Real-time optoacoustic monitoring and three-dimensional mapping of a human arm vasculature

Photoacoustic imaging for cutaneous melanoma assessment: a comprehensive review

Significance

Cutaneous melanoma (CM) has a high morbidity and mortality rate, but it can be cured if the primary lesion is detected and treated at an early stage. Imaging techniques such as photoacoustic (PA) imaging (PAI) have been studied and implemented to aid in the detection and diagnosis of CM.

Aim

Provide an overview of different PAI systems and applications for the study of CM, including the determination of tumor depth/thickness, cancer-related angiogenesis, metastases to lymph nodes, circulating tumor cells (CTCs), virtual histology, and studies using exogenous contrast agents.

Approach

A systematic review and classification of different PAI configurations was conducted based on their specific applications for melanoma detection. This review encompasses animal and preclinical studies, offering insights into the future potential of PAI in melanoma diagnosis in the clinic.

Results

PAI holds great clinical potential as a noninvasive technique for melanoma detection and disease management. PA microscopy has predominantly been used to image and study angiogenesis surrounding tumors and provide information on tumor characteristics. Additionally, PA tomography, with its increased penetration depth, has demonstrated its ability to assess melanoma thickness. Both modalities have shown promise in detecting metastases to lymph nodes and CTCs, and an all-optical implementation has been developed to perform virtual histology analyses. Animal and human studies have successfully shown the capability of PAI to detect, visualize, classify, and stage CM.

Conclusions

PAI is a promising technique for assessing the status of the skin without a surgical procedure. The capability of the modality to image microvasculature, visualize tumor boundaries, detect metastases in lymph nodes, perform fast and label-free histology, and identify CTCs could aid in the early diagnosis and classification of CM, including determination of metastatic status. In addition, it could be useful for monitoring treatment efficacy noninvasively.

A Textile Sleeve for Monitoring Oxygen Saturation Using Multichannel Optical Fibre Photoplethysmography

Textile-based systems are an attractive prospect for wearable technology as they can provide monitoring of key physiological parameters in a comfortable and unobtrusive form. A novel system based on multichannel optical fibre sensor probes integrated into a textile sleeve is described. The system measures the photoplethysmogram (PPG) at two wavelengths (660 and 830 nm), which is then used to calculate oxygen saturation (SpO₂). In order to achieve reliable measurement without adjusting the position of the garment, four plastic optical fibre (POF) probes are utilised to increase the likelihood that a high-quality PPG is obtained due to at least one of the probes being positioned over a blood vessel. Each probe transmits and receives light into the skin to measure the PPG and SpO₂. All POFs are integrated in a stretchable textile sleeve with a circumference of 15 cm to keep the sensor in contact with the subject’s wrist and to minimise motion artefacts. Tests on healthy volunteers show that the multichannel PPG sensor faithfully provides an SpO₂ reading in at least one of the four sensor channels in all cases with no need for adjusting the position of the sleeve. This could not be achieved using a single sensor alone. The multichannel sensor is used to monitor the SpO₂ of 10 participants with an average wrist circumference of 16.0 ± 0.6 cm. Comparing the developed sensor’s SpO₂ readings to a reference commercial oximeter (reflectance Masimo Radical-7) illustrates that the mean difference between the two sensors’ readings is −0.03%, the upper limit of agreement (LOA) is 0.52% and the lower LOA is −0.58%. This multichannel sensor has the potential to achieve reliable, unobtrusive and comfortable textile-based monitoring of both heart rate and SpO₂ during everyday life.

Quantitative analysis of breast tumours aided by three-dimensional photoacoustic/ultrasound functional imaging

In this pilot study, we explored a quantitative method to analyse characteristics of breast tumours using 3D volumetric data obtained from a three-dimensional (3D) photoacoustic/ultrasound (PA/US) functional imaging system. Imaging results from 24 Asian patients with maximum tumour diameters less than 2 cm, including 8 benign tumours, 16 T1 stage invasive breast cancers (IBCs), and 22 normal breasts, were analysed. We found that the volumetric mean oxygenation saturation (SO₂) in tumour regions of T1 stage IBCs was 7.7% lower than that of benign tumours (P = 0.016) and 3.9% lower than that of healthy breasts (P = 0.010). The volumetric mean SO₂ in tumour surrounding regions of T1 stage IBCs was 4.9% lower than that of benign tumours (P = 0.009). For differentiating T1 stage IBCs and benign tumours, with a cut-off SO₂ value of 78.2% inside tumours, we obtained a sensitivity of 100%, a specificity of 62.5%, and an AUC of 0.81; with a cut-off SO₂ value of 77.9% in regions surrounding tumours, we obtained a sensitivity of 100%, a specificity of 75% and an AUC of 0.84. Our preliminary results demonstrate that 3D PA/US functional imaging has the potential to provide valuable quantitative physiological information that may be useful for the detection and evaluation of breast tumours.

Optoacoustic image formation approaches-a clinical perspective

Clinical translation of optoacoustic imaging is fostered by the rapid technical advances in imaging performance as well as the growing number of clinicians recognizing the immense diagnostic potential of this technology. Clinical optoacoustic systems are available in multiple configurations, including hand-held and endoscopic probes as well as raster-scan approaches. The hardware design must be adapted to the accessible portion of the imaged region and other application-specific requirements pertaining the achievable depth, field of view or spatio-temporal resolution. Equally important is the adequate choice of the signal and image processing approach, which is largely responsible for the resulting imaging performance. Thus, new image reconstruction algorithms are constantly evolving in parallel to the newly-developed set-ups. This review focuses on recent progress on optoacoustic image formation algorithms and processing methods in the clinical setting. Major reconstruction challenges include real-time image rendering in two and three dimensions, efficient hybridization with other imaging modalitites as well as accurate interpretation and quantification of bio-markers, herein discussed in the context of ongoing progress in clinical translation.

