Multimodal photoacoustic and optical coherence tomography scanner using an all optical detection scheme for 3D morphological skin imaging

Multimodal optoacoustic imaging: methods and contrast materials

Optoacoustic (OA) imaging offers powerful capabilities for interrogating biological tissues with rich optical absorption contrast while maintaining high spatial resolution for deep tissue observations. The spectrally distinct absorption of visible and near-infrared photons by endogenous tissue chromophores facilitates extraction of diverse anatomic, functional, molecular, and metabolic information from living tissues across various scales, from organelles and cells to whole organs and organisms. The primarily blood-related contrast and limited penetration depth of OA imaging have fostered the development of multimodal approaches to fully exploit the unique advantages and complementarity of the method. We review the recent hybridization efforts, including multimodal combinations of OA with ultrasound, fluorescence, optical coherence tomography, Raman scattering microscopy and magnetic resonance imaging as well as ionizing methods, such as X-ray computed tomography, single-photon-emission computed tomography and positron emission tomography. Considering that most molecules absorb light across a broad range of the electromagnetic spectrum, the OA interrogations can be extended to a large number of exogenously administered small molecules, particulate agents, and genetically encoded labels. This unique property further makes contrast moieties used in other imaging modalities amenable for OA sensing.

Technologies for depth scanning in miniature optical imaging systems [Invited]

Biomedical optical imaging has found numerous clinical and research applications. For achieving 3D imaging, depth scanning presents the most significant challenge, particularly in miniature imaging devices. This paper reviews the state-of-art technologies for depth scanning in miniature optical imaging systems, which include two general approaches: 1) physically shifting part of or the entire imaging device to allow imaging at different depths and 2) optically changing the focus of the imaging optics. We mainly focus on the second group of methods, introducing a wide variety of tunable microlenses, covering the underlying physics, actuation mechanisms, and imaging performance. Representative applications in clinical and neuroscience research are briefly presented. Major challenges and future perspectives of depth/focus scanning technologies for biomedical optical imaging are also discussed.

Barium sulfate and pigment admixture for photoacoustic and x-ray contrast imaging of the gut

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.

Raster-scanning optoacoustic mesoscopy biomarkers for atopic dermatitis skin lesions

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease worldwide. Its severity is assessed using scores that rely on visual observation of the affected body surface area, the morphology of the lesions and subjective symptoms, like pruritus or insomnia. Ideally, such scores should be complemented by objective and accurate measurements of disease severity to standardize disease scoring in routine care and clinical trials. Recently, it was shown that raster-scanning optoacoustic mesoscopy (RSOM) can provide detailed three-dimensional images of skin inflammation processes that capture the most relevant features of their pathology. Moreover, precise RSOM biomarkers of inflammation have been identified for psoriasis. However, the objectivity and validity of such biomarkers in repeated measurements have not yet been assessed for AD. Here, we report the results of a study on the repeatability of RSOM inflammation biomarkers in AD to estimate their precision. Optoacoustic imaging analysis revealed morphological inflammation biomarkers with precision well beyond standard clinical severity metrics. Our findings suggest that optoacoustic mesoscopy may be a good choice for quantitative evaluations of AD that are inaccessible by other methods. This could potentially enable the optimization of disease scoring and drug development.

Multimodal system for optical biopsy of melanoma with integrated ultrasound, optical coherence tomography and Raman spectroscopy

We introduce a new single-head multimodal optical system that integrates optical coherence tomography (OCT), 18 MHz ultrasound (US) tomography and Raman spectroscopy (RS), allowing for fast (<2 min) and noninvasive skin cancer diagnostics and lesion depth measurement. The OCT can deliver structural and depth information of smaller skin lesions (<1 mm), while the US allows to measure the penetration depth of thicker lesions (≥4 mm), and the RS analyzes the chemical composition from a small chosen spot (≤300 μm) that can be used to distinguish between benign and malignant melanoma. The RS and OCT utilize the same scanning and optical setup, allowing for co-localized measurements. The US on the other side is integrated with an acoustical reflector, which enables B-mode measurements on the same position as OCT and RS. The US B-mode scans can be translated across the sample by laterally moving the US transducer, which is made possible by the developed adapter with a flexible membrane. We present the results on custom-made liquid and agar phantoms that show the resolution and depth capabilities of the setup, as well as preliminary ex vivo measurements on mouse models with ∼4.3 mm thick melanoma.

