Sentinel lymph nodes in the rat: noninvasive photoacoustic and US imaging with a clinical US system

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.

Azaphosphinate Dyes: A Low Molecular Weight Near-Infrared Scaffold for Development of Photoacoustic or Fluorescence Imaging Probes

Near-infrared (NIR) dyes are desirable for biological imaging applications including photoacoustic (PA) and fluorescence imaging. Nonetheless, current NIR dyes are often plagued by relatively large molecular weights, poor water solubility, and limited photostability. Herein, we provide the first examples of azaphosphinate dyes which display desirable properties such as low molecular weight, absorption/emission above 750 nm, and remarkable water solubility. In PA imaging, an azaphosphinate dye exhibited a 4.1-fold enhancement in intensity compared to commonly used standards, the ability to multiplex with existing dyes in whole blood, imaging depths of 2.75 cm in a tissue model, and contrast in mice. An improved derivative for fluorescence imaging displayed a >10-fold reduction in photobleaching in water compared to the FDA-approved indocyanine green dye and could be visualized in mice. This new dye class provides a robust scaffold for the development of photoacoustic or NIR fluorescence imaging agents.

Top 100 cited classical articles in sentinel lymph nodes biopsy for breast cancer

Background

The sentinel lymph node biopsy (SLNB) takes on a critical significance in breast cancer surgery since it is the gold standard for assessing axillary lymph node (ALN) metastasis and determining whether to perform axillary lymph node dissection (ALND). A bibliometric analysis is beneficial to visualize characteristics and hotspots in the field of sentinel lymph nodes (SLNs), and it is conducive to summarizing the important themes in the field to provide more insights into SLNs and facilitate the management of SLNs.

Materials and methods

Search terms relating to SLNs were aggregated and searched in the Web of Science core collection database to identify the top 100 most cited articles. Bibliometric tools were employed to identify and analyze publications for annual article volume, authors, countries, institutions, keywords, as well as hotspot topics.

Results

The period was from 1998 to 2018. The total number of citations ranged from 160 to 1925. LANCET ONCOLOGY and JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION were the top two journals in which the above articles were published. Giuliano, AE was the author with the highest number of articles in this field with 15. EUROPEAN INST ONCOL is the institution with the highest number of publications, with 35 articles. Hotspots include the following 4 topics, false-negative SLNs after neoadjuvant chemotherapy; prediction of metastatic SLNs; quality of life and postoperative complications; and lymphography of SLNs.

Conclusion

This study applies bibliometric tools to analyze the most influential literature, the top 100 cited articles in the field of SLNB, to provide researchers and physicians with research priorities and hotspots.

Cylindrical lens configuration for optimizing light delivery in a curvilinear endocavity photoacoustic imaging system

Curvilinear endocavity ultrasound images capture a wide field of view with a miniature probe. In adapting photoacoustic imaging (PAI) to work with such ultrasound systems, light delivery is challenged by the trade-off between image quality and laser safety concerns. Here, we present two novel, to the best of our knowledge, designs based on cylindrical lenses that are optimized for transvaginal PAI B-scan imaging. Our simulation and experimental results demonstrate that, compared to conventional light delivery methods for PAI imaging, the proposed designs are safer for higher pulse energies and provide deeper imaging and a wider lateral field of view. The proposed designs could also improve the performance of endoscopic co-registered ultrasound/photoacoustic imaging in other clinical applications.

Hybrid photoacoustic and fast super-resolution ultrasound imaging

The combination of photoacoustic (PA) imaging and ultrasound localization microscopy (ULM) with microbubbles has great potential in various fields such as oncology, neuroscience, nephrology, and immunology. Here we developed an interleaved PA/fast ULM imaging technique that enables super-resolution vascular and physiological imaging in less than 2 seconds per frame in vivo. By using sparsity-constrained (SC) optimization, we accelerated the frame rate of ULM up to 37 times with synthetic data and 28 times with in vivo data. This allows for the development of a 3D dual imaging sequence with a commonly used linear array imaging system, without the need for complicated motion correction. Using the dual imaging scheme, we demonstrated two in vivo scenarios challenging to image with either technique alone: the visualization of a dye-labeled mouse lymph node showing nearby microvasculature, and a mouse kidney microangiography with tissue oxygenation. This technique offers a powerful tool for mapping tissue physiological conditions and tracking the contrast agent biodistribution non-invasively.

Nanosensitive optical coherence tomography for detecting structural changes in stem cells

Mesenchymal stromal cells (MSCs) are adult stem cells that have been widely investigated for their potential to regenerate damaged and diseased tissues. Multiple pre-clinical studies and clinical trials have demonstrated a therapeutic response following treatment with MSCs for various pathologies, including cardiovascular, neurological and orthopaedic diseases. The ability to functionally track cells following administration in vivo is pivotal to further elucidating the mechanism of action and safety profile of these cells. Effective monitoring of MSCs and MSC-derived microvesicles requires an imaging modality capable of providing both quantitative and qualitative readouts. Nanosensitive optical coherence tomography (nsOCT) is a recently developed technique that detects nanoscale structural changes within samples. In this study, we demonstrate for the first time, the capability of nsOCT to image MSC pellets following labelling with different concentrations of dual plasmonic gold nanostars. We show that the mean spatial period of MSC pellets increases following the labelling with increasing concentrations of nanostars. Additionally, with the help of extra time points and a more comprehensive analysis, we further improved the understanding of the MSC pellet chondrogenesis model. Despite the limited penetration depth (similar to conventional OCT), the nsOCT is highly sensitive in detecting structural alterations at the nanoscale, which may provide crucial functional information about cell therapies and their modes of action.

Application of photoacoustic computed tomography in biomedical imaging: A literature review

Photoacoustic computed tomography (PACT) is a hybrid imaging modality that combines optical excitation and acoustic detection techniques. It obtains high-resolution deep-tissue images based on the deep penetration of light, the anisotropy of light absorption in objects, and the photoacoustic effect. Hence, PACT shows great potential in biomedical sample imaging. Recently, due to its advantages of high sensitivity to optical absorption and wide scalability of spatial resolution with the desired imaging depth, PACT has received increasing attention in preclinical and clinical practice. To date, there has been a proliferation of PACT systems designed for specific biomedical imaging applications, from small animals to human organs, from ex vivo to in vivo real-time imaging, and from simple structural imaging to functional and molecular imaging with external contrast agents. Therefore, it is of great importance to summarize the previous applications of PACT systems in biomedical imaging and clinical practice. In this review, we searched for studies related to PACT imaging of biomedical tissues and samples over the past two decades; divided the studies into two categories, PACT imaging of preclinical animals and PACT imaging of human organs and body parts; and discussed the significance of the studies. Finally, we pointed out the future directions of PACT in biomedical applications. With the development of exogenous contrast agents and advances of imaging technique, in the future, PACT will enable biomedical imaging from organs to whole bodies, from superficial vasculature to internal organs, from anatomy to functions, and will play an increasingly important role in biomedical research and clinical practice.