In vivo optoacoustic temperature imaging for image-guided cryotherapy of prostate cancer

The objective of this study is to demonstrate in vivo the feasibility of optoacoustic temperature imaging during cryotherapy of prostate cancer. We developed a preclinical prototype optoacoustic temperature imager that included pulsed optical excitation at a wavelength of 805 nm, a modified clinical transrectal ultrasound probe, a parallel data acquisition system, image processing and visualization software. Cryotherapy of a canine prostate was performed in vivo using a commercial clinical system, Cryocare^® CS, with an integrated ultrasound imaging. The universal temperature-dependent optoacoustic response of blood was employed to convert reconstructed optoacoustic images to temperature maps. Optoacoustic imaging of temperature during prostate cryotherapy was performed in the longitudinal view over a region of 30 mm (long)  ×  10 mm (deep) that covered the rectum, the Denonvilliers fascia, and the posterior portion of the treated gland. The transrectal optoacoustic images showed high-contrast vascularized regions, which were used for quantitative estimation of local temperature profiles. The constructed temperature maps and their temporal dynamics were consistent with the arrangement of the cryoprobe and readouts of the thermal needle sensors. The temporal profiles of the readouts from the thermal needle sensors and the temporal profile estimated from the normalized optoacoustic intensity of the selected vascularized region showed significant resemblance, except for the initial overshoot, that may be explained as a result of the physiological thermoregulatory compensation. The temperature was mapped with errors not exceeding  ±2 °C (standard deviation) consistent with the clinical requirements for monitoring cryotherapy of the prostate. In vivo results showed that the optoacoustic temperature imaging is a promising non-invasive technique for real-time imaging of tissue temperature during cryotherapy of prostate cancer, which can be combined with transrectal ultrasound-the current standard for guiding clinical cryotherapy procedure.

Melanin-Based Contrast Agents for Biomedical Optoacoustic Imaging and Theranostic Applications

Optoacoustic imaging emerged in early 1990s as a new biomedical imaging technology that generates images by illuminating tissues with short laser pulses and detecting resulting ultrasound waves. This technique takes advantage of the spectroscopic approach to molecular imaging, and delivers high-resolution images in the depth of tissue. Resolution of the optoacoustic imaging is scalable, so that biomedical systems from cellular organelles to large organs can be visualized and, more importantly, characterized based on their optical absorption coefficient, which is proportional to the concentration of absorbing chromophores. Optoacoustic imaging was shown to be useful in both preclinical research using small animal models and in clinical applications. Applications in the field of molecular imaging offer abundant opportunities for the development of highly specific and effective contrast agents for quantitative optoacoustic imaging. Recent efforts are being made in the direction of nontoxic biodegradable contrast agents (such as nanoparticles made of melanin) that are potentially applicable in clinical optoacoustic imaging. In order to increase the efficiency and specificity of contrast agents and probes, they need to be made smart and capable of controlled accumulation in the target cells. This review was written in recognition of the potential breakthroughs in medical optoacoustic imaging that can be enabled by efficient and nontoxic melanin-based optoacoustic contrast agents.

Photoacoustic/ultrasound dual imaging of human thyroid cancers: an initial clinical study

We reported an initial clinical study of in vivo human thyroid by a photoacoustic/ultrasound handheld probe. Our dual-modality system is based on a high-end clinical ultrasound machine. Both healthy and cancerous thyroids were imaged non-invasively, and we compared the photoacoustic imaging with color Doppler ultrasound. The results of photoacoustic thyroid imaging could reveal many blood vessels that were not sensitive for Doppler ultrasound. Our study demonstrated that photoacoustic imaging could provide important complementary information for traditional ultrasound thyroid examination, which has a great potential for clinical diagnosis.

Visualization of vasculature using a hand-held photoacoustic probe: phantom and in vivo validation

Assessment of microvasculature and tissue perfusion can provide diagnostic information on local or systemic diseases. Photoacoustic (PA) imaging has strong clinical potential because of its sensitivity to hemoglobin. We used a hand-held PA probe with integrated diode lasers and examined its feasibility and validity in the detection of increasing blood volume and (sub) dermal vascularization. Blood volume detection was tested in custom-made perfusion phantoms. Results showed that an increase of blood volume in a physiological range of 1.3% to 5.4% could be detected. The results were validated with power Doppler sonography. Using a motorized scanning setup, areas of the skin were imaged at relatively short scanning times ( < 10 ?? s / cm 2 ) with PA. Three-dimensional visualization of these structures was achieved by combining the consecutively acquired cross-sectional images. Images revealed the epidermis and submillimeter vasculature up to depth of 5 mm. The geometries of imaged vasculature were validated with segmentation of the vasculature in high-frequency ultrasound imaging. This study proves the feasibility of PA imaging in its current implementation for the detection of perfusion-related parameters in skin and subdermal tissue and underlines its potential as a diagnostic tool in vascular or dermal pathologies.