A backward-mode optical-resolution photoacoustic microscope for 3D imaging using a planar Fabry-Pérot sensor

Optical-resolution photoacoustic microscopy (OR-PAM) combines high spatial resolution and strong absorption-based contrast in tissue, which has enabled structural and spectroscopic imaging of endogenous chromophores, primarily hemoglobin. Conventional piezoelectric ultrasound transducers are typically placed far away from the photoacoustic source due to their opacity, which reduces acoustic sensitivity. Optical ultrasound sensors are an alternative as their transparency allows them to be positioned close to the sample with minimal source-detector distances. In this work, a backward-mode OR-PAM system based on a planar Fabry-Pérot ultrasound sensor and coaxially aligned excitation and interrogation beams was developed. Two 3D imaging modes, using raster-scanning for enhanced image quality and continuous-scanning for fast imaging, were implemented and tested on a leaf skeleton phantom. In fast imaging mode, a scan-rate of 100,000 A-lines/s was achieved. 3D images of a zebrafish embryo were acquired in vivo in raster-scanning mode. The transparency of the FP sensor in the visible and near-infrared wavelength region makes it suitable for combined functional and molecular imaging applications using OR-PAM and multi-photon fluorescence microscopy.

Enhanced medical diagnosis for dOCTors: a perspective of optical coherence tomography

SIGNIFICANCE

After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance.

AIM

Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis.

APPROACH

A comprehensive review of state-of-the-art accomplishments in OCT has been performed.

RESULTS

The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential.

CONCLUSIONS

With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential-in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.

Generation of high amplitude compressions and rarefactions in a photoacoustically excited droplet

Photoacoustic excitation of a fluid sphere generates an outgoing ultrasonic wave whose time profile permits determination of the density, sound speed, and diameter of the sphere. Experiments with pulsed laser beams have confirmed the major predictions of existing theory. With regard to acoustic waves generated within spheres, although mathematical expressions for their properties are known, virtually no exploration of the waveforms in theory or experiment has taken place. Here, two cases for photoacoustic excitation of a droplet are discussed: first, absorption of radiation in a region of fluid external to the droplet, and, second, absorption of radiation by the droplet itself. Large amplitude transients, compressions in the former and rarefactions in the latter, are generated as the waves approach the center of the sphere. The high amplitudes of the waves suggest shock wave formation.

A Photoacoustic Imaging Algorithm Based on Regularized Smoothed L0 Norm Minimization

The recently emerging technique of sparse reconstruction has received much attention in the field of photoacoustic imaging (PAI). Compressed sensing (CS) has large potential in efficiently reconstructing high-quality PAI images with sparse sampling signal. In this article, we propose a CS-based error-tolerant regularized smooth L0 (ReSL0) algorithm for PAI image reconstruction, which has the same computational advantages as the SL0 algorithm while having a higher degree of immunity to inaccuracy caused by noise. In order to evaluate the performance of the ReSL0 algorithm, we reconstruct the simulated dataset obtained from three phantoms. In addition, a real experimental dataset from agar phantom is also used to verify the effectiveness of the ReSL0 algorithm. Compared to three L0 norm, L1 norm, and TV norm-based CS algorithms for signal recovery and image reconstruction, experiments demonstrated that the ReSL0 algorithm provides a good balance between the quality and efficiency of reconstructions. Furthermore, the PSNR of the reconstructed image calculated by the introduced method was better than the other three methods. In particular, it can notably improve reconstruction quality in the case of noisy measurement.

Progress of clinical translation of handheld and semi-handheld photoacoustic imaging

Photoacoustic imaging (PAI), featuring rich contrast, high spatial/temporal resolution and deep penetration, is one of the fastest-growing biomedical imaging technology over the last decade. To date, numbers of handheld and semi-handheld photoacoustic imaging devices have been reported with corresponding potential clinical applications. Here, we summarize emerged handheld and semi-handheld systems in terms of photoacoustic computed tomography (PACT), optoacoustic mesoscopy (OAMes), and photoacoustic microscopy (PAM). We will discuss each modality in three aspects: laser delivery, scanning protocol, and acoustic detection. Besides new technical developments, we also review the associated clinical studies, and the advantages/disadvantages of these new techniques. In the end, we propose the challenges and perspectives of miniaturized PAI in the future.

Photoacoustic-guided surgery from head to toe [Invited]

Photoacoustic imaging-the combination of optics and acoustics to visualize differences in optical absorption - has recently demonstrated strong viability as a promising method to provide critical guidance of multiple surgeries and procedures. Benefits include its potential to assist with tumor resection, identify hemorrhaged and ablated tissue, visualize metal implants (e.g., needle tips, tool tips, brachytherapy seeds), track catheter tips, and avoid accidental injury to critical subsurface anatomy (e.g., major vessels and nerves hidden by tissue during surgery). These benefits are significant because they reduce surgical error, associated surgery-related complications (e.g., cancer recurrence, paralysis, excessive bleeding), and accidental patient death in the operating room. This invited review covers multiple aspects of the use of photoacoustic imaging to guide both surgical and related non-surgical interventions. Applicable organ systems span structures within the head to contents of the toes, with an eye toward surgical and interventional translation for the benefit of patients and for use in operating rooms and interventional suites worldwide. We additionally include a critical discussion of complete systems and tools needed to maximize the success of surgical and interventional applications of photoacoustic-based technology, spanning light delivery, acoustic detection, and robotic methods. Multiple enabling hardware and software integration components are also discussed, concluding with a summary and future outlook based on the current state of technological developments, recent achievements, and possible new directions.