Sentinel lymph node mapping in patients with breast cancer using a photoacoustic/ultrasound dual-modality imaging system with carbon nanoparticles as the contrast agent: a pilot study

Assessing the metastatic status of axillary lymph nodes is a common clinical practice in the staging of early breast cancers. Yet sentinel lymph nodes (SLNs) are the regional lymph nodes believed to be the first stop along the lymphatic drainage path of the metastasizing cancer cells. Compared to axillary lymph node dissection, sentinel lymph node biopsy (SLNB) helps reduce morbidity and side effects. Current SLNB methods, however, still have suboptimum properties, such as restrictions due to nuclide accessibility and a relatively low therapeutic efficacy when only a single contrast agent is used. To overcome these limitations, researchers have been motivated to develop a non-radioactive SLN mapping method to replace or supplement radionuclide mapping. We proposed and demonstrated a clinical procedure using a dual-modality photoacoustic (PA)/ultrasound (US) imaging system to locate the SLNs to offer surgical guidance. In our work, the high contrast of PA imaging and its specificity to SLNs were based on the accumulation of carbon nanoparticles (CNPs) in the SLNs. A machine-learning model was also trained and validated to distinguish stained SLNs based on single-wavelength PA images. In the pilot study, we imaged 11 patients in vivo, and the specimens from 13 patients were studied ex vivo. PA/US imaging identified stained SLNs in vivo without a single false positive (23 SLNs), yielding 100% specificity and 52.6% sensitivity based on the current PA imaging system. Our machine-learning model can automatically detect SLNs in real time. In the new procedure, single-wavelength PA/US imaging uses CNPs as the contrast agent. The new system can, with that contrast agent, noninvasively image SLNs with high specificity in real time based on the unique features of the SLNs in the PA images. Ultimately, we aim to use our systems and approach to substitute or supplement nuclide tracers for a non-radioactive, less invasive SLN mapping method in SLNB for the axillary staging of breast cancer.

Recent Advances in Contrast-Enhanced Photoacoustic Imaging: Overcoming the Physical and Practical Challenges

For decades now, photoacoustic imaging (PAI) has been investigated to realize its potential as a niche biomedical imaging modality. Despite its highly desirable optical contrast and ultrasonic spatiotemporal resolution, PAI is challenged by such physical limitations as a low signal-to-noise ratio (SNR), diminished image contrast due to strong optical attenuation, and a lower-bound on spatial resolution in deep tissue. In addition, contrast-enhanced PAI has faced practical limitations such as insufficient cell-specific targeting due to low delivery efficiency and difficulties in developing clinically translatable agents. Identifying these limitations is essential to the continuing expansion of the field, and substantial advances in developing contrast-enhancing agents, complemented by high-performance image acquisition systems, have synergistically dealt with the challenges of conventional PAI. This review covers the past four years of research on pushing the physical and practical challenges of PAI in terms of SNR/contrast, spatial resolution, targeted delivery, and clinical application. Promising strategies for dealing with each challenge are reviewed in detail, and future research directions for next generation contrast-enhanced PAI are discussed.

Molecular Imaging for Early-Stage Disease Diagnosis

With the development of cellular biology, molecular biology, and other subjects, targeted molecular probe was combined with medical imaging technologies to launch a new scientific discipline of molecular imaging that is a research discipline to visualize, characterize, and analyze biological process at the cellular and molecular levels for real-time tracking and precision therapy, also termed as the medical imaging in the twenty-first century. An array of imaging techniques has been developed to image specific targets of living cells or tissues by molecular probes, including optical molecular imaging (OI), magnetic resonance molecular imaging, ultrasound (US) molecular imaging, nuclear medicine molecular imaging, X-ray molecular imaging, and multi-mode molecular imaging. These imaging techniques make the early diagnosis of various diseases possible by means of visualization of gene expression, interactions between proteins, signal transduction, cell metabolism, cell traces, and other physiological or pathological processes in the living system, which bridge the gap between molecular biology and clinical medicine. This chapter will lay the emphasis on the early-stage diagnosis of fatal diseases, such as malignant tumors, cardio- or cerebrovascular diseases, digestive system disease, central nervous system disease, and other diseases employing molecular imaging in a real-time visualized manner.

Elevational Synthetic Aperture Focusing for Three-Dimensional Photoacoustic Imaging Using a Clinical One-Dimensional Array Transducer

OBJECTIVE

Two-dimensional (2D) photoacoustic (PA) imaging based on array transducers provide high spatial resolution in the lateral direction by adopting receive dynamic focusing. However, the quality of PA image is often deteriorated by poor elevational resolution which is achieved by an acoustic lens. To overcome this limitation, we present a three-dimensional (3D) image reconstruction method using a commercial one-dimensional (1D) array transducer.

METHODS

In the method, the elevational resolution is improved by applying synthetic aperture focusing (SAF) technique along the elevational direction. For this, a commercially available 1D array transducer with an acoustic lens is modeled and appropriate synthetic focusing delay that can minimize the effect of the acoustic lens is derived by mathematical analysis.

RESULTS

From the simulation and experiment results, it was demonstrated that the proposed method can enhance the image quality of PA imaging, i.e., elevational resolution and signal-to-noise ratio (SNR).

CONCLUSION

3D PA images with improved elevational resolution were achieved using a clinical 1D array transducer.

SIGNIFICANCE

The presented method may be useful for clinical application such as detecting microcalcification, imaging of tumor vasculature and guidance of biopsy in real time.

Contrast Agents for Photoacoustic Imaging: A Review Focusing on the Wavelength Range

Photoacoustic imaging using endogenous chromophores as a contrast has been widely applied in biomedical studies owing to its functional imaging capability at the molecular level. Various exogenous contrast agents have also been investigated for use in contrast-enhanced imaging and functional analyses. This review focuses on contrast agents, particularly in the wavelength range, for use in photoacoustic imaging. The basic principles of photoacoustic imaging regarding light absorption and acoustic release are introduced, and the optical characteristics of tissues are summarized according to the wavelength region. Various types of contrast agents, including organic dyes, semiconducting polymeric nanoparticles, gold nanoparticles, and other inorganic nanoparticles, are explored in terms of their light absorption range in the near-infrared region. An overview of the contrast-enhancing capacity and other functional characteristics of each agent is provided to help researchers gain insights into the development of contrast agents in photoacoustic imaging.

Looking deep inside tissue with photoacoustic molecular probes: a review

Significance

Deep tissue noninvasive high-resolution imaging with light is challenging due to the high degree of light absorption and scattering in biological tissue. Photoacoustic imaging (PAI) can overcome some of the challenges of pure optical or ultrasound imaging to provide high-resolution deep tissue imaging. However, label-free PAI signals from light absorbing chromophores within the tissue are nonspecific. The use of exogeneous contrast agents (probes) not only enhances the imaging contrast (and imaging depth) but also increases the specificity of PAI by binding only to targeted molecules and often providing signals distinct from the background.

Aim

We aim to review the current development and future progression of photoacoustic molecular probes/contrast agents.