On the link between the speckle free nature of optoacoustics and visibility of structures in limited-view tomography

Similar to pulse-echo ultrasound, optoacoustic imaging encodes the location of optical absorbers by the time-of-flight of ultrasound waves. Yet, signal generation mechanisms are fundamentally different for the two modalities, leading to significant distinction between the optimum image formation strategies. While interference of back-scattered ultrasound waves with random phases causes speckle noise in ultrasound images, speckle formation is hindered by the strong correlation between the optoacoustic responses corresponding to individual sources. However, visibility of structures is severely hampered when attempting to acquire optoacoustic images under limited-view tomographic geometries. In this tutorial article, we systematically describe the basic principles of optoacoustic signal generation and image formation for objects ranging from individual sub-resolution absorbers to a continuous absorption distribution. The results are of relevance for the proper interpretation of optoacoustic images acquired under limited-view scenarios and may also serve as a basis for optimal design of tomographic acquisition geometries and image formation strategies.

Optoacoustic Imaging of Human Vasculature: Feasibility by Using a Handheld Probe

Purpose To investigate whether multispectral optoacoustic tomography (MSOT) developed for deep-tissue imaging in humans could enable the clinical assessment of major blood vessels and microvasculature. Materials and Methods The study was approved by the Institutional Review Board of the University Medical Center Groningen (CCMO-NL-43587) and registered in the Dutch National Trial Registry (NTR4125). The authors designed a real-time handheld optoacoustic scanner for human use, based on a concave 8-MHz transducer array, attaining 135° angular coverage. They applied a single-pulse-frame (SPF) sequence, which enabled motion insensitive optoacoustic imaging during handheld operation. SPF optoacoustic imaging was applied to imaging arteries and microvascular landmarks in the lower extremities of 10 healthy volunteers. The diameters selected microvessels were determined by measuring the full width at half maximum through the vessels in the MSOT images. Duplex ultrasonography was performed on the same landmarks in seven of the 10 volunteers for subjective comparison to the corresponding optoacoustic images. Results Optoacoustic imaging resolved blood vessels as small as 100 µm in diameter and within 1 cm depth. Additionally, MSOT provided images reflecting hemoglobin oxygen saturation in blood vessels, clearly identifying arteries and veins, and was able to identify pulsation in arteries during imaging. Larger blood vessels, specifically the tibialis posterior and the dorsalis pedis arteries, were also visualized with MSOT. Conclusion Handheld MSOT was found to be capable of clinical vascular imaging, providing visualization of major blood vessels and microvasculature and providing images of hemoglobin oxygen saturation and pulsation. (©) RSNA, 2016.

Objective assessment and design improvement of a staring, sparse transducer array by the spatial crosstalk matrix for 3D photoacoustic tomography

Accurate reconstruction of 3D photoacoustic (PA) images requires detection of photoacoustic signals from many angles. Several groups have adopted staring ultrasound arrays, but assessment of array performance has been limited. We previously reported on a method to calibrate a 3D PA tomography (PAT) staring array system and analyze system performance using singular value decomposition (SVD). The developed SVD metric, however, was impractical for large system matrices, which are typical of 3D PAT problems. The present study consisted of two main objectives. The first objective aimed to introduce the crosstalk matrix concept to the field of PAT for system design. Figures-of-merit utilized in this study were root mean square error, peak signal-to-noise ratio, mean absolute error, and a three dimensional structural similarity index, which were derived between the normalized spatial crosstalk matrix and the identity matrix. The applicability of this approach for 3D PAT was validated by observing the response of the figures-of-merit in relation to well-understood PAT sampling characteristics (i.e. spatial and temporal sampling rate). The second objective aimed to utilize the figures-of-merit to characterize and improve the performance of a near-spherical staring array design. Transducer arrangement, array radius, and array angular coverage were the design parameters examined. We observed that the performance of a 129-element staring transducer array for 3D PAT could be improved by selection of optimal values of the design parameters. The results suggested that this formulation could be used to objectively characterize 3D PAT system performance and would enable the development of efficient strategies for system design optimization.

Universal hand-held three-dimensional optoacoustic imaging probe for deep tissue human angiography and functional preclinical studies in real time

The exclusive combination of high optical contrast and excellent spatial resolution makes optoacoustics (photoacoustics) ideal for simultaneously attaining anatomical, functional and molecular contrast in deep optically opaque tissues. While enormous potential has been recently demonstrated in the application of optoacoustics for small animal research, vast efforts have also been undertaken in translating this imaging technology into clinical practice. We present here a newly developed optoacoustic tomography approach capable of delivering high resolution and spectrally enriched volumetric images of tissue morphology and function in real time. A detailed description of the experimental protocol for operating with the imaging system in both hand-held and stationary modes is provided and showcased for different potential scenarios involving functional and molecular studies in murine models and humans. The possibility for real time visualization in three dimensions along with the versatile handheld design of the imaging probe make the newly developed approach unique among the pantheon of imaging modalities used in today's preclinical research and clinical practice.

Effect of irradiation distance on image contrast in epi-optoacoustic imaging of human volunteers

In combined clinical optoacoustic (OA) and ultrasound (US) imaging, epi-mode irradiation and detection integrated into one single probe offers flexible imaging of the human body. The imaging depth in epi-illumination is, however, strongly affected by clutter. As shown in previous phantom experiments, the location of irradiation plays an important role in clutter generation. We investigated the influence of the irradiation geometry on the local image contrast of clinical images, by varying the separation distance between the irradiated area and the acoustic imaging plane of a linear ultrasound transducer in an automated scanning setup. The results for different volunteers show that the image contrast can be enhanced on average by 25% and locally by more than a factor of two, when the irradiated area is slightly separated from the probe. Our findings have an important impact on the design of future optoacoustic probes for clinical application.

