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Li T, Xu G, Li W, Liu Y. A systematic review and meta-analysis of randomized controlled trials comparing low-dose versus standard-dose computed tomography-guided lung biopsy. J Cardiothorac Surg 2024; 19:297. [PMID: 38778306 PMCID: PMC11110412 DOI: 10.1186/s13019-024-02792-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 05/18/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Despite the existence of several Randomized Controlled Trials (RCTs) investigating Low-Dose Computed Tomography (LDCT) as a guide in lung biopsies, conclusive findings remain elusive. To address this contention, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of LDCT-guided lung biopsies. METHODS A comprehensive search across major databases identified RCTs comparing the effectiveness of LDCT-guided with Standard-Dose Computed Tomography (SDCT)-guided lung biopsies. Subsequently, we utilized a random-effects model meta-analysis to assess diagnostic accuracy, radiation dose, operation duration, and clinical complications associated with these procedures. RESULTS Out of 292 scrutinized studies, six RCTs representing 922 patients were included in the final analysis. Results indicated the differences between the LDCT and SDCT groups were not different with statistical significance in terms of diagnostic accuracy rates (Intent-to-Treat (ITT) populations: Relative Risk (RR) 1.01, 95% Confidence interval [CI] 0.97-1.06, p = 0.61; Per-Protocol (PP) populations: RR 1.01, 95% CI 0.98-1.04, p = 0.46), incidence of pneumothorax (RR 1.00, 95% CI 0.75-1.35, p = 0.98), incidence of hemoptysis (RR 0.95, 95% CI 0.63-1.43, p = 0.80), and operation duration (minutes) (Mean Differences [MD] -0.34, 95% CI -1.67-0.99, p = 0.61). Notably, LDCT group demonstrated a lower radiation dose (mGy·cm) with statistical significance (MD -188.62, 95% CI -273.90 to -103.34, p < 0.0001). CONCLUSIONS The use of LDCT in lung biopsy procedures demonstrated equivalent efficacy and safety to standard methods while notably reducing patient radiation exposure.
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Affiliation(s)
- Teng Li
- Department of Interventional Radiology, The People's Hospital of Weifang, 151 Guangwen Street, Weifang, Shandong, 261041, China
| | - Guanghui Xu
- Department of Interventional Radiology, The People's Hospital of Weifang, 151 Guangwen Street, Weifang, Shandong, 261041, China
| | - Wenjun Li
- Department of Interventional Radiology, The People's Hospital of Weifang, 151 Guangwen Street, Weifang, Shandong, 261041, China
| | - Yun Liu
- Department of Hematology, The People's Hospital of Weifang, 151 Guangwen Street, Weifang, Shandong, 261041, China.
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Nozdriukhin D, Kalva SK, Özsoy C, Reiss M, Li W, Razansky D, Deán‐Ben XL. Multi-Scale Volumetric Dynamic Optoacoustic and Laser Ultrasound (OPLUS) Imaging Enabled by Semi-Transparent Optical Guidance. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306087. [PMID: 38115760 PMCID: PMC10953719 DOI: 10.1002/advs.202306087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/05/2023] [Indexed: 12/21/2023]
Abstract
Major biological discoveries are made by interrogating living organisms with light. However, the limited penetration of un-scattered photons within biological tissues limits the depth range covered by optical methods. Deep-tissue imaging is achieved by combining light and ultrasound. Optoacoustic imaging exploits the optical generation of ultrasound to render high-resolution images at depths unattainable with optical microscopy. Recently, laser ultrasound has been suggested as a means of generating broadband acoustic waves for high-resolution pulse-echo ultrasound imaging. Herein, an approach is proposed to simultaneously interrogate biological tissues with light and ultrasound based on layer-by-layer coating of silica optical fibers with a controlled degree of transparency. The time separation between optoacoustic and ultrasound signals collected with a custom-made spherical array transducer is exploited for simultaneous 3D optoacoustic and laser ultrasound (OPLUS) imaging with a single laser pulse. OPLUS is shown to enable large-scale anatomical characterization of tissues along with functional multi-spectral imaging of chromophores and assessment of cardiac dynamics at ultrafast rates only limited by the pulse repetition frequency of the laser. The suggested approach provides a flexible and scalable means for developing a new generation of systems synergistically combining the powerful capabilities of optoacoustics and ultrasound imaging in biology and medicine.