Approach

First, PAI and the need for using contrast agents are briefly introduced. Then, the recent development of contrast agents in terms of materials used to construct them is discussed. Then, various probes are discussed based on targeting mechanisms, in vivo molecular imaging applications, multimodal uses, and use in theranostic applications.

Results

Material combinations are being used to develop highly specific contrast agents. In addition to passive accumulation, probes utilizing activation mechanisms show promise for greater controllability. Several probes also enable concurrent multimodal use with fluorescence, ultrasound, Raman, magnetic resonance imaging, and computed tomography. Finally, targeted probes are also shown to aid localized and molecularly specific photo-induced therapy.

Conclusions

The development of contrast agents provides a promising prospect for increased contrast, higher imaging depth, and molecularly specific information. Of note are agents that allow for controlled activation, explore other optical windows, and enable multimodal use to overcome some of the shortcomings of label-free PAI.

Photoacoustic imaging systems based on clinical ultrasound platform

Photoacoustic imaging has drawn a significant amount of attention due to its unique capacity for functional, metabolic, and molecular imaging, which is achieved by the combination of optical excitation and acoustic detection. With both strengths of light and ultrasound, photoacoustic images can provide strong optical contrast at high ultrasound resolution in deep tissue. As photoacoustic imaging can be used to visualize complementary information to ultrasound imaging using the same data acquisition process, several studies have been conducted on combining photoacoustic imaging with existing clinical ultrasound systems. This review highlights our development of a photoacoustic/ultrasound dual-modal imaging system, various features and functionalities implemented for clinical translation, and preclinical/clinical studies performed by using the systems.

Sentinel lymph node detection by combining nonradioactive techniques with contrast agents: State of the art and prospects

The status of sentinel lymph nodes (SLNs) has a substantial prognostic value because these nodes are the first place where cancer cells accumulate along their spreading route. Routine SLN biopsy ("gold standard") involves peritumoral injections of radiopharmaceuticals, such as technetium-99m, which has obvious disadvantages. This review examines the methods used as "gold standard" analogs to diagnose SLNs. Nonradioactive preoperative and intraoperative methods of SLN detection are analyzed. Promising photonic tools for SLNs detection are reviewed, including NIR-I/NIR-II fluorescence imaging, photoswitching dyes for SLN detection, in vivo photoacoustic detection, imaging and biopsy of SLNs. Also are discussed methods of SLN detection by magnetic resonance imaging, ultrasonic imaging systems including as combined with photoacoustic imaging, and methods based on the magnetometer-aided detection of superparamagnetic nanoparticles. The advantages and disadvantages of nonradioactive SLN-detection methods are shown. The review concludes with prospects for the use of conservative diagnostic methods in combination with photonic tools.

Seeing through the Skin: Photoacoustic Tomography of Skin Vasculature and Beyond

Skin diseases are the most common human diseases and manifest in distinct structural and functional changes to skin tissue components such as basal cells, vasculature, and pigmentation. Although biopsy is the standard practice for skin disease diagnosis, it is not sufficient to provide in vivo status of the skin and highly depends on the timing of diagnosis. Noninvasive imaging technologies that can provide structural and functional tissue information in real time would be invaluable for skin disease diagnosis and treatment evaluation. Among the modern medical imaging technologies, photoacoustic (PA) tomography (PAT) shows great promise as an emerging optical imaging modality with high spatial resolution, high imaging speed, deep penetration depth, rich contrast, and inherent sensitivity to functional and molecular information. Over the last decade, PAT has undergone an explosion in technical development and biomedical applications. Particularly, PAT has attracted increasing attention in skin disease diagnosis, providing structural, functional, metabolic, molecular, and histological information. In this concise review, we introduce the principles and imaging capability of various PA skin imaging technologies. We highlight the representative applications in the past decade with a focus on imaging skin vasculature and melanoma. We also envision the critical technical developments necessary to further accelerate the translation of PAT technologies to fundamental skin research and clinical impacts.

Theragnostic Glycol Chitosan-Conjugated Gold Nanoparticles for Photoacoustic Imaging of Regional Lymph Nodes and Delivering Tumor Antigen to Lymph Nodes

Lymph node mapping is important in cancer immunotherapy because the morphology of lymph nodes is one of the crucial evaluation criteria of immune responses. We developed new theragnostic glycol-chitosan-coated gold nanoparticles (GC-AuNPs), which highlighted lymph nodes in ultrasound-guided photoacoustic (US/PA) imaging. Moreover, the ovalbumin epitope was conjugated GC-AuNPs (OVA-GC-AuNPs) for delivering tumor antigen to lymph node resident macrophage. In vitro studies proved the vigorous endocytosis activity of J774A.1 macrophage and consequent strong photoacoustic signals from them. The macrophages also presented a tumor antigen when OVA-GC-AuNPs were used for cellular uptake. After the lingual injection of GC-AuNPs into healthy mice, cervical lymph nodes were visible in a US/PA imaging system with high contrast. Three-dimensional analysis of lymph nodes revealed that the accumulation of GC-AuNPs in the lymph node increased as the post-injection time passed. Histological analysis showed GC-AuNPs or OVA-GC-AuNPs located in subcapsular and medullar sinuses where macrophages are abundant. Our new theragnostic GC-AuNPs present a superior performance in US/PA imaging of lymph nodes without targeting moieties or complex surface modification. Simultaneously, GC-AuNPs were able to deliver tumor antigens to cause macrophages to present the OVA epitope at targeted lymph nodes, which would be valuable for cancer immunotherapy.

Deep learning for biomedical photoacoustic imaging: A review

Photoacoustic imaging (PAI) is a promising emerging imaging modality that enables spatially resolved imaging of optical tissue properties up to several centimeters deep in tissue, creating the potential for numerous exciting clinical applications. However, extraction of relevant tissue parameters from the raw data requires the solving of inverse image reconstruction problems, which have proven extremely difficult to solve. The application of deep learning methods has recently exploded in popularity, leading to impressive successes in the context of medical imaging and also finding first use in the field of PAI. Deep learning methods possess unique advantages that can facilitate the clinical translation of PAI, such as extremely fast computation times and the fact that they can be adapted to any given problem. In this review, we examine the current state of the art regarding deep learning in PAI and identify potential directions of research that will help to reach the goal of clinical applicability.

Imaging technology of the lymphatic system

The lymphatic system plays critical roles in tissue fluid homeostasis and immunity and has been implicated in the development of many different pathologies, ranging from lymphedema, the spread of cancer to chronic inflammation. In this review, we first summarize the state-of-the-art of lymphatic imaging in the clinic and the advantages and disadvantages of these existing techniques. We then detail recent progress on imaging technology, including advancements in tracer design and injection methods, that have allowed visualization of lymphatic vessels with excellent spatial and temporal resolution in preclinical models. Finally, we describe the different approaches to quantifying lymphatic function that are being developed and discuss some emerging topics for lymphatic imaging in the clinic. Continued advancements in lymphatic imaging technology will be critical for the optimization of diagnostic methods for lymphatic disorders and the evaluation of novel therapies targeting the lymphatic system.