Handheld photoacoustic tomography probe built using optical-fiber parallel acoustic delay lines

The development of the first miniaturized parallel acoustic delay line (PADL) probe for handheld photoacoustic tomography (PAT) is reported. Using fused-silica optical fibers with low acoustic attenuation, we constructed two arrays of eight PADLs. Precision laser micromachining was conducted to produce robust and accurate mechanical support and alignment structures for the PADLs, with minimal acoustic distortion and interchannel coupling. The 16 optical-fiber PADLs, each with a different time delay, were arranged to form one input port and two output ports. A handheld PADL probe was constructed using two single-element transducers and two data acquisition channels (equal to a channel reduction ratio of 8∶1). Photoacoustic (PA) images of a black-ink target embedded in an optically scattering phantom were successfully acquired. After traveling through the PADLs, the eight channels of differently time-delayed PA signals reached each single-element ultrasonic transducer in a designated nonoverlapping time series, allowing clear signal separation for PA image reconstruction. Our results show that the PADL technique and the handheld probe can potentially enable real-time PAT, while significantly reducing the complexity and cost of the ultrasound receiver system.

Real-time clinical clutter reduction in combined epi-optoacoustic and ultrasound imaging

Flexible imaging of the human body, a requirement for broad clinical application, is obtained by direct integration of optoacoustic (OA) imaging with echo ultrasound (US) in a multimodal epi-illumination system. Up to date, successful deep epi-OA imaging is difficult to achieve owing to clutter. Clutter signals arise from optical absorption in the region of tissue irradiation and strongly reduce contrast and imaging depth. Recently, we developed a displacement-compensated averaging (DCA) technique for clutter reduction based on the clutter decorrelation that occurs when palpating the tissue. To gain first clinical experience on the practical value of DCA, we implemented this technique in a combined clinical OA and US imaging system. Our experience with freehand scanning of human volunteers reveals that real-time feedback on the clutter-reduction outcome is a key factor for achieving superior contrast and imaging depth.

Portable spherical array probe for volumetric real-time optoacoustic imaging at centimeter-scale depths

We report on a novel hand-held imaging probe for real-time optoacoustic visualization of deep tissues in three dimensions. The system incorporates an annular two-dimensional array of ultrasonic sensors densely distributed on a spherical surface. Simultaneous recording and processing of time-resolved data from all the channels enables acquisition of entire volumetric data sets for each illumination laser pulse. The proposed solution utilizes a transparent membrane in order to allow efficient coupling of optoacoustically generated waves to the ultrasonic detectors while avoiding direct contact of the imaged object with the coupling medium. The hand-held approach further allows convenient handling of both pre-clinical experiments as well as clinical measurements in human subjects. Here we demonstrate an imaging speed of 10 volumetric frames per second with spatial resolution down to 200 micrometers in the imaged region while also achieving imaging depth of more than 1.5 cm in living tissues without signal averaging.

Volumetric real-time tracking of peripheral human vasculature with GPU-accelerated three-dimensional optoacoustic tomography

Optoacoustic tomography provides a unique possibility for ultra-high-speed 3-D imaging by acquiring complete volumetric datasets from interrogation of tissue by a single nanosecond-duration laser pulse. Yet, similarly to ultrasound, optoacoustics is a time-resolved imaging method, thus, fast 3-D imaging implies real-time acquisition and processing of high speed data from hundreds of detectors simultaneously, which presents significant technological challenges. Herein we present a highly efficient graphical processing unit (GPU) framework for real-time reconstruction and visualization of 3-D tomographic optoacoustic data. By utilizing a newly developed 3-D optoacoustic scanner, which simultaneously acquires signals with a handheld 256-element spherical ultrasonic array system, we further demonstrate tracking of deep tissue human vasculature rendered at a rate of 10 volumetric frames per second. The flexibility provided by the handheld hardware design, combined with the real-time operation, makes the developed platform highly usable for both clinical imaging practice and small animal research applications.

Nonionizing photoacoustic cystography with near-infrared absorbing gold nanostructures as optical-opaque tracers

AIM

The objectives of this study were to demonstrate nonionizing photoacoustic tomography (PAT) of bladders with near-infrared absorbing gold nanocages (GNCs) as an optical-turbid tracer and to investigate the fate of GNCs after photoacoustic imaging.

MATERIALS & METHODS

The rats' bladders were visualized using PAT after transurethral injection of 2-nM GNCs. The fate of GNCs in the bladders was investigated. Spectroscopic PAT was applied to identify GNC-filled bladders in vivo and study biodistribution ex vivo.

RESULTS

Rats' bladders filled with GNCs were successfully imaged using a PAT system. The photoacoustic amplitude was enhanced by approximately 2240%. Both in vivo and ex vivo PAT results reveal that no accumulation of GNCs in the bladder and kidney was observed, and were validated with inductively coupled plasma mass spectrometry.

CONCLUSION

The PAT with transurethral injection of GNCs provides two crucial safety features for clinical translation: no radiation exposure and no long-term heavy metal accumulation.

Using optoacoustic imaging for measuring the temperature dependence of Grüneisen parameter in optically absorbing solutions

Grüneisen parameter is a key temperature-dependent physical characteristic responsible for thermoelastic efficiency of materials. We propose a new methodology for accurate measurements of temperature dependence of Grüneisen parameter in optically absorbing solutions. We use two-dimensional optoacoustic (OA) imaging to improve accuracy of measurements. Our approach eliminates contribution of local optical fluence and absorbance. To validate the proposed methodology, we studied temperature dependence of aqueous cupric sulfate solutions in the range from 22 to 4 °C. Our results for the most diluted salt perfectly matched known temperature dependence for the Grüneisen parameter of water. We also found that Grüneisen-temperature relationship for cupric sulfate exhibits linear trend with respect to the concentration. In addition to accurate measurements of Grüneisen changes with temperature, the developed technique provides a basis for future high precision OA temperature monitoring in live tissues.

