Measurement of fibrous cap thickness in atherosclerotic plaques by spatiotemporal analysis of laser speckle images

Laser speckle rheological microscopy reveals wideband viscoelastic spectra of biological tissues

Viscoelastic transformation of tissue drives aberrant cellular functions and is an early biomarker of disease pathogenesis. Tissues scale a range of viscoelastic moduli, from biofluids to bone. Moreover, viscoelastic behavior is governed by the frequency at which tissue is probed, yielding distinct viscous and elastic responses modulated over a wide frequency band. Existing tools do not quantify wideband viscoelastic spectra in tissues, leaving a vast knowledge gap. We present wideband laser speckle rheological microscopy (WB-SHEAR) that reveals elastic and viscous response over sub-megahertz frequencies previously not investigated in tissue. WB-SHEAR uses an optical, noncontact approach to quantify wideband viscoelastic spectra in specimens spanning a range of moduli from low-viscosity fibrin to highly elastic bone. Via laser scanning, micromechanical imaging is enabled to access wideband viscoelastic spectra in heterogeneous tumor specimens with high spatial resolution (25 micrometers). The ability to interrogate the viscoelastic landscape of diverse biospecimens could transform our understanding of mechanobiological processes in various diseases.

A new perspective on quantitative assessment of photodynamic therapy mediated hydrogel nanocomposite in wound healing using objective biospeckle and morphological local-gradient

Skin wounding is a serious public health issue, especially when considering factors that accelerate tissue recovery. Consequently, the use of photodynamic therapy (PDT) as an effective wound-healing treatment has attracted more scientific attention. Although assessing the wound healing rate is crucial for appropriate monitoring of the probability of wound healing and evaluating the treatment efficiency, the currently used techniques lack the ability to provide such information. Therefore, this study has two aims, first, it contributes to the development of a new image-guided biospeckle system for quantitative monitoring of skin wound healing rate. Second, it evaluates the potential of using a novel synthesized PDT-mediated polyethylene glycol fabric with methylene blue (PEG-MB) hydrogel nanocomposite in accelerating wound healing. The proposed imaging system initially acquires raw biospeckle images from the wound regions of adult healthy albino mice treated with the synthesized hydrogel nanocomposite. Each raw biospeckle image is then converted into maps of morphological local-gradient matrices implemented from the combination of dilation and erosion operations at different radii up to 25 pixels. Subsequently, their intensity histogram statistics are computed, taking central moments as the feature set. Final characterization is achieved via a linear combination of the biospeckle statistics maintaining as much variance as possible using principal component analysis (PCA). The results confirmed by cytokine concentration measurement and histological investigation demonstrate that the innovative biospeckle image-guided system is ideal for investigating wound healing and suggest the potential of the hydrogel nanocomposite as an active dressing.

Speckle rheological spectroscopy reveals wideband viscoelastic spectra of biological tissues

Mechanical transformation of tissue is not merely a symptom but a decisive driver in pathological processes. Comprising intricate network of cells, fibrillar proteins, and interstitial fluid, tissues exhibit distinct solid-(elastic) and liquid-like (viscous) behaviours that span a wide band of frequencies. Yet, characterization of wideband viscoelastic behaviour in whole tissue has not been investigated, leaving a vast knowledge gap in the higher frequency range that is linked to fundamental intracellular processes and microstructural dynamics. Here, we present wideband Speckle rHEologicAl spectRoScopy (SHEARS) to address this need. We demonstrate, for the first time, analysis of frequency-dependent elastic and viscous moduli up to the sub-MHz regime in biomimetic scaffolds and tissue specimens of blood clots, breast tumours, and bone. By capturing previously inaccessible viscoelastic behaviour across the wide frequency spectrum, our approach provides distinct and comprehensive mechanical signatures of tissues that may provide new mechanobiological insights and inform novel disease prognostication.