Empirical assessment of laser safety for photoacoustic-guided liver surgeries

Photoacoustic imaging is a promising technique to provide guidance during multiple surgeries and procedures. One challenge with this technique is that major blood vessels in the liver are difficult to differentiate from surrounding tissue within current safety limits, which only exist for human skin and eyes. In this paper, we investigate the safety of raising this limit for liver tissue excited with a 750 nm laser wavelength and approximately 30 mJ laser energy (corresponding to approximately 150 mJ/cm² fluence). Laparotomies were performed on six swine to empirically investigate potential laser-related liver damage. Laser energy was applied for temporal durations of 1 minute, 10 minutes, and 20 minutes. Lasered liver lobes were excised either immediately after laser application (3 swine) or six weeks after surgery (3 swine). Cell damage was assessed using liver damage blood biomarkers and histopathology analyses of 41 tissue samples total. The biomarkers were generally normal over a 6 week post-surgical in vivo study period. Histopathology revealed no cell death, although additional pathology was present (i.e., hemorrhage, inflammation, fibrosis) due to handling, sample resection, and fibrous adhesions as a result of the laparotomy. These results support a new protocol for studying laser-related liver damage, indicating the potential to raise the safety limit for liver photoacoustic imaging to approximately 150 mJ/cm² with a laser wavelength of 750 nm and for imaging durations up to 10 minutes without causing cell death. This investigation and protocol may be applied to other tissues and extended to additional wavelengths and energies, which is overall promising for introducing new tissue-specific laser safety limits for photoacoustic-guided surgery.

Technical considerations in the Verasonics research ultrasound platform for developing a photoacoustic imaging system

Photoacoustic imaging (PAI) is an emerging functional and molecular imaging technology that has attracted much attention in the past decade. Recently, many researchers have used the vantage system from Verasonics for simultaneous ultrasound (US) and photoacoustic (PA) imaging. This was the motivation to write on the details of US/PA imaging system implementation and characterization using Verasonics platform. We have discussed the experimental considerations for linear array based PAI due to its popularity, simple setup, and high potential for clinical translatability. Specifically, we describe the strategies of US/PA imaging system setup, signal generation, amplification, data processing and study the system performance.

Towards non-contact photoacoustic imaging [review]

Photoacoustic imaging (PAI) takes advantage of both optical and ultrasound imaging properties to visualize optical absorption with high resolution and contrast. Photoacoustic microscopy (PAM) is usually categorized with all-optical microscopy techniques such as optical coherence tomography or confocal microscopes. Despite offering high sensitivity, novel imaging contrast, and high resolution, PAM is not generally an all-optical imaging method unlike the other microscopy techniques. One of the significant limitations of photoacoustic microscopes arises from their need to be in physical contact with the sample through a coupling media. This physical contact, coupling, or immersion of the sample is undesirable or impractical for many clinical and pre-clinical applications. This also limits the flexibility of photoacoustic techniques to be integrated with other all-optical imaging microscopes for providing complementary imaging contrast. To overcome these limitations, several non-contact photoacoustic signal detection approaches have been proposed. This paper presents a brief overview of current non-contact photoacoustic detection techniques with an emphasis on all-optical detection methods and their associated physical mechanisms.

Photoacoustic imaging with fiber optic technology: A review

Photoacoustic imaging (PAI) has achieved remarkable growth in the past few decades since it takes advantage of both optical and ultrasound (US) imaging. In order to better promote the wide clinical applications of PAI, many miniaturized and portable PAI systems have recently been proposed. Most of these systems utilize fiber optic technologies. Here, we overview the fiber optic technologies used in PAI. This paper discusses three different fiber optic technologies: fiber optic light transmission, fiber optic US transmission, and fiber optic US detection. These fiber optic technologies are analyzed in different PAI modalities including photoacoustic microscopy (PAM), photoacoustic computed tomography (PACT), and minimally invasive photoacoustic imaging (MIPAI).