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Affiliation(s)
- Daniil Nozdriukhin
- Institute of Pharmacology and Toxicology and Institute for Biomedical EngineeringFaculty of MedicineUniversity of ZürichWinterthurerstrasse 190Zürich8057Switzerland
- Institute for Biomedical Engineering, Department of Information Technology and Electrical EngineeringETH ZürichWolfgang‐Pauli‐Strasse 27Zürich8093Switzerland
| | - Sandeep Kumar Kalva
- Institute of Pharmacology and Toxicology and Institute for Biomedical EngineeringFaculty of MedicineUniversity of ZürichWinterthurerstrasse 190Zürich8057Switzerland
- Institute for Biomedical Engineering, Department of Information Technology and Electrical EngineeringETH ZürichWolfgang‐Pauli‐Strasse 27Zürich8093Switzerland
| | - Cagla Özsoy
- Institute of Pharmacology and Toxicology and Institute for Biomedical EngineeringFaculty of MedicineUniversity of ZürichWinterthurerstrasse 190Zürich8057Switzerland
- Institute for Biomedical Engineering, Department of Information Technology and Electrical EngineeringETH ZürichWolfgang‐Pauli‐Strasse 27Zürich8093Switzerland
| | - Michael Reiss
- Institute of Pharmacology and Toxicology and Institute for Biomedical EngineeringFaculty of MedicineUniversity of ZürichWinterthurerstrasse 190Zürich8057Switzerland
- Institute for Biomedical Engineering, Department of Information Technology and Electrical EngineeringETH ZürichWolfgang‐Pauli‐Strasse 27Zürich8093Switzerland
| | - Weiye Li
- Institute of Pharmacology and Toxicology and Institute for Biomedical EngineeringFaculty of MedicineUniversity of ZürichWinterthurerstrasse 190Zürich8057Switzerland
- Institute for Biomedical Engineering, Department of Information Technology and Electrical EngineeringETH ZürichWolfgang‐Pauli‐Strasse 27Zürich8093Switzerland
| | - Daniel Razansky
- Institute of Pharmacology and Toxicology and Institute for Biomedical EngineeringFaculty of MedicineUniversity of ZürichWinterthurerstrasse 190Zürich8057Switzerland
- Institute for Biomedical Engineering, Department of Information Technology and Electrical EngineeringETH ZürichWolfgang‐Pauli‐Strasse 27Zürich8093Switzerland
| | - Xosé Luís Deán‐Ben
- Institute of Pharmacology and Toxicology and Institute for Biomedical EngineeringFaculty of MedicineUniversity of ZürichWinterthurerstrasse 190Zürich8057Switzerland
- Institute for Biomedical Engineering, Department of Information Technology and Electrical EngineeringETH ZürichWolfgang‐Pauli‐Strasse 27Zürich8093Switzerland
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Kilian HI, Zhang H, Shiraz Bhurwani MM, Nilam AM, Seong D, Jeon M, Ionita CN, Xia J, Lovell JF. Barium sulfate and pigment admixture for photoacoustic and x-ray contrast imaging of the gut. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:082803. [PMID: 36776721 PMCID: PMC9917716 DOI: 10.1117/1.jbo.28.8.082803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Significance X-ray imaging is frequently used for gastrointestinal imaging. Photoacoustic imaging (PAI) of the gastrointestinal tract is an emerging approach that has been demonstrated for preclinical imaging of small animals. A contrast agent active in both modalities could be useful for imaging applications. Aim We aimed to develop a dual-modality contrast agent comprising an admixture of barium sulfate with pigments that absorb light in the second near-infrared region (NIR-II), for preclinical imaging with both x-ray and PAI modalities. Approach Eleven different NIR-II dyes were evaluated after admixture with a 40% w/v barium sulfate mixture. The resulting NIR-II absorption in the soluble fraction and in the total mixture was characterized. Proof-of-principle imaging studies in mice were carried out. Results Pigments that produced more uniform suspensions were assessed further for photoacoustic contrast signal at a wavelength of 1064 nm that corresponds to the output of the Nd:YAG laser used. Phantom imaging studies demonstrated that the pigment-barium sulfate mixture generated imaging contrast in both x-ray and PAI modalities. The optimal pigment selected for further study was a cyanine tetrafluoroborate salt. Ex-vivo and whole-body mouse imaging demonstrated that photoacoustic and x-ray contrast signals co-localized in the intestines for both imaging modalities. Conclusion These data demonstrate that commercially-available NIR-II pigments can simply be admixed with barium sulfate to generate a dual-modality contrast agent appropriate for small animal gastrointestinal imaging.