Netrin-1: A Modulator of Macrophage Driven Acute and Chronic Inflammation

Netrins belong to the family of laminin-like secreted proteins, which guide axonal migration and neuronal growth in the developing central nervous system. Over the last 20 years, it has been established that netrin-1 acts as a chemoattractive or chemorepulsive cue in diverse biological processes far beyond neuronal development. Netrin-1 has been shown to play a central role in cell adhesion, cell migration, proliferation, and cell survival in neuronal and non-neuronal tissue. In this context, netrin-1 was found to orchestrate organogenesis, angiogenesis, tumorigenesis, and inflammation. In inflammation, as in neuronal development, netrin-1 plays a dichotomous role directing the migration of leukocytes, especially monocytes in the inflamed tissue. Monocyte-derived macrophages have long been known for a similar dual role in inflammation. In response to pathogen-induced acute injury, monocytes are rapidly recruited to damaged tissue as the first line of immune defense to phagocyte pathogens, present antigens to initiate the adaptive immune response, and promote wound healing in the resolution phase. On the other hand, dysregulated macrophages with impaired phagocytosis and egress capacity accumulate in chronic inflammation sites and foster the maintenance-and even the progression-of chronic inflammation. In this review article, we will highlight the dichotomous roles of netrin-1 and its impact on acute and chronic inflammation.

Technological perspectives on laser speckle micro-rheology for cancer mechanobiology research

SIGNIFICANCE

The ability to measure the micro-mechanical properties of biological tissues and biomaterials is crucial for numerous fields of cancer research, including tumor mechanobiology, tumor-targeting drug delivery, and therapeutic development.

AIM

Our goal is to provide a renewed perspective on the mainstream techniques used for micro-mechanical evaluation of biological tissues and biomimetic scaffoldings. We specifically focus on portraying the outlook of laser speckle micro-rheology (LSM), a technology that quantifies the mechanical properties of biomaterials and tissues in a rapid, non-contact manner.

APPROACH

First, we briefly explain the motivation and significance of evaluating the tissue micro-mechanics in various fields of basic and translational cancer research and introduce the key concepts and quantitative metrics used to explain the mechanical properties of tissue. This is followed by reviewing the general active and passive themes of measuring micro-mechanics. Next, we focus on LSM and elaborate on the theoretical grounds and working principles of this technique. Then, the perspective for measuring the micro-mechanical properties via LSM is outlined. Finally, we draw an overview picture of LSM in cancer mechanobiology research.

RESULTS

With the continued emergence of new approaches for measuring the mechanical attributes of biological tissues, the field of micro-mechanical imaging is at its boom. As one of these competent innovations, LSM presents a tremendous potential for both technical maturation and prospective applications in cancer biomechanics and mechanobiology research.

CONCLUSION

By elaborating the current viewpoint of LSM, we expect to accelerate the expansion of this approach to new territories in both technological domains and applied fields. This renewed perspective on LSM may also serve as a road map for other micro-mechanical measurement concepts to be applied for answering mechanobiological questions.

In-vivo mechanical characterization of coronary atherosclerotic plaques in living swine using intravascular laser speckle imaging

The ability to evaluate the viscoelastic properties of coronary arteries is crucial for identifying mechanically unstable atherosclerotic plaques. Here, we demonstrate for the first time in living swine, the capability of intravascular laser speckle imaging (ILSI) to measure an index of coronary plaque viscoelasticity, τ, using a human coronary to swine xenograft model. Cardiac motion effects are evaluated by comparing the EKG-non-gated τ ¯ N G , and EKG-gated τ ¯ G among different plaque types. Results show that both τ ¯ N G and τ ¯ G are significantly lower in necrotic-core plaques compared with stable lesions. Discrete-point pullback measurements demonstrate the capability of ILSI for rapid mechanical characterization of coronary segments under physiological conditions, in-vivo.

Nanoscale quantitative surface roughness measurement of articular cartilage using second-order statistical-based biospeckle

Quantitative measurement of nanoscale surface roughness of articular cartilage tissue is significant to assess the surface topography for early treatment of osteoarthritis, the most common joint disease worldwide. Since it was not established by clinical diagnostic tools, the current studies have been suggesting the use of alternative diagnostic tools using pre-clinical methods. This study aims to measure the nanoscale surface roughness of articular cartilage tissue utilizing biospeckle which is used as a non-destructive and non-contact optical imaging technique. An experimental setup was implemented to capture biospeckle images from twelve cross-section areas of articular cartilage tissue gathered from bovine knee joints at 632 nm wavelength laser radiation. Then, to analyze the biospeckle image, a second-order statistical-based method was proposed through the combination of 308 highly correlated statistical features extracted from implemented gray-level co-occurrence matrices by employing principal component analysis. The result indicated that the measurement of the nanoscale surface roughness based on the first principal component only is able to provide accurate and precise quantitative measurement of early signs of articular cartilage degeneration up to 2500 nm.