Three-dimensional optoacoustic tomography using a conventional ultrasound linear detector array: whole-body tomographic system for small animals

PURPOSE

Optoacoustic imaging relies on the detection of ultrasonic waves induced by laser pulse excitations to map optical absorption in biological tissue. A tomographic geometry employing a conventional ultrasound linear detector array for volumetric optoacoustic imaging is reported. The geometry is based on a translate-rotate scanning motion of the detector array, and capitalizes on the geometrical characteristics of the transducer assembly to provide a large solid angular detection aperture. A system for three-dimensional whole-body optoacoustic tomography of small animals is implemented.

METHODS

The detection geometry was tested using a 128-element linear array (5.0∕7.0 MHz, Acuson L7, Siemens), moved by steps with a rotation∕translation stage assembly. Translation and rotation range of 13.5 mm and 180°, respectively, were implemented. Optoacoustic emissions were induced in tissue-mimicking phantoms and ex vivo mice using a pulsed laser operating in the near-IR spectral range at 760 nm. Volumetric images were formed using a filtered backprojection algorithm.

RESULTS

The resolution of the optoacoustic tomography system was measured to be better than 130 μm in-plane and 330 μm in elevation (full width half maximum), and to be homogenous along a 15 mm diameter cross section due to the translate-rotate scanning geometry. Whole-body volumetric optoacoustic images of mice were performed ex vivo, and imaged organs and blood vessels through the intact abdominal and head regions were correlated to the mouse anatomy.

CONCLUSIONS

Overall, the feasibility of three-dimensional and high-resolution whole-body optoacoustic imaging of small animal using a conventional linear array was demonstrated. Furthermore, the scanning geometry may be used for other linear arrays and is therefore expected to be of great interest for optoacoustic tomography at macroscopic and mesoscopic scale. Specifically, conventional detector arrays with higher central frequencies may be investigated.

Real-time photoacoustic and ultrasound imaging: a simple solution for clinical ultrasound systems with linear arrays

Recent clinical studies have demonstrated that photoacoustic imaging (PAI) provides important diagnostic information during a routine breast exam for cancer. PAI enhances contrast between blood vessels and background tissue, which can help characterize suspicious lesions. However, most PAI systems are either not compatible with commercial ultrasound systems or inefficiently deliver light to the region of interest, effectively reducing the sensitivity of the technique. To address and potentially overcome these limitations, we developed an accessory for a standard linear ultrasound array that optimizes light delivery for PAI. The photoacoustic enabling device (PED) exploits an optically transparent acoustic reflector to help direct laser illumination to the region of interest. This study compares the PED with standard fiber bundle illumination in scattering and non-scattering media. In scattering media with the same incident fluence, the PED enhanced the photoacoustic signal by 18 dB at a depth of 5 mm and 6 dB at a depth of 20 mm. To demonstrate in vivo feasibility, we also used the device to image a mouse with a pancreatic tumor. The PED identified blood vessels at the periphery of the tumor, suggesting that PAI provides complementary contrast to standard pulse echo ultrasound. The PED is a simple and inexpensive solution that facilitates the translation of PAI technology to the clinic for routine screening of breast cancer.

Optoacoustic imaging of blood perfusion: techniques for intraoperative tissue viability assessment

Reliably assessing tissue viability during surgery is of major importance in surgical procedures. The most basic requirement for viability is sufficient oxygen supply to the tissue. Therefore it is highly desirable to visualize in real-time the dynamic process of blood perfusion up to and within the microvasculature. A modality sensitive to structures in the range of few hundred micrometers and offering high contrast to the embedding tissue is then needed. To this end, a number of methods have been developed, but have had no significant impact on the clinical routine due to various deficiencies. In this paper we demonstrate the applicability of optoacoustic imaging, which combines ultrasonic resolution with strong optical contrast. A method for optoacoustic perfusion assessment, based on a local and repeatable injection of saline, was proposed and assessed ex-vivo on large pig bowels and in-vivo in mouse tails. The obtained dynamic perfusion images highlight the method's potential to enable immediate and quantitative assessment of tissue viability during surgery.

Real-time handheld multispectral optoacoustic imaging

Multispectral optoacoustic tomography (MSOT) of functional and molecular contrast has the potential to find broad deployment in clinical practice. We have developed the first handheld MSOT imaging device with fast wavelength tuning achieving a frame rate of 50 Hz. In this Letter, we demonstrate its clinical potential by dynamically resolving multiple disease-relevant tissue chromophores, including oxy-/deoxyhemoglobin, and melanin, in human volunteers.

Electromagnetic acoustic imaging

Electromagnetic acoustic imaging (EMAI) is a new imaging technique that uses long-wavelength RF electromagnetic (EM) waves to induce ultrasound emission. Signal intensity and image contrast have been found to depend on spatially varying electrical conductivity of the medium in addition to conventional acoustic properties. The resultant conductivity- weighted ultrasound data may enhance the diagnostic performance of medical ultrasound in cancer and cardiovascular applications because of the known changes in conductivity of malignancy and blood-filled spaces. EMAI has a potential advantage over other related imaging techniques because it combines the high resolution associated with ultrasound detection with the generation of the ultrasound signals directly related to physiologically important electrical properties of the tissues. Here, we report the theoretical development of EMAI, implementation of a dual-mode EMAI/ultrasound apparatus, and successful demonstrations of EMAI in various phantoms designed to establish feasibility of the approach for eventual medical applications.