Another decade of photoacoustic imaging

Photoacoustic imaging - a hybrid biomedical imaging modality finding its way to clinical practices. Although the photoacoustic phenomenon was known more than a century back, only in the last two decades it has been widely researched and used for biomedical imaging applications. In this review we focus on the development and progress of the technology in the last decade (2010-2020). From becoming more and more user friendly, cheaper in cost, portable in size, photoacoustic imaging promises a wide range of applications, if translated to clinic. The growth of photoacoustic community is steady, and with several new directions researchers are exploring, it is inevitable that photoacoustic imaging will one day establish itself as a regular imaging system in the clinical practices.

Synchronously Amplified Photoacoustic Image Recovery (SAPhIRe)

In molecular and cellular photoacoustic imaging with exogenous contrast agents, image contrast is plagued by background resulting from endogenous absorbers in tissue. By using optically modulatable nanoparticles, we develop ultra-sensitive photoacoustic imaging by rejecting endogenous background signals and drastically improving signal contrast through time-delayed pump-probe pulsed laser illumination. Gated by prior pump excitation, modulatable photoacoustic (mPA) signals are recovered from unmodulatable background through simple, real-time image processing to yield background-free photoacoustic signal recovery within tissue mimicking phantoms and from ex-vivo tissues. Inherently multimodal, the fluorescence and mPA sensitivity improvements demonstrate the promise of Synchronously Amplified Photoacoustic Image Recovery (SAPhIRe) for PA imaging in diagnosis and therapy.

In Vivo Dual-Modal Photoacoustic and Ultrasound Imaging of Sentinel Lymph Nodes Using a Solid-State Dye Laser System

Photoacoustic imaging (PAI) is being actively investigated as a non-invasive and non-radioactive imaging technique for sentinel lymph node (SLN) biopsy. By taking advantage of optical and ultrasound imaging, PAI probes SLNs non-invasively with methylene blue (MB) in both live animals and breast cancer patients. However, these PAI systems have limitations for widespread use in clinics and commercial marketplaces because the lasers used by the PAI systems, e.g., tunable liquid dye laser systems and optical parametric oscillator (OPO) lasers, are bulky in size, not economical, and use risky flammable and toxic liquid dyes. To overcome these limitations, we are proposing a novel dual-modal photoacoustic and ultrasound imaging system based on a solid-state dye laser (SD-PAUSI), which is compact, convenient, and carries far less risk of flammability and toxicity. Using a solid-state dye handpiece that generates 650-nm wavelength, we successfully imaged the MB tube positioned deeply (~3.9 cm) in chicken breast tissue. The SLNs were also photoacoustically detected in the in vivo rats beneath a 2.2-cm-thick layer of chicken breast, which is deeper than the typical depth of SLNs in humans (1.2 ± 0.5 cm). Furthermore, we showed the multispectral capability of the PAI by switching the dye handpiece, in which the MB-dyed SLN was selectively highlighted from the surrounding vasculature. These results demonstrated the great potential of the SD-PAUSI as an easy but effective modality for SLN detection.

Three-dimensional clinical handheld photoacoustic/ultrasound scanner

Clinical 2D photoacoustic (PA) imaging can be easily implemented in a traditional ultrasound (US) system. However, 3D PA imaging is still preferable because 2D B-mode PA/US imaging suffers from low reproducibility and high-operator dependency. Here, we demonstrate a compact clinical handheld 3D PA/US scanner using an 1D linear array US transducer combined with a mechanical scanning stage working via a Scotch yoke mechanism. The entire scanner measures just 100 × 80 × 100 mm3 and weighs only 950 g, so it can easily be operated by hand. Blood vessels and hemoglobin oxygen saturation images of different parts of the human body (e.g., neck, wrist, thigh, and instep) have been successfully acquired. The system can potentially be used for clinical applications in fields such as oncology, dermatology, nephrology, and internal medicine.

Deep learning improves contrast in low-fluence photoacoustic imaging

Low fluence illumination sources can facilitate clinical transition of photoacoustic imaging because they are rugged, portable, affordable, and safe. However, these sources also decrease image quality due to their low fluence. Here, we propose a denoising method using a multi-level wavelet-convolutional neural network to map low fluence illumination source images to its corresponding high fluence excitation map. Quantitative and qualitative results show a significant potential to remove the background noise and preserve the structures of target. Substantial improvements up to 2.20, 2.25, and 4.3-fold for PSNR, SSIM, and CNR metrics were observed, respectively. We also observed enhanced contrast (up to 1.76-fold) in an in vivo application using our proposed methods. We suggest that this tool can improve the value of such sources in photoacoustic imaging.

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

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

Effective photoacoustic absorption spectrum for collagen-based tissue imaging

SIGNIFICANCE

Collagen is a basic component of many tissues such as tendons, muscles, and skin, and its imaging helps diagnose and monitor treatments in a variety of fields, including orthopedics. However, due to the overlapping peaks of the absorption spectrum with water in the short-wave infrared region (SWIR), it is difficult to select an optimal wavelength and obtain the photoacoustic (PA) image for collagen-based tissues. Therefore, an additional approach to selecting the proper wavelength is needed.

AIM

The aim of this study is to derive an effective PA absorption spectrum of collagen to select the optimal wavelength for high-sensitive PA imaging (PAI).

APPROACH

We measure the absorption spectrum by acquiring the PA signal from various collagen-based samples. To derive an effective PA absorption spectrum in the SWIR band, the following two parameters should be considered: (1) the laser excitation for generating the PA signal and (2) the absorption spectrum for water in the SWIR band. This molecular intrinsic property suggests the optimal wavelength for high-sensitive PAI of collagen-based samples.

RESULTS

PA absorption spectral peaks of collagen were found at wavelengths of 1200, 1550, and 1700 nm. Thereby, the PA signal increased by up to five times compared with the wavelength commonly used in collagen PAI. We applied a pulsed fiber laser with a center wavelength of 1560 nm, and the three-dimensional PA image of a collagen patch was obtained.

CONCLUSIONS

The effective PA absorption spectrum contributes to the improvement of the PA image sensitivity by presenting the optimal wavelength of the target samples.

From Light to Sound: Photoacoustic and Ultrasound Imaging in Fundamental Research of Alzheimer's Disease

Alzheimer's disease (AD) causes severe cognitive dysfunction and has long been studied for the underlining physiological and pathological mechanisms. Several biomedical imaging modalities have been applied, including MRI, PET, and high-resolution optical microscopy, for research purposes. However, there is still a strong need for imaging tools that can provide high spatiotemporal resolutions with relatively deep penetration to enhance our understanding of AD pathology and monitor treatment progress in fundamental research. Photoacoustic (PA) imaging and ultrasound (US) imaging can potentially address these unmet needs in AD research. PA imaging provides functional information with endogenous and/or exogenous contrast, while US imaging provides structural information. Recent studies have demonstrated the ability to monitor physiological parameters in small-animal brains with PA and US imaging as well as the feasibility of using US imaging as a therapeutic tool for AD. This concise review aims to introduce recent advances in AD research using PA and US imaging, provide the fundamentals, and discuss the potentials and challenges for future advances.