Tutorial on laser speckle rheology: technology, applications, and opportunities

SIGNIFICANCE

The onset of several diseases is frequently marked with anomalous mechanical alteration of the affected tissue at the intersection of cells and their microenvironment. Therefore, mapping the micromechanical attributes of the tissues could enhance our understanding of the etiology of human disease, improve the diagnosis, and help stratify therapies that target these mechanical aberrations.

AIM

We review the tremendous opportunities offered through using optics for imaging the micromechanical properties, at length scales inaccessible to other modalities, in both basic research and clinical medicine. We specifically focus on laser speckle rheology (LSR), a technology that quantifies the mechanical properties of tissues in a rapid, noncontact manner.

APPROACH

In LSR, the shear viscoelastic modulus is measured from the time-variant speckle intensity fluctuations reflected off the tissue. The LSR technology is engineered and configured into several embodiments, including bench-top optical systems, endoscopes for minimally invasive procedures, portable point-of-care devices, and microscopes.

RESULTS

These technological nuances have primed the LSR for widespread applications in diagnosis and therapeutic monitoring, as demonstrated here, in cardiovascular disease, coagulation disorders, and tumor malignancies.

CONCLUSION

The fast-paced technological advancements, elaborated here, position the LSR as a competent candidate for many more exciting opportunities in basic research and medicine.

Analysis of blood coagulation process based on fractality and dynamic characteristic of laser speckle pattern

The reflection and transmission of coherent light from a biological system can yield information about its condition. In the case of blood exposed to the air, there is a change in the properties of the speckle patterns observed in the coagulation process. This can be studied by means of the rate of temporal variation, the contrast, and also the fractality of patterns. The fractality of the speckle pattern can be investigated by a fractal dimension, which can quantify a level of the complexity of platelet aggregation structure and a fibrin network formed in the process of blood coagulation. In addition, dynamic characteristics of a movement in blood also contain information on the progress of the coagulation process. Fractality and dynamic characteristics are investigated simultaneously for speckle patterns observed in the coagulation process of stored horse blood. Experimental results show the feasibility of the proposed method for detecting hemolysis and formation of platelet aggregation structure and the fibrin network during the coagulation process.

Intraluminal laser speckle rheology using an omni-directional viewing catheter

A number of disease conditions in luminal organs are associated with alterations in tissue mechanical properties. Here, we report a new omni-directional viewing Laser Speckle Rheology (LSR) catheter for mapping the mechanical properties of luminal organs without the need for rotational motion. The LSR catheter incorporates multiple illumination fibers, an optical fiber bundle and a multi-faceted mirror to permit omni-directional viewing of the luminal wall. By retracting the catheter using a motor-drive assembly, cylindrical maps of tissue mechanical properties are reconstructed. Evaluation conducted in a test phantom with circumferentially-varying mechanical properties demonstrates the capability of the LSR catheter for the accurate mechanical assessment of luminal organs.

Laser Speckle Rheology for evaluating the viscoelastic properties of hydrogel scaffolds

Natural and synthetic hydrogel scaffolds exhibit distinct viscoelastic properties at various length scales and deformation rates. Laser Speckle Rheology (LSR) offers a novel, non-contact optical approach for evaluating the frequency-dependent viscoelastic properties of hydrogels. In LSR, a coherent laser beam illuminates the specimen and a high-speed camera acquires the time-varying speckle images. Cross-correlation analysis of frames returns the speckle intensity autocorrelation function, g₂(t), from which the frequency-dependent viscoelastic modulus, G*(ω), is deduced. Here, we establish the capability of LSR for evaluating the viscoelastic properties of hydrogels over a large range of moduli, using conventional mechanical rheometry and atomic force microscopy (AFM)-based indentation as reference-standards. Results demonstrate a strong correlation between |G*(ω)| values measured by LSR and mechanical rheometry (r = 0.95, p < 10⁻⁹), and z-test analysis reports that moduli values measured by the two methods are identical (p > 0.08) over a large range (47 Pa – 36 kPa). In addition, |G*(ω)| values measured by LSR correlate well with indentation moduli, E, reported by AFM (r = 0.92, p < 10⁻⁷). Further, spatially-resolved moduli measurements in micro-patterned substrates demonstrate that LSR combines the strengths of conventional rheology and micro-indentation in assessing hydrogel viscoelastic properties at multiple frequencies and small length-scales.