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Affiliation(s)
- Hailey I Kilian
- University at Buffalo, State University of New York, Department of Biomedical Engineering, Buffalo, New York, United States
| | - Huijuan Zhang
- University at Buffalo, State University of New York, Department of Biomedical Engineering, Buffalo, New York, United States
| | - Mohammad Mahdi Shiraz Bhurwani
- University at Buffalo, State University of New York, Department of Biomedical Engineering, Buffalo, New York, United States
- Canon Stroke and Vascular Research Center, Buffalo, New York, United States
| | - Anoop M Nilam
- University at Buffalo, State University of New York, Department of Biomedical Engineering, Buffalo, New York, United States
| | - Daewoon Seong
- Kyungpook National University, College of IT Engineering, School of Electronic and Electrical Engineering, Daegu, Republic of Korea
| | - Mansik Jeon
- Kyungpook National University, College of IT Engineering, School of Electronic and Electrical Engineering, Daegu, Republic of Korea
| | - Ciprian N Ionita
- University at Buffalo, State University of New York, Department of Biomedical Engineering, Buffalo, New York, United States
- Canon Stroke and Vascular Research Center, Buffalo, New York, United States
| | - Jun Xia
- University at Buffalo, State University of New York, Department of Biomedical Engineering, Buffalo, New York, United States
| | - Jonathan F Lovell
- University at Buffalo, State University of New York, Department of Biomedical Engineering, Buffalo, New York, United States
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Li M, Beaumont N, Ma C, Rojas J, Vu T, Harlacher M, O'Connell G, Gessner RC, Kilian H, Kasatkina L, Chen Y, Huang Q, Shen X, Lovell JF, Verkhusha VV, Czernuszewicz T, Yao J. Three-Dimensional Deep-Tissue Functional and Molecular Imaging by Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT). IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:2704-2714. [PMID: 35442884 PMCID: PMC9563100 DOI: 10.1109/tmi.2022.3168859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Non-invasive small-animal imaging technologies, such as optical imaging, magnetic resonance imaging and x -ray computed tomography, have enabled researchers to study normal biological phenomena or disease progression in their native conditions. However, existing small-animal imaging technologies often lack either the penetration capability for interrogating deep tissues (e.g., optical microscopy), or the functional and molecular sensitivity for tracking specific activities (e.g., magnetic resonance imaging). To achieve functional and molecular imaging in deep tissues, we have developed an integrated photoacoustic, ultrasound and acoustic angiographic tomography (PAUSAT) system by seamlessly combining light and ultrasound. PAUSAT can perform three imaging modes simultaneously with complementary contrast: high-frequency B-mode ultrasound imaging of tissue morphology, microbubble-enabled acoustic angiography of tissue vasculature, and multi-spectral photoacoustic imaging of molecular probes. PAUSAT can provide three-dimensional (3D) multi-contrast images that are co-registered, with high spatial resolutions at large depths. Using PAUSAT, we performed proof-of-concept in vivo experiments on various small animal models: monitoring longitudinal development of placenta and embryo during mouse pregnancy, tracking biodistribution and metabolism of near-infrared organic dye on the whole-body scale, and detecting breast tumor expressing genetically-encoded photoswitchable phytochromes. These results have collectively demonstrated that PAUSAT has broad applicability in biomedical research, providing comprehensive structural, functional, and molecular imaging of small animal models.