Towards Clinical Translation of LED-Based Photoacoustic Imaging: A Review

Photoacoustic imaging, with the capability to provide simultaneous structural, functional, and molecular information, is one of the fastest growing biomedical imaging modalities of recent times. As a hybrid modality, it not only provides greater penetration depth than the purely optical imaging techniques, but also provides optical contrast of molecular components in the living tissue. Conventionally, photoacoustic imaging systems utilize bulky and expensive class IV lasers, which is one of the key factors hindering the clinical translation of this promising modality. Use of LEDs which are portable and affordable offers a unique opportunity to accelerate the clinical translation of photoacoustics. In this paper, we first review the development history of LED as an illumination source in biomedical photoacoustic imaging. Key developments in this area, from point-source measurements to development of high-power LED arrays, are briefly discussed. Finally, we thoroughly review multiple phantom, ex-vivo, animal in-vivo, human in-vivo, and clinical pilot studies and demonstrate the unprecedented preclinical and clinical potential of LED-based photoacoustic imaging.

An economic photoacoustic imaging platform using automatic laser synchronization and inverse beamforming

We present a proof-of-concept of an automatic integration of photoacoustic (PA) imaging on clinical ultrasound (US) imaging platforms. Here we tackle two critical challenges: the laser synchronization and the inaccessibility to the beamformer core embedded in commercial US imaging platform. In particular, the line trigger frequency (LTF) estimation and the asynchronous synthetic aperture inverse beamforming (ASAIB) were developed and evaluated in both k-Wave simulation and phantom experiment. The proposed method is an economical solution to enable PA imaging on a greater number of US equipment to further thrive the PA imaging research community.

3D Monte Carlo simulation of light distribution in mouse brain in quantitative photoacoustic computed tomography

Background

Photoacoustic computed tomography (PACT) detects light-induced ultrasound (US) waves to reconstruct the optical absorption contrast of the biological tissues. Due to its relatively deep penetration (several centimeters in soft tissue), high spatial resolution, and inherent functional sensitivity, PACT has great potential for imaging mouse brains with endogenous and exogenous contrasts, which is of immense interest to the neuroscience community. However, conventional PACT either assumes homogenous optical fluence within the brain or uses a simplified attenuation model for optical fluence estimation. Both approaches underestimate the complexity of the fluence heterogeneity and can result in poor quantitative imaging accuracy.

Methods

To optimize the quantitative performance of PACT, we explore for the first time 3D Monte Carlo (MC) simulation to study the optical fluence distribution in a complete mouse brain model. We apply the MCX MC simulation package on a digital mouse (Digimouse) brain atlas that has complete anatomy information. To evaluate the impact of the brain vasculature on light delivery, we also incorporate the whole-brain vasculature in the Digimouse atlas. k-wave toolbox was used to investigate the effect of inhomogeneous illumination on the reconstructed images and chromophore concentration estimation.

Results

The simulation results clearly show that the optical fluence in the mouse brain is heterogeneous at the global level and can decrease by a factor of five with increasing depth. Moreover, the strong absorption and scattering of the brain vasculature also induce the fluence disturbance at the local level.

Conclusions

Both global and local fluence heterogeneity contributes to the reduced quantitative accuracy of the reconstructed PACT images of mouse brain. Correcting the optical fluence distribution can improve the quantitative accuracy of PACT.

Subcutaneous Lymphatic Vessels in the Lower Extremities: Comparison between Photoacoustic Lymphangiography and Near-Infrared Fluorescence Lymphangiography

Background Detailed visualization of the lymphatic vessels would greatly assist in the diagnosis and monitoring of lymphatic diseases and aid in preoperative planning of lymphedema surgery and postoperative evaluation. Purpose To evaluate the usefulness of photoacoustic imaging (PAI) for obtaining three-dimensional images of both lymphatic vessels and surrounding venules. Materials and Methods In this prospective study, the authors recruited healthy participants from March 2018 to January 2019 and imaged lymphatic vessels in the lower limbs. Indocyanine green (5.0 mg/mL) was injected into the subcutaneous tissue of the first and fourth web spaces of the toes and below the lateral malleolus. After confirmation of the lymphatic flow with near-infrared fluorescence (NIRF) imaging as the reference standard, PAI was performed over a field of view of 270 × 180 mm. Subsequently, the number of enhancing lymphatic vessels was counted in both proximal and distal areas of the calf and compared between PAI and NIRF. Results Images of the lower limbs were obtained with PAI and NIRF in 15 participants (three men, 12 women; average age, 42 years ± 12 [standard deviation]). All participants exhibited a linear pattern on NIRF images, which is generally considered a reflection of good lymphatic function. A greater number of lymphatic vessels were observed with PAI than with NIRF in both the distal (mean: 3.6 vessels ± 1.2 vs 2.0 vessels ± 1.1, respectively; P < .05) and proximal (mean: 6.5 vessels ± 2.6 vs 2.6 vessels ± 1.6; P < .05) regions of the calf. Conclusion Compared with near-infrared fluorescence imaging, photoacoustic imaging provided a detailed, three-dimensional representation of the lymphatic vessels and facilitated an increased understanding of their relationship with the surrounding venules. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Lillis and Krishnamurthy in this issue.

Photoacoustic Imaging for Management of Breast Cancer: A Literature Review and Future Perspectives

In this review article, a detailed chronological account of the research related to photoacoustic imaging for the management of breast cancer is presented. Performing a detailed analysis of the breast cancer detection related photoacoustic imaging studies undertaken by different research groups, this review attempts to present the clinical evidence in support of using photoacoustic imaging for breast cancer detection. Based on the experimental evidence obtained from the clinical studies conducted so far, the performance of photoacoustic imaging is compared with that of conventional breast imaging modalities. While we find that there is enough experimental evidence to support the use of photoacoustic imaging for breast cancer detection, additional clinical studies are required to be performed to evaluate the diagnostic potential of photoacoustic imaging for identifying different types of breast cancer. To establish the utility of photoacoustic imaging for breast cancer screening, clinical studies with high-risk asymptomatic patients need to be done.

Photoacoustic imaging of cells in a three-dimensional microenvironment

Imaging live cells in a three-dimensional (3D) culture system yields more accurate information and spatial visualization of the interplay of cells and the surrounding matrix components compared to using a two-dimensional (2D) cell culture system. However, the thickness of 3D cultures results in a high degree of scattering that makes it difficult for the light to penetrate deeply to allow clear optical imaging. Photoacoustic (PA) imaging is a powerful imaging modality that relies on a PA effect generated when light is absorbed by exogenous contrast agents or endogenous molecules in a medium. It combines a high optical contrast with a high acoustic spatiotemporal resolution, allowing the noninvasive visualization of 3D cellular scaffolds at considerable depths with a high resolution and no image distortion. Moreover, advances in targeted contrast agents have also made PA imaging capable of molecular and cellular characterization for use in preclinical personalized diagnostics or PA imaging-guided therapeutics. Here we review the applications and challenges of PA imaging in a 3D cellular microenvironment. Potential future developments of PA imaging in preclinical applications are also discussed.