Quest for the Vulnerable Atheroma: Carotid Stenosis and Diametric Strain--A Feasibility Study

The Bernoulli effect may result in eruption of a vulnerable carotid atheroma, causing a stroke. We measured electrocardiography (ECG)-registered QRS intra-stenotic blood velocity and atheroma strain dynamics in carotid artery walls using ultrasonic tissue Doppler methods, providing displacement and time resolutions of 0.1 μm and 3.7 ms. Of 22 arteries, 1 had a peak systolic velocity (PSV) >280 cm/s, 4 had PSVs between 165 and 280 cm/s and 17 had PSVs <165 cm/s. Eight arteries with PSVs <65 cm/s and 4 of 9 with PSVs between 65 and 165 cm/s had normal systolic diametric expansion (0% and 7%) and corresponding systolic wall thinning. The remaining 10 arteries had abnormal systolic strain dynamics, 2 with diametric reduction (>-0.05 mm), 2 with extreme wall expansion (>0.1 mm), 2 with extreme wall thinning (>-0.1 mm) and 4 with combinations. Decreases in systolic diameter and/or extreme systolic arterial wall thickening may indicate imminent atheroma rupture.

In vivo burn diagnosis by camera-phone diffuse reflectance laser speckle detection

Burn diagnosis using laser speckle light typically employs widefield illumination of the burn region to produce two-dimensional speckle patterns from light backscattered from the entire irradiated tissue volume. Analysis of speckle contrast in these time-integrated patterns can then provide information on burn severity. Here, by contrast, we use point illumination to generate diffuse reflectance laser speckle patterns of the burn. By examining spatiotemporal fluctuations in these time-integrated patterns along the radial direction from the incident point beam, we show the ability to distinguish partial-thickness burns in a porcine model in vivo within the first 24 hours post-burn. Furthermore, our findings suggest that time-integrated diffuse reflectance laser speckle can be useful for monitoring burn healing over time post-burn. Unlike conventional diffuse reflectance laser speckle detection systems that utilize scientific or industrial-grade cameras, our system is designed with a camera-phone, demonstrating the potential for burn diagnosis with a simple imager.

Optical Thromboelastography to evaluate whole blood coagulation

Measurement of blood viscoelasticity during clotting provides a direct metric of haemostatic conditions. Therefore, technologies that quantify blood viscoelasticity at the point-of-care are invaluable for diagnosing coagulopathies. We present a new approach, Optical Thromboelastography (OTEG) that measures the viscoelastic properties of coagulating blood by evaluating temporal laser speckle fluctuations, reflected from a few blood drops. During coagulation, platelet-fibrin clot formation restricts the mean square displacements (MSD) of scatterers and decelerates speckle fluctuations. Cross-correlation analysis of speckle frames provides the speckle intensity temporal autocorrelation, g2 (t), from which MSD is deduced and the viscoelastic modulus of blood is estimated. Our results demonstrate a close correspondence between blood viscoelasticity evaluated by OTEG and mechanical rheometry. Spatio-temporal speckle analyses yield 2-dimensional maps of clot viscoelasticity, enabling the identification of micro-clot formation at distinct rates in normal and coagulopathic specimens. These findings confirm the unique capability of OTEG for the rapid evaluation of patients' coagulation status and highlight the potential for point-of-care use.

Estimation of particle size variations for laser speckle rheology of materials

Laser speckle rheology (LSR) is an optical technique for assessing the viscoelastic properties of materials with several industrial, biological, and medical applications. In LSR, the viscoelastic modulus, G*(ω), of a material is quantified by analyzing the temporal fluctuations of speckle patterns. However, the size of scattering particles within the material also influences the rate of speckle fluctuations, independent of sample mechanical properties, and complicates the accurate estimation of G*(ω). Here, we demonstrate that the average particle size may be retrieved from the azimuth-angle dependence of time-averaged speckle intensities, permitting the accurate quantification of the viscoelastic moduli of materials with unknown particle size distribution using LSR.