Parallel acoustic delay lines for photoacoustic tomography

Achieving real-time photoacoustic (PA) tomography typically requires multi-element ultrasound transducer arrays and their associated multiple data acquisition (DAQ) electronics to receive PA waves simultaneously. We report the first demonstration of a photoacoustic tomography (PAT) system using optical fiber-based parallel acoustic delay lines (PADLs). By employing PADLs to introduce specific time delays, the PA signals (on the order of a few micro seconds) can be forced to arrive at the ultrasonic transducers at different times. As a result, time-delayed PA signals in multiple channels can be ultimately received and processed in a serial manner with a single-element transducer, followed by single-channel DAQ electronics. Our results show that an optically absorbing target in an optically scattering medium can be photoacoustically imaged using the newly developed PADL-based PAT system. Potentially, this approach could be adopted to significantly reduce the complexity and cost of ultrasonic array receiver systems.

Translational optical imaging

OBJECTIVE

Optical imaging is experiencing significant technologic advances. Simultaneously, an array of specific optical imaging agents has brought new capabilities to biomedical research and is edging toward clinical use. We review progress in the translation of macroscopic optical imaging-including fluorescence-guided surgery and endoscopy, intravascular fluorescence imaging, diffuse fluorescence and optical tomography, and multispectral optoacoustics (photoacoustics)-for applications ranging from tumor resection and assessment of atherosclerotic plaques to dermatologic and breast examinations.

CONCLUSION

Optical imaging could play a major role in the move from imaging of structure and morphology to the visualization of the individual biologic processes underlying disease and could, therefore, contribute to more accurate diagnostics and improved treatment efficacy.

Non-invasive carotid imaging using optoacoustic tomography

The high prevalence of atherosclerosis and the corresponding derived morbidity drives the investigation of novel imaging tools for disease diagnosis and assessment. Multi-spectral optoacoustic tomography (MSOT) can resolve structural, hemodynamic and molecular parameters that relate to cardiovascular disease. Similarly to ultrasound imaging, optoacoustic (photoacoustic) imaging can be implemented as a handheld arrangement which further brings dissemination potential to point of care applications. Correspondingly, we experimentally investigate herein the performance of non-invasive optoacoustic scanning developed for carotid imaging, in phantoms and humans. The results demonstrate that traditional transducers employed in ultrasound imaging do not offer optimal MSOT imaging. Instead, feasibility to detect human carotids and carotid-sized vessels in clinically-relevant depths is better demonstrated with curved arrays and tomographic approaches.

Echographic detectability of optoacoustic signals from low-concentration PEG-coated gold nanorods

Purpose:

To evaluate the diagnostic performance of gold nanorod (GNR)-enhanced optoacoustic imaging employing a conventional echographic device and to determine the most effective operative configuration in order to assure optoacoustic effectiveness, nanoparticle stability, and imaging procedure safety.

Methods:

The most suitable laser parameters were experimentally determined in order to assure nanoparticle stability during the optoacoustic imaging procedures. The selected configuration was then applied to a novel tissue-mimicking phantom, in which GNR solutions covering a wide range of low concentrations (25–200 pM) and different sample volumes (50–200 μL) were exposed to pulsed laser irradiation. GNR-emitted optoacoustic signals were acquired either by a couple of single-element ultrasound probes or by an echographic transducer. Off-line analysis included: (a) quantitative evaluation of the relationships between GNR concentration, sample volume, phantom geometry, and amplitude of optoacoustic signals propagating along different directions; (b) echographic detection of “optoacoustic spots,” analyzing their intensity, spatial distribution, and clinical exploitability. MTT measurements performed on two different cell lines were also used to quantify biocompatibility of the synthesized GNRs in the adopted doses.

Results:

Laser irradiation at 30 mJ/cm² for 20 seconds resulted in the best compromise among the requirements of effectiveness, safety, and nanoparticle stability. Amplitude of GNR-emitted optoacoustic pulses was proportional to both sample volume and concentration along each considered propagation direction for all the tested boundary conditions, providing an experimental confirmation of isotropic optoacoustic emission. Average intensity of echographically detected spots showed similar behavior, emphasizing the presence of an “ideal” GNR concentration (100 pM) that optimized optoacoustic effectiveness. The tested GNRs also exhibited high biocompatibility over the entire considered concentration range.

Conclusion:

An optimal configuration for GNR-enhanced optoacoustic imaging was experimentally determined, demonstrating in particular its feasibility with a conventional echographic device. The proposed approach can be easily extended to quantitative performance evaluation of different contrast agents for optoacoustic imaging.

Photoacoustic section imaging using an elliptical acoustic mirror and optical detection

A method is proposed that utilizes the advantages of optical ultrasound detection in two-dimensional photoacoustic section imaging, combining an optical interferometer with an acoustic mirror. The concave mirror has the shape of an elliptical cylinder and concentrates the acoustic wave generated around one focal line in the other one, where an optical beam probes the temporal evolution of acoustic pressure. This yields line projections of the acoustic sources at distances corresponding to the time of flight, which, after rotating the sample about an axis perpendicular to the optical detector, allows reconstruction of a section using the inverse Radon transform. A resolution of 120 [micro sign]m within and 1.5 mm between the sections can be obtained with the setup. Compared to a bare optical probe beam, the signal-to-noise ratio (SNR) is seven times higher with the mirror. Furthermore, the imaging system is tested on a biological sample.