Towards clinical photoacoustic and ultrasound imaging: Probe improvement and real-time graphical user interface

Photoacoustic imaging is a non-invasive and non-ionizing biomedical technique that has been investigated widely for various clinical applications. By taking the advantages of conventional ultrasound imaging, hand-held operation with a linear array transducer should be favorable for successful clinical translation of photoacoustic imaging. In this paper, we present new key updates contributed to the previously developed real-time clinical photoacoustic and ultrasound imaging system for improving the clinical usability of the system. We developed a seamless image optimization platform, designed a real-time parameter control software with a user-friendly graphical user interface, performed Monte Carlo simulation of the optical fluence in the imaging plane, and optimized the geometry of the imaging probe. The updated system allows optimizing of all imaging parameters while continuously acquiring the photoacoustic and ultrasound images in real-time. The updated system has great potential to be used in a variety of clinical applications such as assessing the malignancy of thyroid cancer, breast cancer, and melanoma.

Impact statement

Photoacoustic imaging is a promising biomedical imaging modality that can visualize both structural and functional information of biological tissue. Because of its easiness to be integrated with conventional ultrasound imaging systems, numerous studies have been conducted to develop and apply clinical photoacoustic imaging systems. However, most of the systems were not suitable for general-purpose clinical applications due to one of the following reasons: target specific design, immobility, inaccessible operation sequence, and lack of hand-held operation. This study demonstrates a real-time clinical photoacoustic and ultrasound imaging system, which can overcome the limitations of the previous systems for successful clinical translation.

Investigation of light delivery geometries for photoacoustic applications using Monte Carlo simulations with multiple wavelengths, tissue types, and species characteristics

Combined ultrasound and photoacoustic imaging systems are being developed for biomedical and clinical applications. One common probe configuration is to use a linear transducer array with external light delivery to produce coregistered ultrasound and photoacoustic images. The diagnostic capability of these systems is dependent on the effectiveness of light delivery to the imaging target. We use Monte Carlo modeling to investigate the optimal design geometry of an integrated probe. Simulations are conducted with multiple tissue compositions and wavelengths. The effect of a skin layer with the thickness of a mouse or a human is also considered. The model was validated using a tissue-mimicking gelatin phantom and corresponding Monte Carlo simulations. The optimal illumination angle is shallower with human skin thickness, whereas intermediate angles are ideal with mouse skin thickness. The effect of skin thickness explains differences in the results of prior work. The simulations also indicate that even with identical hardware and imaging parameters, light delivery will be up to 3  ×   smaller in humans than in mice, due to the increased scattering from thicker skin. Our findings have clear implications for the many researchers using mice to test and develop imaging methods for clinical translation.

Three-dimensional interventional photoacoustic imaging for biopsy needle guidance with a linear array transducer

Needle placement is important for many clinical interventions, such as tissue biopsy, regional anesthesia and drug delivery. It is essential to visualize the spatial position of the needle and the target tissue during the interventions using appropriate imaging techniques. Based on the contrast of optical absorption, photoacoustic imaging is well suited for the guidance of interventional procedures. However, conventional photoacoustic imaging typically provides two-dimensional (2D) slices of the region of interest and could only visualize the needle and the target when they are within the imaging plane of the probe at the same time. This requires great alignment skill and effort. To ease this problem, we developed a 3D interventional photoacoustic imaging technique by fast scanning a linear array ultrasound probe and stitching acquired image slices. in vivo sentinel lymph node biopsy experiment shows that the technique could precisely locate a needle and a sentinel lymph node in a tissue volume while a perfusion experiment demonstrates that the technique could visualize the 3D distribution of injected methylene blue dye underneath the skin at high temporal and spatial resolution. The proposed technique provides a practical way for photoacoustic image-guided interventions.

Enhanced contrast acoustic-resolution photoacoustic microscopy using double-stage delay-multiply-and-sum beamformer for vasculature imaging

In acoustic-resolution photoacoustic microscopy (AR-PAM) systems, the lateral resolution in the focal zone of the ultrasound (US) transducer is determined by the numerical aperture (NA) of the transducer. To have a high lateral resolution, a large NA is used. However, the larger the NA, the smaller the depth of focus [DOF]. As a result, the lateral resolution is deteriorated at depths out of the focal region. The synthetic aperture focusing technique (SAFT) along with a beamformer can be used to improve the resolution outside the focal region. In this work, for image formation in AR-PAM, we propose the double-stage delay-multiply-and-sum (DS_DMAS) algorithm to be combined with SAFT. The proposed method is evaluated experimentally using hair targets and in vivo vasculature imaging. It is shown that DS_DMAS provides a higher resolution and contrast compared to other methods. For the B-mode images obtained using the hair phantom, the proposed method reduces the average noise level for all the depths by about 134%, 57% and 23%, compared to the original low- resolution, SAFT+DAS and SAFT+DMAS methods, respectively. All the results indicate that the proposed method can be an appropriate algorithm for image formation in AR-PAM systems.

Review on practical photoacoustic microscopy

Photoacoustic imaging (PAI) has many interesting advantages, such as deep imaging depth, high image resolution, and high contrast to intrinsic and extrinsic chromophores, enabling morphological, functional, and molecular imaging of living subjects. Photoacoustic microscopy (PAM) is one form of the PAI inheriting its characteristics and is useful in both preclinical and clinical research. Over the years, PAM systems have been evolved in several forms and each form has its relative advantages and disadvantages. Thus, to maximize the benefits of PAM for a specific application, it is important to configure the PAM system optimally by targeting a specific application. In this review, we provide practical methods for implementing a PAM system to improve the resolution, signal-to-noise ratio (SNR), and imaging speed. In addition, we review the preclinical and the clinical applications of PAM and discuss the current challenges and the scope for future developments.

Cell penetrating peptide-modified nanoparticles for tumor targeted imaging and synergistic effect of sonodynamic/HIFU therapy

Background

Theranostics based on multifunctional nanoparticles (NPs) is a promising field that combines therapeutic and diagnostic functionalities into a single nanoparticle system. However, the major challenges that lie ahead are how to achieve accurate early diagnosis and how to develop efficient and noninvasive treatment. Sonodynamic therapy (SDT) utilizing ultrasound combined with a sonosensitizer represents a novel noninvasive modality for cancer therapy. Different ultrasound frequencies have been used for SDT, nevertheless, whether the effect of SDT can enhance synergistic HIFU ablation remains to be investigated.