Diagnostics of skin features through 3D skin mapping based on electro-controlled deposition of conducting polymers onto metal-sebum modified surfaces and their possible applications in skin treatment

Analytical diagnostics of skin features was developed through application of portable and fast skin mapping based on electro-controlled deposition of conducting polymers onto metal-sebum modified surfaces. In this analytical diagnostic technique, the development of skin pattern is based on electropolymerization of conducting polymers within insulating barriers in skin stamp provided by natural sebum to monitor the 3D nature of various skin features. The recorded skin maps reach a μm-level resolution and are proved to be capable of recognition, enhancement, and reproduction of surface outlines of various skin topographies, subsequently assisting dermatological diagnosis. The technique can precisely record skin surface morphology and reflect the vertical dimension information within 10 min and is aimed to assist dermatologists working with patients suffering from skin diseases via recording or monitoring the skin surface conditions. Additionally, successful trials of loading and electro-controlled release of Cu²⁺ into/from the developed skin patterns reveals its potential to be also utilized for treatment of pathological skin conditions. Based on the developed analytical diagnostic technique, a well-designed 3D printed portable prototype device based on electrosynthesis of the conducting polymer powered by an ordinary battery (1.5 V) was tested and was found to have excellent performance in onsite 3D skin pattern reproduction from live human skin.

Towards quantitative assessment of burn based on photoacoustic and optical coherence tomography

Accurate and timely assessment of the severity of burn is essential for the treatment of burns. Currently, although most first-degree and third-degree burns are easily diagnosed through visual inspection or auxiliary diagnostic methods, the second-degree burn is still difficult to distinguish due to the ambiguity boundaries of second-degree with first-degree and third-degree burns. In this study, we proposed a non-invasive technique by combing photoacoustic imaging (PAI) and optical coherence tomography (OCT) to multi-parameter quantitatively assess the burns. The feasibility and capacity of the dual-mode PAT/OCT for assessing the burns was first testified by tissue-mimicking phantom and burn wounds in mouse pinna in vivo. The further experiments conducted on the back of rats showed that the changes in skin scattering structure, vascular morphology and blood flow provided by the dual-mode PAI/OCT system can determine distinct boundaries and depth of the burns. The experimental results prove that combined PAI/OCT as a novel method can be used to assess the severity of burn, which has the potential to diagnose the burns in clinic.

Resolution-matched reflection mode photoacoustic microscopy and optical coherence tomography dual modality system

Photoacoustic microscopy (PAM) and optical coherence tomography (OCT) are sensitive to optical absorption and scattering characteristics, respectively. As such, the integration of these two modalities in order to combine important complementary information has garnered much attention. Due to the relatively low axial resolution of PAM, PAM and OCT dual modality systems generally have a large resolution gap, especially for reflection mode systems. In this study, based on a wide-band transparent pure-optical ultrasonic detector, we developed a dual modality system (PAM-OCT system) in which PAM has a similar spatial resolution (i.e. several micrometers in both the lateral and axial directions) to OCT. In addition, due to the optical transparency advantage, the integrated system works in reflection mode, which is ideal for in vivo biomedical imaging. We successfully imaged the skin of a mouse hindlimb, which cannot be done by a transmission mode dual modality system. Our work demonstrates this dual modality system has potential in biomedical studies with complementary imaging contrasts.

Multimodal imaging with spectral-domain optical coherence tomography and photoacoustic remote sensing microscopy

We develop a multimodal imaging platform, combining depth-resolved scattering contrast from spectral-domain optical coherence tomography (SD-OCT) with complementary, non-contact absorption contrast using photoacoustic remote sensing (PARS) microscopy. The system provides a widefield OCT mode using a telecentric scan lens, and a high-resolution, dual-contrast mode using a 0.26 numerical aperture apochromatic objective. An interlaced acquisition approach is used to achieve simultaneous, co-registered imaging. The SD-OCT modality provides a 9.7 µm axial resolution. Comprehensive in vivo imaging of a nude mouse ear is demonstrated, with the SD-OCT scattering intensity revealing dermal morphology, and PARS microscopy providing a map of microvasculature.

Overview of Ultrasound Detection Technologies for Photoacoustic Imaging

Ultrasound detection is one of the major components of photoacoustic imaging systems. Advancement in ultrasound transducer technology has a significant impact on the translation of photoacoustic imaging to the clinic. Here, we present an overview on various ultrasound transducer technologies including conventional piezoelectric and micromachined transducers, as well as optical ultrasound detection technology. We explain the core components of each technology, their working principle, and describe their manufacturing process. We then quantitatively compare their performance when they are used in the receive mode of a photoacoustic imaging system.

All-optical, an ultra-thin endoscopic photoacoustic sensor using multi-mode fiber

Photoacoustic endoscopy (PAE) is a method of in-vivo imaging that uses tissue absorption properties. In PAE, the main tools used to detect the acoustic signal are mechanical ultrasound transducers, which require direct contact and which are difficult to miniaturize. All-optic photoacoustic sensors can challenge this issue as they can provide contact-free sensing. Here, we demonstrate sensing of photo-acoustic signals through a multimode fiber (MMF) which can provide an ultra-thin endoscopic photoacoustic sensor. Furthermore, we show the advantage of using the optical-flow method for speckle sensing and extract the photoacoustic signal despite the mode-mixing along the MMF. Moreover, it is demonstrated for the first time that the speckle reconstruction method can be used without the need for imaging of the speckles as this enables the use of multimode fibers for the speckle method.