3D-visual laser-diode-based photoacoustic imaging

We present a 3D-visual laser-diode-based photoacoustic imaging (LD-PAI) system with a pulsed semiconductor laser source, which has the properties of being inexpensive, portable, and durable. The laser source was operated at a wavelength of 905 nm with a repetition rate of 0.8 KHz. The energy density on the sample surface is about 2.35 mJ/cm(2) with a pulse energy as low as 5.6 μJ. By raster-scanning, preliminary 3D volumetric renderings of the knotted and helical blood vessel phantoms have been visualized integrally with an axial resolution of 1.1 mm and a lateral resolution of 0.5 mm, and typical 2D photoacoustic image slices with different thickness and orientation were produced with clarity for detailed comparison and analysis in 3D diagnostic visualization. In addition, the pulsed laser source was integrated with the optical lens group and the 3D adjustable rotational stage, with the result that the compact volume of the total radiation source is only 10 × 3 × 3 cm(3). Our goal is to significantly reduce the costs and sizes of the deep 3D-visual PAI system for future producibility.

Performance benchmarks of an array-based hand-held photoacoustic probe adapted from a clinical ultrasound system for non-invasive sentinel lymph node imaging

Clinical translation of photoacoustic (PA) imaging can be facilitated by integration with commercial ultrasound (US) scanners to enable dual-modality imaging. An array-based US scanner was modified for hand-held PA imaging. The performance was benchmarked in terms of signal-to-noise ratio (SNR), axial spatial resolution and sensitivity. PA images of a tube, filled with methylene blue (MB; approx. 30 mM) and placed at various depths in chicken tissue, were acquired. A 5 cm penetration depth was achieved with an 18.6 dB SNR using a laser fluence of 3 mJ cm(-2), only one-seventh of the safety limit (20 mJ cm(-2)). An axial resolution of approximately 400 μm was maintained at all imaging depths. The PA sensitivity to MB placed 2.3 cm deep in chicken tissue was less than 100 μM. Further, after intradermal injection of MB (approx. 30 mM), a rat sentinel lymph node was clearly identified in vivo, beneath a 3.8 cm thick layer of chicken breast. The accumulated concentration of MB in the node was estimated to be approximately 7 mM. The noise-equivalent sensitivities (approx. 2 cm depth) were 17 and 85 μM, ex vivo and in vivo, respectively. These results support the use of this PA system for non-invasive mapping and image-guided needle biopsy of sentinel nodes in breast cancer patients.

Photoacoustic section imaging with an integrating cylindrical detector

A piezoelectric detector with a cylindrical shape is investigated for photoacoustic section imaging. Images are acquired by rotating a sample in front of the cylindrical detector. With its length exceeding the size of the imaging object, it works as an integrating sensor and therefore allows reconstructing section images with the inverse Radon transform. Prior to the reconstruction the Abel transform is applied to the measured signals to improve the accuracy of the image. A resolution of about 100 µm within a section and of 500 µm between sections is obtained. Additionally, a series of images of a zebra fish is shown.

Nonionizing photoacoustic cystography in vivo

We demonstrate the feasibility of a novel and nonionizing process for bladder imaging in vivo, called photoacoustic cystography (PAC). Using a photoacoustic imaging system, we have successfully imaged a rat bladder filled with clinically used Methylene Blue (MB) dye. An image contrast of ~8 was achieved. Further, spectroscopic PAC confirmed the accumulation of MB in the bladder. Using a laser pulse energy of less than 1 mJ/cm² (1/20 of the ANSI safety limit), a deeply (1.2 cm) positioned bladder in biological tissues was clearly visible in the PA image. Our results suggest that PAC can potentially provide a nonionizing, relatively cheap, and portable tool for bladder mapping. Among our clinical interests, nonionizing PAC with an injection of MB can potentially monitor vesicoureteral reflux in children.

Biomedical photoacoustic imaging

Photoacoustic (PA) imaging, also called optoacoustic imaging, is a new biomedical imaging modality based on the use of laser-generated ultrasound that has emerged over the last decade. It is a hybrid modality, combining the high-contrast and spectroscopic-based specificity of optical imaging with the high spatial resolution of ultrasound imaging. In essence, a PA image can be regarded as an ultrasound image in which the contrast depends not on the mechanical and elastic properties of the tissue, but its optical properties, specifically optical absorption. As a consequence, it offers greater specificity than conventional ultrasound imaging with the ability to detect haemoglobin, lipids, water and other light-absorbing chomophores, but with greater penetration depth than purely optical imaging modalities that rely on ballistic photons. As well as visualizing anatomical structures such as the microvasculature, it can also provide functional information in the form of blood oxygenation, blood flow and temperature. All of this can be achieved over a wide range of length scales from micrometres to centimetres with scalable spatial resolution. These attributes lend PA imaging to a wide variety of applications in clinical medicine, preclinical research and basic biology for studying cancer, cardiovascular disease, abnormalities of the microcirculation and other conditions. With the emergence of a variety of truly compelling in vivo images obtained by a number of groups around the world in the last 2-3 years, the technique has come of age and the promise of PA imaging is now beginning to be realized. Recent highlights include the demonstration of whole-body small-animal imaging, the first demonstrations of molecular imaging, the introduction of new microscopy modes and the first steps towards clinical breast imaging being taken as well as a myriad of in vivo preclinical imaging studies. In this article, the underlying physical principles of the technique, its practical implementation, and a range of clinical and preclinical applications are reviewed.