Materials and methods

We prepared a nanosystem for codelivery of a sonosensitizer (methylene blue, MB) and a magnetic resonance contrast agent (gadodiamide, Gd-DTPA-BMA) based on hydrophilic biodegradable polymeric NPs composed of poly (lactic-co-glycolic acid) (PLGA). To enhance accumulation and penetration of the NPs at the tumor site, the surface of PLGA NPs was decorated with a tumor-homing and penetrating peptide-F3 and polyethylene glycol (PEG). The physicochemical, imaging and therapeutic properties of F3-PLGA@MB/Gd and drug safety were thoroughly evaluated both in vitro and in vivo. F3-PLGA@MB/Gd was evaluated by both photoacoustic and resonance imaging.

Results

F3-PLGA@MB/Gd NPs exhibited higher cellular association than non-targeted NPs and showed a more preferential enrichment at the tumor site. Furthermore, with good drug safety, the apoptosis triggered by ultrasound in the F3-PLGA@MB/Gd group was greater than that in the contrast group.

Conclusion

F3-PLGA@MB/Gd can work as a highly efficient theranostic agent, and the incorporation of targeted multimodal and combined therapy could be an encouraging strategy for cancer treatment.

Impacts of the murine skull on high-frequency transcranial photoacoustic brain imaging

Non-invasive photoacoustic tomography (PAT) of mouse brains with intact skulls has been a challenge due to the skull's strong acoustic attenuation, aberration, and reverberation, especially in the high-frequency range (>15 MHz). In this paper, we systematically investigated the impacts of the murine skull on the photoacoustic wave propagation and on the PAT image reconstruction. We studied the photoacoustic acoustic wave aberration due to the acoustic impedance mismatch at the skull boundaries and the mode conversion between the longitudinal wave and shear wave. The wave's reverberation within the skull was investigated for both longitudinal and shear modes. In the inverse process, we reconstructed the transcranial photoacoustic computed tomography (PACT) and photoacoustic microscopy (PAM) images of a point target enclosed by the mouse skull, showing the skull's different impacts on both modalities. Finally, we experimentally validated the simulations by imaging an in vitro mouse skull phantom using representative transcranial PAM and PACT systems. The experimental results agreed well with the simulations and confirmed the accuracy of our forward and inverse models. We expect that our results will provide better understanding of the impacts of the murine skull on transcranial photoacoustic brain imaging and pave the ways for future technical improvements.

Ultrasound-guided immunofunctional photoacoustic imaging for diagnosis of lymph node metastases

Metastases, rather than primary tumors, determine mortality in the majority of cancer patients. A non-invasive immunofunctional imaging method was developed to detect sentinel lymph node (SLN) metastases using ultrasound-guided photoacoustic (USPA) imaging combined with glycol-chitosan-coated gold nanoparticles (GC-AuNPs) as an imaging contrast agent. GC-AuNPs, injected peritumorally into breast tumor-bearing mice, were taken up by immune cells, and subsequently transported to the SLN. Two-dimensional and three-dimensional USPA imaging was used to isolate the signal from GC-AuNP-tagged cells. Volumetric analysis was used to quantify GC-AuNP accumulation in the SLN after cellular uptake and transport by immune cells. The results show that the spatio-temporal distribution of GC-AuNPs in the SLN was affected by the presence of metastases. The parameter describing the spatial distribution of GC-AuNP-tagged cells within the SLN was more than 2-fold lower in metastatic lymph nodes compared with non-metastatic controls. Histological analysis confirmed that the distribution of GC-AuNP-tagged immune cells is changed by the presence of metastatic cells. The USPA immunofunctional imaging successfully distinguished metastatic from non-metastatic lymph nodes using biocompatible nanoparticles. This method could aid physicians in the detection of micrometastases, thus guiding SLN biopsy and avoiding unnecessary biopsy procedures.

Photoacoustic clinical imaging

Photoacoustic is an emerging biomedical imaging modality, which allows imaging optical absorbers in the tissue by acoustic detectors (light in - sound out). Such a technique has an immense potential for clinical translation since it allows high resolution, sufficient imaging depth, with diverse endogenous and exogenous contrast, and is free from ionizing radiation. In recent years, tremendous developments in both the instrumentation and imaging agents have been achieved. These opened avenues for clinical imaging of various sites allowed applications such as brain functional imaging, breast cancer screening, diagnosis of psoriasis and skin lesions, biopsy and surgery guidance, the guidance of tumor therapies at the reproductive and urological systems, as well as imaging tumor metastases at the sentinel lymph nodes. Here we survey the various clinical and pre-clinical literature and discuss the potential applications and hurdles that still need to be overcome.

Photonic cancer nanomedicine using the near infrared-II biowindow enabled by biocompatible titanium nitride nanoplatforms

Light-activated photoacoustic imaging (PAI) and photothermal therapy (PTT) using the second near-infrared biowindow (NIR-II, 1000-1350 nm) hold great promise for efficient tumor detection and diagnostic imaging-guided photonic nanomedicine. In this work, we report on the construction of titanium nitride (TiN) nanoparticles, with a high photothermal-conversion efficiency and desirable biocompatibility, as an alternative theranostic agent for NIR-II laser-excited photoacoustic (PA) imaging-guided photothermal tumor hyperthermia. Working within the NIR-II biowindow provides a larger maximum permissible exposure (MPE) and desirable penetration depth of the light, which then allows detection of the tumor to the full extent using PA imaging and complete tumor ablation using photothermal ablation, especially in deeper regions. After further surface polyvinyl-pyrrolidone (PVP) modification, the TiN-PVP photothermal nanoagents exhibited a high photothermal conversion efficiency of 22.8% in the NIR-II biowindow, and we further verified their high penetration depth using the NIR-II biowindow and their corresponding therapeutic effect on the viability of tumor cells in vitro. Furthermore, these TiN-PVP nanoparticles were developed as a contrast agent for NIR-II-activated PA imaging both in vitro and in vivo for the first time and realized efficient photothermal ablation of the tumor in vivo within both the NIR-I and NIR-II biowindows. This work not only provides a paradigm for TiN-PVP photothermal nanoagents working in the NIR-II biowindow both in vitro and in vivo, but also proves the feasibility of PAI and PTT cancer theranostics using NIR-II laser excitation.

Design and Fabrication of a Miniaturized Convex Array for Combined Ultrasound and Photoacoustic Imaging of the Prostate

Although transrectal ultrasound (TRUS) imaging is widely used for screening and diagnosing prostate cancer, it is often not found on TRUS images, depending on its stage, size, and location. In addition, due to the weak echo signal and the low contrast of TRUS images, it is difficult to diagnose early-stage prostate cancers and distinguish malignant tumors from benign prostatic hyperplasia. For this reason, TRUS image-guided biopsy is mandatory to confirm the malignancy of the suspicious tumor, but the diagnostic accuracy of initial biopsy is only 20%-30%, so that the patients inevitably undergo repeated biopsies. TRUS-photoacoustic (TRUS-PA) imaging is one way to resolve those problems. However, the development of a TRUS-PA probe, in which an ultrasound array transducer and optical fibers are integrated, is demanding because the overall size of the probe should be as small as possible for the convenience of the patients, while providing the desired performances. Here, we report a recently developed TRUS-PA probe. The core element of the TRUS-PA is a miniaturized 128-element, 7-MHz convex array transducer of which size in the lateral and elevational directions is 11.4 and 5 mm, respectively. A new concept of a flexible printed circuit board was also developed to limit the size of the TRUS-PA probe to less than 15 mm. From the performance evaluation, it was found that the developed array with a field-of-view of 134° has a center frequency of 6.75 MHz, a -6-dB fractional bandwidth of 66%, and a crosstalk of less than -45 dB. In the tissue-mimicking phantom test and ex vivo experiments, the miniaturized convex array proved to be capable of providing combined US and PA images with acceptable imaging quality in spite of its small size.