Low cost blood vein detection system based on near-infrared LEDs and image-processing techniques

Drawing blood and injecting drugs are common medical procedures, for which accurate identification of veins is needed to avoid causing unnecessary pain. In this paper, we propose a low-cost system for the detection of veins. The system emits near-infrared radiation from four light-emitting diodes (LEDs), with a charge-coupled device (CCD) camera located in the middle of the LEDs. The camera captures an image of the palm of the hand. A series of digital image-processing techniques, ranging from image enhancement and increased contrast to isolation using a threshold limit based on statistical properties, are applied to effectively isolate the veins from the rest of the image.

Rapid functional optoacoustic micro-angiography in a burst mode

Optoacoustic microscopy (OAM) can image intrinsic optical absorption contrast at depths of several millimeters where state-of-the-art optical microscopy techniques fail due to intense light scattering in living tissues. Yet, wide adoption of OAM in biology and medicine is hindered by slow image acquisition speed, small field of view (FOV), and/or lack of spectral differentiation capacity of common system implementations. We report on a rapid acquisition functional optoacoustic micro-angiography approach that employs a burst-mode laser triggering scheme to simultaneously acquire multi-wavelength 3D images over an extended FOV covering ${50}\;{\rm mm} \times {50}\;{\rm mm}$50mm×50mm in a single mechanical overfly scan, attaining 28 µm and 14 µm resolution in lateral and axial dimensions, respectively. Owing to an ultrawideband low-noise design featuring a spherically focused polyvinylidene difluoride transducer, we demonstrate imaging of human skin and underlying vasculature at up to 3.8 mm depth when using per-pulse laser energies of only 25 µJ without employing signal averaging. Overall, the developed system greatly enhances performance and usability of OAM for dermatologic and micro-angiographic studies.

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.

Optical coherence tomography angiography and photoacoustic imaging in dermatology

Optical coherence tomography angiography (OCTA) is a relatively novel functional extension of the widely accepted ophthalmic imaging tool named optical coherence tomography (OCT). Since OCTA's debut in ophthalmology, researchers have also been trying to expand its translational application in dermatology. The ability of OCTA to resolve microvasculature has shown promising results in imaging skin diseases. Meanwhile, photoacoustic imaging (PAI), which uses laser pulse induced ultrasound waves as the signal, has been studied to differentiate human skin layers and to help in skin disease diagnosis. This perspective article gives a short review of OCTA and PAI in the field of photodermatology. After an introduction to the principles of OCTA and PAI, we describe the most updated results of skin disease imaging using these two optical imaging modalities. We also place emphasis on dual modality imaging combining OCTA and photoacoustic tomography (PAT) for dermatological applications. In the end, the challenges and prospects of these two imaging modalities in dermatology are discussed.

The integrated high-resolution reflection-mode photoacoustic and fluorescence confocal microscopy

A dual modality microscopy with the highest imaging resolution reported so far based on reflection-mode photoacoustic and confocal fluorescence is presented in this study. The unique design of the imaging head of the microscope makes it highly convenient for scalable high-resolution imaging by simply switching the optical objectives. The submicron resolution performance of the system is demonstrated via in vivo imaging of zebrafish, normal mouse ear, and a xenograft tumor model inoculated in the mouse ear. The imaging results confirm that the presented dual-modality microscopy imaging system could play a vital role in observing model organism, studying tumor angiogenesis and assessment of antineoplastic drugs.

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.

Single Transparent Piezoelectric Detector for Optoacoustic Sensing-Design and Signal Processing

In this article, we present a simple and intuitive approach to create a handheld optoacoustic setup for near field measurements. A single piezoelectric transducer glued in between two sheets of polymethyl methacrylate (PMMA) facilitates nearfield depth profiling of layered media. The detector electrodes are made of indium tin oxide (ITO) which is both electrically conducting as well as optically transparent, enabling an on-axis illumination through the detector. By mapping the active detector area, we show that it matches the design form precisely. We also present a straightforward approach to determine the instrument response function, which allows to obtain the original pressure profile arriving at the detector. To demonstrate the validity of this approach, the measurement on a simple test sample is deconvolved with the instrument response function and compared to simulation results. Except for the sputter instrumentation, all required materials and instruments as well as the tools needed to create such a setup are available to standard scientific laboratories.