Correction of optical absorption and scattering variations in Laser Speckle Rheology measurements

Laser Speckle Rheology (LSR) is an optical technique to evaluate the viscoelastic properties by analyzing the temporal fluctuations of backscattered speckle patterns. Variations of optical absorption and reduced scattering coefficients further modulate speckle fluctuations, posing a critical challenge for quantitative evaluation of viscoelasticity. We compare and contrast two different approaches applicable for correcting and isolating the collective influence of absorption and scattering, to accurately measure mechanical properties. Our results indicate that the numerical approach of Monte-Carlo ray tracing (MCRT) reliably compensates for any arbitrary optical variations. When scattering dominates absorption, yet absorption is non-negligible, diffusing wave spectroscopy (DWS) formalisms perform similar to MCRT, superseding other analytical compensation approaches such as Telegrapher equation. The computational convenience of DWS greatly simplifies the extraction of viscoelastic properties from LSR measurements in a number of chemical, industrial, and biomedical applications.

Assessing blood coagulation status with laser speckle rheology

We have developed and investigated a novel optical approach, Laser Speckle Rheology (LSR), to evaluate a patient's coagulation status by measuring the viscoelastic properties of blood during coagulation. In LSR, a blood sample is illuminated with laser light and temporal speckle intensity fluctuations are measured using a high-speed CMOS camera. During blood coagulation, changes in the viscoelastic properties of the clot restrict Brownian displacements of light scattering centers within the sample, altering the rate of speckle intensity fluctuations. As a result, blood coagulation status can be measured by relating the time scale of speckle intensity fluctuations with clinically relevant coagulation metrics including clotting time and fibrinogen content. Our results report a close correlation between coagulation metrics measured using LSR and conventional coagulation results of activated partial thromboplastin time, prothrombin time and functional fibrinogen levels, creating the unique opportunity to evaluate a patient's coagulation status in real-time at the point of care.

Optical measurement of arterial mechanical properties: from atherosclerotic plaque initiation to rupture

During the pathogenesis of coronary atherosclerosis, from lesion initiation to rupture, arterial mechanical properties are altered by a number of cellular, molecular, and hemodynamic processes. There is growing recognition that mechanical factors may actively drive vascular cell signaling and regulate atherosclerosis disease progression. In advanced plaques, the mechanical properties of the atheroma influence stress distributions in the fibrous cap and mediate plaque rupture resulting in acute coronary events. This review paper explores current optical technologies that provide information on the mechanical properties of arterial tissue to advance our understanding of the mechanical factors involved in atherosclerosis development leading to plaque rupture. The optical approaches discussed include optical microrheology and traction force microscopy that probe the mechanical behavior of single cell and extracellular matrix components, and intravascular imaging modalities including laser speckle rheology, optical coherence elastography, and polarization-sensitive optical coherence tomography to measure the mechanical properties of advanced coronary lesions. Given the wealth of information that these techniques can provide, optical imaging modalities are poised to play an increasingly significant role in elucidating the mechanical aspects of coronary atherosclerosis in the future.

Evaluation and correction for optical scattering variations in laser speckle rheology of biological fluids

Biological fluids fulfill key functionalities such as hydrating, protecting, and nourishing cells and tissues in various organ systems. They are capable of these versatile tasks owing to their distinct structural and viscoelastic properties. Characterizing the viscoelastic properties of bio-fluids is of pivotal importance for monitoring the development of certain pathologies as well as engineering synthetic replacements. Laser Speckle Rheology (LSR) is a novel optical technology that enables mechanical evaluation of tissue. In LSR, a coherent laser beam illuminates the tissue and temporal speckle intensity fluctuations are analyzed to evaluate mechanical properties. The rate of temporal speckle fluctuations is, however, influenced by both optical and mechanical properties of tissue. Therefore, in this paper, we develop and validate an approach to estimate and compensate for the contributions of light scattering to speckle dynamics and demonstrate the capability of LSR for the accurate extraction of viscoelastic moduli in phantom samples and biological fluids of varying optical and mechanical properties.

Depth-resolved mapping of tissue mechanical properties using a novel optical approach

Progression of most diseases, such as atherosclerosis, cancer, neurodegenerative disease and osteoarthritis is accompanied with drastic changes in biomechanics of tissue. Hence, non-contact and non-invasive technologies for 3-dimensional mapping of tissue biomechanics are invaluable for diagnostic purposes. Laser speckle Microrheology (LSM) is developed in our lab to enable high resolution mechanical evaluation of tissue. To this end, the tissue sample is illuminated by a coherent and focused laser beam and the back-scattered laser speckle pattern is spatio-temporally processed to extract a color-map of τ, which is the decay time constant of intensity decorrelation at each pixel in the image plane. Time constant, τ, is proven to be closely correlated with tissue mechanical properties. In this paper we validate the theoretical basis for LSM technology and investigate the potential for acquiring depth-resolved information from a light-scattering point of view. The patch analysis approach is introduced and the inter-relation between τ, number of scattering events, and penetration depth is explored for each patch. Axial variation of τ is characterized for two sample arterial regions and in-depth changes of mechanical properties are characterized. Finally, the required corrective measures are discussed.