Small Molecule Optoacoustic Contrast Agents: An Unexplored Avenue for Enhancing In Vivo Imaging

Almost every variety of medical imaging technique relies heavily on exogenous contrast agents to generate high-resolution images of biological structures. Organic small molecule contrast agents, in particular, are well suited for biomedical imaging applications due to their favorable biocompatibility and amenability to structural modification. PET/SPECT, MRI, and fluorescence imaging all have a large host of small molecule contrast agents developed for them, and there exists an academic understanding of how these compounds can be developed. Optoacoustic imaging is a relatively newer imaging technique and, as such, lacks well-established small molecule contrast agents; many of the contrast agents used are the same ones which have found use in fluorescence imaging applications. Many commonly-used fluorescent dyes have found successful application in optoacoustic imaging, but others generate no detectable signal. Moreover, the structural features that either enable a molecule to generate a detectable optoacoustic signal or prevent it from doing so are poorly understood, so design of new contrast agents lacks direction. This review aims to compile the small molecule optoacoustic contrast agents that have been successfully employed in the literature to bridge the information gap between molecular design and optoacoustic signal generation. The information contained within will help to provide direction for the future synthesis of optoacoustic contrast agents.

A Mechanistic Investigation of Methylene Blue and Heparin Interactions and Their Photoacoustic Enhancement

We recently reported a real-time method to measure heparin in human whole blood based on the photoacoustic change of methylene blue (MB). Intriguingly, the MB behaved unlike other "turn on" photoacoustic probes-the absorbance decreased as the photoacoustic signal increased. The underlying mechanism was not clear and motivated this study. We studied the binding mechanism of MB and heparin in water and phosphate buffer saline (PBS) with both experimental and computational methods. We found that the photoacoustic enhancement of the MB-heparin mixture was a result of MB-heparin aggregation due to charge neutralization and resulting sequestration of MB in these aggregates. The sequestration of MB in the MB-heparin aggregates led to decreased absorbance-there was simply less free dye in solution to absorb light. The highest photoacoustic signal and aggregation occurred when the number of negatively charged sulfate groups on heparin was approximately equal to the number of positively charged MB molecule. The MB-heparin aggregates dissociated when there were more sulfated groups from heparin than MB molecules because of the electrostatic repulsion between negatively charged sulfate groups. PBS facilitated MB dimer formation regardless of heparin concentration and reprecipitated free MB in aggregates due to ionic strength and ionic shielding. Further molecular dynamics experiments found that binding of heparin occurred at the sulfates and glucosamines in heparin. Phosphate ions could interact with the heparin via sodium ions to impair the MB-heparin binding. Finally, our model found 3.7-fold more MB dimerization upon addition of heparin in MB solution confirming that heparin facilitates MB aggregation. We conclude that the addition of heparin in MB decreases the absorbance of the sample because of MB-heparin aggregation leading to fewer MB molecules in solution; however, the aggregation also increases the PA intensity because the MB molecules in the MB-heparin aggregate have reduced degrees of freedom and poor heat transfer to solvent.

Compact and low-cost handheld quasibright-field linear-array probe design in photoacoustic computed tomography

The optimal photoacoustic probe design is the key to obtain highest imaging sensitivity in photoacoustic computed tomography. Two commonly used probe design types are dark- and bright-field designs. We proposed a design for photoacoustic probe called quasibright-field illumination and compared the performance of all three kinds of probes theoretically and experimentally. Our conclusion is that the proposed quasibright-field illumination photoacoustic probe is superior compared to the existing probe designs as demonstrated. However, each type of illumination should still have its own advantages under certain circumstances. The dark-field illumination is capable of minimizing surface interference signals and reducing their contributions to the background of deeper signals. Hence, it should perform better when imaging samples with high optical absorbance at the surface layer. The bright field may perform better under circumstance when phase distortion is less. We also designed and fabricated three kinds of probes using a single multimode optical fiber for laser energy delivery instead of fiber bundle. Single fiber probes are low cost, transmit laser energy efficiently, and are compact for easy handling. Thus, our study not only provides a method for probe design but also a guidance for cost-effective transducer array-based photoacoustic probe design and manufacturing in the future.

Optimizing the light delivery of linear-array-based photoacoustic systems by double acoustic reflectors

Although linear transducer arrays have been intensely used in photoacoustic imaging, their geometrical shape constrains light illumination. Today, most linear array based photoacoustic systems utilize side-illumination geometry, which consists of two line fiber bundles attached to the side of the probe. The angled light illumination increases the light travel distance in deep tissue, consequently limiting the imaging depth. This issue was partially addressed by adding a right angle prism in front of the transducer. While this design makes the light illumination and acoustic detection co-axial, the transducer and the fiber bundles are orthogonal to each other, making the system inconvenient for handheld use. To overcome this limitation, here we propose a double-reflector design, in which the second reflector redirects the acoustic signals by another 90°, so that the transducer and the fiber bundle are now parallel to each other. In this design, both the transducer and fiber bundle output are fitted into a compact housing for convenient handheld imaging. To evaluate the efficiency of our design, we performed various phantom and human in vivo experiments. Our results demonstrate that the double-reflector design indeed provides deeper imaging depth and it also allows for easy imaging of objects with uneven surfaces.

Highly Sensitive Fluorescence and Photoacoustic Detection of Metastatic Breast Cancer in Mice Using Dual-Modal Nanoprobes

The biomedical imaging of metastatic breast cancer, especially in lymphatic and lung metastasis, is highly significant in cancer staging as it helps assess disease prognosis and treatment. Using an albumin-indocyanine green dual-modal nanoprobe developed in our laboratory, in vivo fluorescence imaging and photoacoustic imaging of metastatic breast cancer tumors were performed separately. Fluorescence imaging at the near-infrared window features high imaging sensitivity but is generally limited by a low imaging depth. Thus, tumors can only be observed in situ whereas tumor cells in the lymph nodes and lung cannot be imaged in a precise manner. In contrast, photoacoustic imaging often helps overcome the limitations of imaging depth with high acoustic spatial resolution, which could provide complementary information for imaging cancer metastases. Ex vivo fluorescence and photoacoustic imaging were also performed to verify the tumor metastatic route. This study may not only provide insights into the design of dual-modal nanoprobes for breast cancer diagnosis but may also demonstrate the superiority of combined fluorescence imaging and photoacoustic imaging for guiding, monitoring, and evaluating lymphatic and lung metastatic stages of breast cancer with a high imaging specificity as well as sensitivity.