Efficacy of High Temporal Frequency Photoacoustic Guidance of Laser Ablation Procedures

Ultrasound and Photoacoustic Imaging for the Guidance of Laser Ablation Procedures

The accuracy and efficacy of laser ablation procedures depend on the accurate placement of the laser applicator within the diseased tissue, monitoring the real-time temperature during the ablation procedure, and mapping the extent of the ablated region. Ultrasound (US) imaging has been widely used to guide ablation procedures. While US imaging offers significant advantages for guiding ablation procedures, its limitations include low imaging contrast, angular dependency, and limited ability to monitor the temperature. Photoacoustic (PA) imaging is a relatively new imaging modality that inherits the advantages of US imaging and offers enhanced capabilities for laser-guided ablations, such as accurate, angle-independent tracking of ablation catheters, the potential for quantitative thermometry, and monitoring thermal lesion formation. This work provides an overview of ultrasound-guided procedures and how different US-related artifacts limit their utility, followed by introducing PA as complementary to US as a solution to address the existing limitations and improve ablation outcomes. Furthermore, we highlight the integration of PA-driven features into existing US-guided laser ablation systems, along with their limitations and future outlooks. Integrated US/PA-guided laser ablation procedures can lead to safer and more precise treatment outcomes.

Integrated Ultrasound and Photoacoustic-Guided Laser Ablation Theranostic Endoscopic System

Advancements in ablation techniques have paved the way towards the development of safer and more effective clinical procedures for treating various maladies such as atrial fibrillation (AF). AF is characterized by rapid, chaotic atrial activation and is commonly treated using radiofrequency applicators or laser ablation catheters. However, the lack of thermal lesion formation and temperature monitoring capabilities in these devices prevents them from measuring the treatment outcome directly. In addition, poor differentiation between healthy and ablated tissues leads to incomplete ablation, which reduces safety and causes complications in patients. Hence, a novel photoacoustic (PA)-guided laser ablation theranostic device was developed around a traditional phased-array endoscope. The proposed technology provides lesion formation, tissue distinguishing, and temperature monitoring capabilities. Our results have validated the lesion monitoring capability of the proposed technology through PA correlation maps. The tissue distinguishing capability of the theranostic device was verified by the measurable differences in the PA signal between pre-and post-ablated mice myocardial tissue. The increase in the PA signal with temperature variations caused by the ablation laser confirmed the ability of the proposed device to provide temperature feedback.

Optimized Reconstruction Procedure of Photoacoustic Imaging for Reflection Artifacts Reduction

Photoacoustic (PA) imaging technology is of some value in medical diagnoses such as breast cancer detection, vasculature imaging, and surgery navigating. While as most imaging objects are bounded, the received RF signals consist of the direct-arrived signals (DAS) from the PA sources and the boundary-reflected signals (BRS). The undesired BRS will severely impair the quality during the image reconstruction. They will bring in many artifacts and confuse the actual shape and location of the PA sources. We improved the reconstruction procedure by removing the BRS before the regular reconstruction process to suppress those artifacts. To verify our proposed method, we compared the results of the conventional and optimized procedures experimentally. In terms of qualitative observation, the reconstructed images by the optimized procedure illustrate fewer artifacts and more accurate shapes of the PA sources. To quantitatively evaluate the traditional and the optimized imaging procedure, we calculated the Distribution Relative Error (DRE) between each experiment result and its standard drawing of the phantoms. For both phantoms and the ex-vivo sample, the DREs of reconstruction result by the optimized reconstruction procedure decrease significantly. The results suggest that the optimized reconstruction process can effectively suppress the reflection artifacts and improve the shape accuracy of the PA sources.

Photoacoustic-guided endovenous laser ablation: Characterization and in vivo canine study

Endovenous laser ablation (EVLA) is a minimally invasive surgical procedure, often guided by ultrasound (US) imaging, for treating venous insufficiencies. US imaging limitations in accurately visualizing the catheter and the lack of a temperature monitoring system can lead to sub-optimal outcomes. An integrated photoacoustic (PA)-guided EVLA system has been previously developed and reported to overcome the shortcomings of US-guided procedure. In this study, we further characterized the system and tested the in vivo utility. In addition, PA thermometry was further explored by compensating the variation of PA signal with temperature with respect to the temperature-dependent absorption of blood and water. In vivo imaging results indicated that the PA-guided EVLA system can provide high contrast and accurate images of the ablation catheter tip overlaid on US images of the background tissue. Additionally, absorption-compensated PA signal amplitudes over a relevant range of temperature were measured and demonstrated.