Measurement of bulk mechanical properties of tissue using laser speckle rheology

In virtually all tissues, disease progression is accompanied by changes in the mechanical properties. Laser speckle rheology (LSR) is a new technique we have developed to measure the mechanical properties of tissue. By illuminating the sample with coherent laser light and calculating the speckle intensity modulations from reflected laser speckle patterns, LSR calculates τ, the decay time constant of intensity decorrelation which is closely associated with tissue mechanical properties. In this paper we validate the use of LSR technology in measuring mechanical properties of tissue. LSR measurements of τ are performed on a variety of phantom and tissue samples and compared with the complex shear modulus G*, measured using a rheometer. In all cases, strong correlation is observed between τ and G* (r=0.95, p < 0.002). These results demonstrate the efficacy of LSR as a non-invasive and non-contact technology for mechanical evaluation of biological samples.

Automated tracing of the adventitial contour of aortoiliac and peripheral arterial walls in CT angiography (CTA) to allow calculation of non-calcified plaque burden

Aortoiliac and lower extremity arterial atherosclerotic plaque burden is a risk factor for the development of visceral and peripheral ischemic and aneurismal vascular disease. While prior research allows automated quantification of calcified plaque in these body regions using CT angiograms, no automated method exists to quantify soft plaque. We developed an automatic algorithm that defines the outer wall contour and wall thickness of vessels to quantify non-calcified plaque in CT angiograms of the chest, abdomen, pelvis, and lower extremities. The algorithm encodes the search space as a constrained graph and calculates the outer wall contour by deriving a minimum cost path through the graph, following the visible outer wall contour while minimizing path tortuosity. Our algorithm was statistically equivalent to a reference standard made by two reviewers. Absolute error was 1.9 ± 2.3% compared to the inter-observer variability of 3.9 ± 3.6%. Wall thickness in vessels with atherosclerosis was 3.4 ± 1.6 mm compared to 1.2 ± 0.4 mm in normal vessels. The algorithm shows promise as a tool for quantification of non-calcified plaque in CT angiography. When combined with previous research, our method has the potential to quantify both non-calcified and calcified plaque in all clinically significant systemic arteries, from the thoracic aorta to the arteries of the calf, over a wide range of diameters. This algorithm has the potential to enable risk stratification of patients and facilitate investigations into the relationships between asymptomatic atherosclerosis and a variety of behavioral, physiologic, pathologic, and genotypic conditions.

Evaluating the viscoelastic properties of tissue from laser speckle fluctuations

Most pathological conditions such as atherosclerosis, cancer, neurodegenerative, and orthopedic disorders are accompanied with alterations in tissue viscoelasticity. Laser Speckle Rheology (LSR) is a novel optical technology that provides the invaluable potential for mechanical assessment of tissue in situ. In LSR, the specimen is illuminated with coherent light and the time constant of speckle fluctuations, τ, is measured using a high speed camera. Prior work indicates that τ is closely correlated with tissue microstructure and composition. Here, we investigate the relationship between LSR measurements of τ and sample mechanical properties defined by the viscoelastic modulus, G*. Phantoms and tissue samples over a broad range of viscoelastic properties are evaluated using LSR and conventional mechanical testing. Results demonstrate a strong correlation between τ and |G*| for both phantom (r = 0.79, p <0.0001) and tissue (r = 0.88, p<0.0001) specimens, establishing the unique capability of LSR in characterizing tissue viscoelasticity.

Intravascular optical imaging technology for investigating the coronary artery

There is an ever-increasing demand for new imaging methods that can provide additional information about the coronary wall to better characterize and stratify high-risk plaques, and to guide interventional and pharmacologic management of patients with coronary artery disease. While there are a number of imaging modalities that facilitate the assessment of coronary artery pathology, this review paper focuses on intravascular optical imaging modalities that provide information on the microstructural, compositional, biochemical, biomechanical, and molecular features of coronary lesions and stents. The optical imaging modalities discussed include angioscopy, optical coherence tomography, polarization sensitive-optical coherence tomography, laser speckle imaging, near-infrared spectroscopy, time-resolved laser induced fluorescence spectroscopy, Raman spectroscopy, and near-infrared fluorescence molecular imaging. Given the wealth of information that these techniques can provide, optical imaging modalities are poised to play an increasingly significant role in the evaluation of the coronary artery in the future.

