20 mm × 8 mm. In addition to simulation and phantom validations, in vivo human trials are successfully carried out, demonstrating the high imaging quality and stability of the system for potential clinical translations.

Functional photoacoustic microscopy of hemodynamics: a review

Functional blood imaging can reflect tissue metabolism and organ viability, which is important for life science and biomedical studies. However, conventional imaging modalities either cannot provide sufficient contrast or cannot support simultaneous multi-functional imaging for hemodynamics. Photoacoustic imaging, as a hybrid imaging modality, can provide sufficient optical contrast and high spatial resolution, making it a powerful tool for in vivo vascular imaging. By using the optical-acoustic confocal alignment, photoacoustic imaging can even provide subcellular insight, referred as optical-resolution photoacoustic microscopy (OR-PAM). Based on a multi-wavelength laser source and developed the calculation methods, OR-PAM can provide multi-functional hemodynamic microscopic imaging of the total hemoglobin concentration (C_Hb), oxygen saturation (sO₂), blood flow (BF), partial oxygen pressure (pO₂), oxygen extraction fraction, and metabolic rate of oxygen (MRO₂). This concise review aims to systematically introduce the principles and methods to acquire various functional parameters for hemodynamics by photoacoustic microscopy in recent studies, with characteristics and advantages comparison, typical biomedical applications introduction, and future outlook discussion.