Biomedical photoacoustic imaging

Photoacoustic (PA) imaging, also called optoacoustic imaging, is a new biomedical imaging modality based on the use of laser-generated ultrasound that has emerged over the last decade. It is a hybrid modality, combining the high-contrast and spectroscopic-based specificity of optical imaging with the high spatial resolution of ultrasound imaging. In essence, a PA image can be regarded as an ultrasound image in which the contrast depends not on the mechanical and elastic properties of the tissue, but its optical properties, specifically optical absorption. As a consequence, it offers greater specificity than conventional ultrasound imaging with the ability to detect haemoglobin, lipids, water and other light-absorbing chomophores, but with greater penetration depth than purely optical imaging modalities that rely on ballistic photons. As well as visualizing anatomical structures such as the microvasculature, it can also provide functional information in the form of blood oxygenation, blood flow and temperature. All of this can be achieved over a wide range of length scales from micrometres to centimetres with scalable spatial resolution. These attributes lend PA imaging to a wide variety of applications in clinical medicine, preclinical research and basic biology for studying cancer, cardiovascular disease, abnormalities of the microcirculation and other conditions. With the emergence of a variety of truly compelling in vivo images obtained by a number of groups around the world in the last 2-3 years, the technique has come of age and the promise of PA imaging is now beginning to be realized. Recent highlights include the demonstration of whole-body small-animal imaging, the first demonstrations of molecular imaging, the introduction of new microscopy modes and the first steps towards clinical breast imaging being taken as well as a myriad of in vivo preclinical imaging studies. In this article, the underlying physical principles of the technique, its practical implementation, and a range of clinical and preclinical applications are reviewed.

A quantitative study to design an experimental setup for photoacoustic imaging

During the last decade, a new modality called photoacoustic imaging has emerged. The increasing interest for this new modality is due to the fact that it combines advantages of ultrasound and optical imaging, i.e. the high contrast due to optical absorption and the low acoustic attenuation in biological tissues. It is thus possible to study vascularization because blood has high optical absorption coefficient. Papers in the literature often focus on applications and rarely discuss quantitative parameters. The goal of this paper is to provide quantitative elements to design an acquisition setup. By defining the targeted resolution and penetration depth, it is then possible to evaluate which kind of excitation and reception systems have to be used. First, we recall theoretical background related to photoacoustic effect before to describe the experiments based on a nanosecond laser at 1064 nm and 2.25-5 MHz transducers. Second, we present results about the relation linking fluence laser to signal amplitude and axial and lateral resolutions of our acquisition setup. We verify the linear relation between fluence and amplitude before to estimate axial resolution at 550 μm for a 2.25 MHz ultrasonic transducer. Concerning lateral resolution, we show that a reconstruction technique based on curvilinear acquisition of 30 lines improves it by a factor of 3 compared to a lateral displacement. Future works will include improvement of lateral resolution using probes, like in ultrasound imaging, instead of single-element transducers.

Subwavelength-resolution label-free photoacoustic microscopy of optical absorption in vivo

Optical absorption provides essential biological functional information but cannot be sensed by mainstream optical microscopy technologies directly, which detect fluorescence or scattering and may require undesirable labeling. Here we developed in vivo subwavelength-resolution photoacoustic microscopy (SW-PAM) that provides exquisitely high optical-absorption contrast due to nonfluorescent, or fluorescent, endogenous pigments. Having approached the ultimate diffraction-limited optical resolution, SW-PAM can resolve subcellular organelles. Vasculature and early-stage melanoma were imaged with 12:1 and 17:1 contrasts, respectively, without labeling. SW-PAM along with the scaled-up macroscopy, as the only technology that measures the same contrast origin over such a wide length scale, can potentially accelerate translation from microscopic research to clinical practice.

Deeply penetrating in vivo photoacoustic imaging using a clinical ultrasound array system

Using a hand-held photoacoustic probe integrated with a clinical ultrasound array system, we successfully imaged objects deeply positioned in biological tissues. The optical contrasts were enhanced by methylene blue with a concentration of ~30 mM. The penetration depth reached ~5.2 cm in chicken breast tissue by using 650-nm wavelength, which is ~4.7 times the 1/e optical penetration depth. This imaging depth was achieved using a laser fluence on the tissue surface of only 3 mJ/cm(2), which is 1/7 of the American National Standards Institute (ANSI) safety limit (20 mJ/cm(2)). The noise equivalent sensitivity at this depth was ~11 mM. Further, after intradermal injection of methylene blue in a rat, a sentinel lymph node was easily detected in vivo, beneath a 2-cm thick layer of chicken breast. Also, blood located 3.5 cm deep in the rat was clearly imaged with intrinsic contrast. We have photoacoustically guided insertion of a needle into a rat sentinel lymph node with accumulated methylene blue. These results highlight the clinical potential of photoacoustic image-guided identification and needle biopsy of sentinel lymph nodes for axillary staging in breast cancer patients.

Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

By modifying a clinical ultrasound array system, we develop a novel handheld photoacoustic probe for image-guided needle biopsy. The integration of optical fiber bundles for pulsed laser light delivery enables photoacoustic image-guided insertion of a needle into rat axillary lymph nodes with accumulated indocyanine green (ICG). Strong photoacoustic contrast of the needle is achieved. After subcutaneous injection of the dye in the left forepaw, sentinel lymph nodes are easily detected, in vivo and in real time, beneath 2-cm-thick chicken breast overlaying the axillary region. ICG uptake in axillary lymph nodes is confirmed with fluorescence imaging both in vivo and ex vivo. These results demonstrate the clinical potential of this handheld photoacoustic system for facile identification and needle biopsy of sentinel lymph nodes for cancer staging and metastasis detection in humans.