Ultrastructural features of human atherosclerosis

Healthy human arteries are composed of three layers: the intima, the media, and the adventitia. Endothelial cells, which form the tunica intima, provide the physical interface between blood and surrounding tissue, regulate nutrient and blood component traffic, and participate in many physiologic events, such as hemostasis, inflammation, and angiogenesis. Within the tunica media, smooth muscle cells and extracellular matrix proteins, such as elastin, collagen, and proteoglycans, are quantitatively the largest components of the aortic vascular wall. The structural changes with atherosclerosis are currently considered degenerative phenomena, which primarily involve a sequence of reactions within the intima and include monocyte recruitment and macrophage formation, lipid deposition, smooth muscle cell migration, proliferation, and extracellular matrix synthesis. The molecular and cellular mechanisms underlying the disease cascade have been thoroughly investigated in experimental animals and cell culture, but the question of how these models can correctly mimic the human course of the disease remains open to debate. In the present review the basic structure of healthy human arteries and the pathological events occurring during the atherosclerotic process have been examined by both transmission and scanning electron microscopy. Human atherosclerotic lesions are presented and described in the following order: initial lesions, fatty dots and streaks, intermediate lesions, atheroma and fibrofatty plaques, and complicated lesions.

Intravascular laser speckle imaging catheter for the mechanical evaluation of the arterial wall

Laser speckle imaging (LSI) is a novel technique for measuring the mechanical properties of atherosclerotic plaques. In LSI, the decorrelation time constant of speckle intensity fluctuations provides an index of viscoelasticity that is closely related to plaque microstructure and composition. Here, we demonstrate for the first time, the feasibility of conducting LSI in vivo using a prototype 1.5 mm (4.5 Fr) diameter intravascular catheter. Investigation of the catheter performance using human arterial samples ex vivo shows that plaque time constants measured by the LSI catheter correlate well with those measured using a free-space bulk optics system. To demonstrate LSI in vivo, the catheter is interfaced with a portable console for intravascular evaluation in the aorta of a living rabbit. Distinct differences in arterial time constants are identified at normal aortic and stented sites in vivo with intravascular LSI.

Laser speckle imaging of atherosclerotic plaques through optical fiber bundles

Laser speckle imaging (LSI), a new technique that measures an index of plaque viscoelasticity, has been investigated recently to characterize atherosclerotic plaques. These prior studies demonstrated the diagnostic potential of LSI for detecting high-risk plaques and were conducted ex vivo. To conduct intracoronary LSI in vivo, the laser speckle pattern must be transmitted from the coronary wall to the image detector in the presence of cardiac motion. Small-diameter, flexible optical fiber bundles, similar to those used in coronary angioscopy, may be incorporated into an intravascular catheter for this purpose. A key challenge is that laser speckle is influenced by inter-fiber leakage of light, which may be exacerbated during bundle motion. In this study, we tested the capability of optical fiber bundles to transmit laser speckle patterns obtained from atherosclerotic plaques and evaluated the influence of motion on the diagnostic accuracy of fiber bundle-based LSI. Time-varying helium-neon laser speckle images of aortic plaques were obtained while cyclically moving the flexible length of the bundle to mimic coronary motion. Our results show that leached fiber bundles may reliably transmit laser speckle images in the presence of cardiac motion, providing a viable option to conduct intracoronary LSI.

Evaluation of collagen in atherosclerotic plaques: the use of two coherent laser-based imaging methods

Acute coronary events such as myocardial infarction are frequently caused by the rupture of unstable atherosclerotic plaque. Collagen plays a key role in determining plaque stability. Methods to measure plaque collagen content are invaluable in detecting unstable atherosclerotic plaques. Recently, novel coherent laser-based imaging techniques, such as polarization-sensitive optical coherence tomography (PSOCT) and laser speckle imaging (LSI) have been investigated, and they provide a wealth of information related to collagen content and plaque stability. Additionally, given their potential for intravascular use, these technologies will be invaluable for improving our understanding of the natural history of plaque development and rupture and, hence, enable the detection of unstable plaques. In this article we review recent developments in these techniques and potential challenges in translating these methods into intra-arterial use in patients.