Direct Synthesis of Water-Dispersible Magnetic/Plasmonic Heteronanostructures for Multimodality Biomedical Imaging

Magnetic/plasmonic hybrid nanoparticles are highly desirable for multimodal bioimaging and biosensing. Although the synthesis of heterodimeric nanoparticles has been reported, the products are usually hydrophobic so that post-treatment procedures are required to transfer them into water which are often difficult to perform and cause damages to the structures. Direct synthesis of hydrophilic hybrid nanostructures has remained a grand challenge albeit its immediate advantage of biocompatibility. Herein we report a general seed-mediated approach to the synthesis of hydrophilic and biocompatible M-Fe₃O₄ (M = Au, Ag, and Pd) heterodimers, in which the size of metals and Fe₃O₄ can be independently regulated in a wide range. Benefiting from the aqueous synthesis, this approach can be further extended to design more complex heterodimeric structures such as AgPt_alloy-Fe₃O₄, Au_core@Pd_shell-Fe₃O₄, and Au_shell-Fe₃O₄. The hydrophilic nature of our heterodimers makes them readily useful for biomedical applications without the need of additional ligand exchange processes in contrast to those prepared in nonpolar solvents. These nanoscale magnetic/plasmonic heterostructures were shown to be ideally suited for integrated biomedical diagnoses, such as magnetic resonance imaging, photoacoustic imaging, optical coherence tomography, and computed tomography, in virtue of their biocompatibility and combined tunable magnetic and plasmonic properties.

Optoacoustic mesoscopy for biomedicine

Fuelled by innovation, optical microscopy plays a critical role in the life sciences and medicine, from basic discovery to clinical diagnostics. However, optical microscopy is limited by typical penetration depths of a few hundred micrometres for in vivo interrogations in the visible spectrum. Optoacoustic microscopy complements optical microscopy by imaging the absorption of light, but it is similarly limited by penetration depth. In this Review, we summarize progress in the development and applicability of optoacoustic mesoscopy (OPAM); that is, optoacoustic imaging with acoustic resolution and wide-bandwidth ultrasound detection. OPAM extends the capabilities of optical imaging beyond the depths accessible to optical and optoacoustic microscopy, and thus enables new applications. We explain the operational principles of OPAM, its placement as a bridge between optoacoustic microscopy and optoacoustic macroscopy, and its performance in the label-free visualization of tissue pathophysiology, such as inflammation, oxygenation, vascularization and angiogenesis. We also review emerging applications of OPAM in clinical and biological imaging.

Microvascular imaging of the skin

Despite our understanding that the microvasculature plays a multifaceted role in the development and progression of various conditions, we know little about the extent of this involvement. A need exists for non-invasive, clinically meaningful imaging modalities capable of elucidating microvascular information to aid in our understanding of disease, and to aid in the diagnosis/monitoring of disease for more patient-specific care. In this review article, a number of imaging techniques are summarized that have been utilized to investigate the microvasculature of skin, along with their advantages, disadvantages and future perspectives in preclinical and clinical settings. These techniques include dermoscopy, capillaroscopy, Doppler sonography, laser Doppler flowmetry (LDF) and perfusion imaging, laser speckle contrast imaging (LSCI), optical coherence tomography (OCT), including its Doppler and dynamic variant and the more recently developed OCT angiography (OCTA), photoacoustic imaging, and spatial frequency domain imaging (SFDI). Attention is largely, but not exclusively, placed on optical imaging modalities that use intrinsic optical signals to contrast the microvasculature. We conclude that whilst each imaging modality has been successful in filling a particular niche, there is no one, all-encompassing modality without inherent flaws. Therefore, the future of cutaneous microvascular imaging may lie in utilizing a multi-modal approach that will counter the disadvantages of individual systems to synergistically augment our imaging capabilities.

All-optical dual photoacoustic and optical coherence tomography intravascular probe

Intravascular imaging in percutaneous coronary interventions can be an invaluable tool in the treatment of coronary artery disease. It is of significant interest to provide molecular imaging contrast that is complementary to structural contrast provided by optical coherence tomography (OCT) and intravascular ultrasound imaging (IVUS). In this study, we developed a dual-modality intravascular imaging probe comprising a commercial OCT catheter and a high sensitivity fiber optic ultrasound sensor, to provide both photoacoustic (PA) and OCT imaging. With PA imaging, the lateral resolution varied from 18 μm to 40 μm; the axial resolution was consistently in the vicinity of 45 μm. We demonstrated the clinical potential of the probe with 2-D circumferential PA and OCT imaging, and with multispectral PA imaging.

Ultrasound detection via low-noise pulse interferometry using a free-space Fabry-Pérot

Coherence-restored pulse interferometry (CRPI) is a recently developed method for optical detection of ultrasound that achieves shot-noise-limited sensitivity and high dynamic range. In principle, the wideband source employed in CRPI may enable the interrogation of multiple detectors by using wavelength multiplexing. However, the noise-reduction scheme in CRPI has not been shown to be compatible with wideband operation. In this work, we introduce a new scheme for CRPI that relies on a free-space Fabry-Pérot filter for noise reduction and a pulse stretcher for reducing nonlinear effects. Using our scheme, we demonstrate that shot-noise-limited detection may be achieved for a spectral band of 80 nm and powers of up to 5 mW.