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Ren D, Li C, Shi J, Chen R. A Review of High-Frequency Ultrasonic Transducers for Photoacoustic Imaging Applications. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:1848-1858. [PMID: 34941509 DOI: 10.1109/tuffc.2021.3138158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Photoacoustic imaging (PAI) is a new and rapidly growing hybrid biomedical imaging modality that combines the virtues of both optical and ultrasonic (US) imaging. The nature of the interaction between light and ultrasound waves allows PAI to make good use of the rich contrast produced by optics while retaining the imaging depths in US imaging. High-frequency US transducers are an important part of the PAI systems, used to detect the high-frequency and broad-bandwidth photoacoustic signals excited by the target tissues irradiated by short laser pulses. Advancement in high-frequency US transducer technology has influenced the boost of PAI to broad applications. Here, we present a review on high-frequency US transducer technologies for PAI applications, including advanced piezoelectric materials and representative transducers. In addition, we discuss the new challenges and directions facing the development of high-frequency US transducers for PAI applications.
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Abstract
Photoacoustic imaging is a new type of noninvasive, nonradiation imaging modality that combines the deep penetration of ultrasonic imaging and high specificity of optical imaging. Photoacoustic imaging systems employing conventional ultrasonic sensors impose certain constraints such as obstructions in the optical path, bulky sensor size, complex system configurations, difficult optical and acoustic alignment, and degradation of signal-to-noise ratio. To overcome these drawbacks, an ultrasonic sensor in the optically transparent form has been introduced, as it enables direct delivery of excitation light through the sensors. In recent years, various types of optically transparent ultrasonic sensors have been developed for photoacoustic imaging applications, including optics-based ultrasonic sensors, piezoelectric-based ultrasonic sensors, and microelectromechanical system-based capacitive micromachined ultrasonic transducers. In this paper, the authors review representative transparent sensors for photoacoustic imaging applications. In addition, the potential challenges and future directions of the development of transparent sensors are discussed.
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Yao J, Wang LV. Perspective on fast-evolving photoacoustic tomography. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210105-PERR. [PMID: 34196136 PMCID: PMC8244998 DOI: 10.1117/1.jbo.26.6.060602] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/17/2021] [Indexed: 05/19/2023]
Abstract
SIGNIFICANCE Acoustically detecting the rich optical absorption contrast in biological tissues, photoacoustic tomography (PAT) seamlessly bridges the functional and molecular sensitivity of optical excitation with the deep penetration and high scalability of ultrasound detection. As a result of continuous technological innovations and commercial development, PAT has been playing an increasingly important role in life sciences and patient care, including functional brain imaging, smart drug delivery, early cancer diagnosis, and interventional therapy guidance. AIM Built on our 2016 tutorial article that focused on the principles and implementations of PAT, this perspective aims to provide an update on the exciting technical advances in PAT. APPROACH This perspective focuses on the recent PAT innovations in volumetric deep-tissue imaging, high-speed wide-field microscopic imaging, high-sensitivity optical ultrasound detection, and machine-learning enhanced image reconstruction and data processing. Representative applications are introduced to demonstrate these enabling technical breakthroughs in biomedical research. CONCLUSIONS We conclude the perspective by discussing the future development of PAT technologies.
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Affiliation(s)
- Junjie Yao
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | - Lihong V. Wang
- California Institute of Technology, Andrew and Peggy Cherng Department of Medical Engineering, Department of Electrical Engineering, Pasadena, California, United States
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