Looking at sound: optoacoustics with all-optical ultrasound detection

Originally developed for diagnostic ultrasound imaging, piezoelectric transducers are the most widespread technology employed in optoacoustic (photoacoustic) signal detection. However, the detection requirements of optoacoustic sensing and imaging differ from those of conventional ultrasonography and lead to specifications not sufficiently addressed by piezoelectric detectors. Consequently, interest has shifted to utilizing entirely optical methods for measuring optoacoustic waves. All-optical sound detectors yield a higher signal-to-noise ratio per unit area than piezoelectric detectors and feature wide detection bandwidths that may be more appropriate for optoacoustic applications, enabling several biomedical or industrial applications. Additionally, optical sensing of sound is less sensitive to electromagnetic noise, making it appropriate for a greater spectrum of environments. In this review, we categorize different methods of optical ultrasound detection and discuss key technology trends geared towards the development of all-optical optoacoustic systems. We also review application areas that are enabled by all-optical sound detectors, including interventional imaging, non-contact measurements, magnetoacoustics, and non-destructive testing.

Trimodal system for in vivo skin cancer screening with combined optical coherence tomography-Raman and colocalized optoacoustic measurements

A new multimodal system for rapid, noninvasive in vivo skin cancer screening is presented, combining optical coherence tomography (OCT) and optoacoustic (OA) modalities to provide precise tumor depth determination with a Raman spectroscopic modality capable of detecting the lesion type and, thus, providing diagnostic capability. Both OA and Raman setups use wide field skin illumination to ensure the compliance with maximum permissible exposure (MPE) requirements. The Raman signal is collected via the OCT scanning lens to maximize the signal-to-noise ratio of the measured signal while keeping radiation levels below MPE limits. OCT is used to optically determine the tumor thickness and for volumetric imaging whereas OA utilizes acoustic signals generated by optical absorption contrast for thickness determination at potentially higher penetration depths compared to OCT. Preliminary results of first clinical trials using our setup are presented. The measured lesion depth is in good agreement with histology results, while Raman measurements show distinctive differences between normal skin and melanocytic lesions, and, moreover, between different skin areas. In future, we will validate the setup presented for reliable detection of pathophysiological parameters, morphology and thickness of suspicious skin lesions.

A handheld microscope integrating photoacoustic microscopy and optical coherence tomography

The combination of optical resolution photoacoustic microscopy (ORPAM) and optical coherence tomography (OCT) is capable of providing complementary imaging contrasts. Unfortunately, the miniaturization of ORPAM remains a major challenge in the development of a handheld dual-modality imaging microscope with OCT. Here, we report the design and evaluation of an integrated ORPAM and OCT imaging probe using a two-dimensional MEMS (micro-electro-mechanical-system)-based optical scanner. This microscope, weighting 35.4 g, has an ultracompact size of 65×30×18 mm³, and an effective imaging area of 2×2 mm². The experimental lateral resolutions are 3.7 μm (ORPAM) and 5.6 μm (OCT), and the axial resolutions are measured as 120 μm (ORPAM) and 7.3 μm (OCT). Besides phantom and animal experiments, we carried out oral imaging of a healthy volunteer to show the clinical feasibility of this technique.

Naphthalocyanines as contrast agents for photoacoustic and multimodal imaging

Naphthalocyanines (Ncs) are a family of aromatic small molecule with large near infrared extinction coefficients, making them appealing contrast agent candidates for photoacoustic imaging (PAI). Depending on the substitutions on the Nc periphery or metal center, different spectrally-resolved absorption peak wavelengths are possible, which can enable photoacoustic contrast multiplexing. Owing to their generally poor aqueous solubility, approaches have been developed to modify Ncs or formulate them as biocompatible contrast agents for PAI. Due to their inherent capacity for metal ion chelation, Ncs hold potential for complementary multimodal contrast imaging techniques such as 64Cu positron emission tomography. In this research perspective, we highlight some recent reports involving the use of Ncs in PAI.

Multispectral photoacoustic microscopy and optical coherence tomography using a single supercontinuum source

We report on the use of a single supercontinuum (SC) source for multimodal imaging. The 2-octave bandwidth (475-2300 nm) makes the SC source suitable for optical coherence tomography (OCT) as well as for multispectral photoacoustic microscopy (MPAM). The IR band centered at 1310 nm is chosen for OCT to penetrate deeper into tissue with 8 mW average power on the sample. The 500-840 nm band is used for MPAM. The source has the ability to select the central wavelength as well as the spectral bandwidth. An energy of more than 35 nJ within a less than 50 nm bandwidth is achieved on the sample for wavelengths longer than 500 nm. In the present paper, we demonstrate the capabilities of such a multimodality imaging instrument based on a single optical source. In vitro mouse ear B-scan images are presented.

The dermal arteries in the cutaneous angiosome of the descending genicular artery

Studies examining thick skin of the thumb pad have challenged the existence of an arterial plexus in the papillary dermis. Instead of a plexus, discrete arterial units, interconnected by arterio-arterial anastomoses, were identified. We hypothesise that the dermal arteries of thin skin are arranged likewise and that there are fewer arterio-arterial anastomoses in the centre of an angiosome than in zones where neighbouring angiosomes overlap. To test these hypotheses, we examined the dermal arteries in the centre of the cutaneous angiosome of the descending genicular artery (DGA) and its zone of overlap with neighbouring angiosomes. Using traditional perfusion techniques, the cutaneous angiosomes of the DGA and the popliteal artery were identified in 11 fresh frozen human lower limbs. Biopsies were harvested from the centre of the cutaneous DGA angiosome and from the zone where neighbouring vascular territories overlapped. Employing high-resolution episcopic microscopy (HREM), digital volume data were generated and the dermal arteries were three-dimensionally reconstructed and examined. In all examined skin areas, the dermal arteries showed tree-like ramifications. The branches of the dermal arteries were connected on average by 1.73 ± 1.01 arterio-arterial anastomoses in the centre of the DGA angiosome and by 3.27 ± 1.27 in the zone where angiosomes overlapped. We demonstrate that discrete but overlapping dermal arterial units with a mean dimension of 1.62 ± 1.34 and 1.80 ± 1.56 mm² , respectively, supply oxygen and nutrients to the superficial dermis and epidermis of the thin skin of the medial femur. This forms the basis for diagnosing and researching skin pathologies.

Non-invasive multimodal optical coherence and photoacoustic tomography for human skin imaging

The cutaneous vasculature is involved in many diseases. Current clinical examination techniques, however, cannot resolve the human vasculature with all plexus in a non-invasive manner. By combining an optical coherence tomography system with angiography extension and an all optical photoacoustic tomography system, we can resolve in 3D the blood vessels in human skin for all plexus non-invasively. With a customized imaging unit that permits access to various parts of patients' bodies, we applied our multimodality imaging system to investigate several different types of skin conditions. Quantitative vascular analysis is given for each of the dermatological conditions to show the potential diagnostic value of our system in non-invasive examination of diseases and physiological processes. Improved performance of our system over its previous generation is also demonstrated with an updated characterization.

Hybrid nonlinear photoacoustic and reflectance confocal microscopy for label-free subcellular imaging with a single light source

Nonlinear photoacoustic microscopy is capable of achieving subcellular optically resolved absorption contrast in three dimensions but cannot provide structural context for the acquired images. We have developed a dual-modality imaging system that combines the optical absorption contrast of a nonlinear photoacoustic microscope with the optical scattering contrast of a reflectance confocal microscope. By integrating the confocal detection optics into the optical setup of the nonlinear photoacoustic microscope, the two systems were co-registered and may be acquired at the same time and with the same light source. Simultaneous images of fixed erythrocytes and fibroblasts were measured to demonstrate the complementary information that is provided by the two modalities.

Hybrid Photoacoustic/Ultrasound Tomograph for Real-Time Finger Imaging

We report a target-enclosing, hybrid tomograph with a total of 768 elements based on capacitive micromachined ultrasound transducer technology and providing fast, high-resolution 2-D/3-D photoacoustic and ultrasound tomography tailored to finger imaging. A freely programmable ultrasound beamforming platform sampling data at 80 MHz was developed to realize plane wave transmission under multiple angles. A multiplexing unit enables the connection and control of a large number of elements. Fast image reconstruction is provided by GPU processing. The tomograph is composed of four independent and fully automated movable arc-shaped transducers, allowing imaging of all three finger joints. The system benefits from photoacoustics, yielding high optical contrast and enabling visualization of finger vascularization, and ultrasound provides morphologic information on joints and surrounding tissue. A diode-pumped, Q-switched Nd:YAG laser and an optical parametric oscillator are used to broaden the spectrum of emitted wavelengths to provide multispectral imaging. Custom-made optical fiber bundles enable illumination of the region of interest in the plane of acoustic detection. Precision in positioning of the probe in motion is ensured by use of a motor-driven guide slide. The current position of the probe is encoded by the stage and used to relate ultrasound and photoacoustic signals to the corresponding region of interest of the suspicious finger joint. The system is characterized in phantoms and a healthy human finger in vivo. The results obtained promise to provide new opportunities in finger diagnostics and establish photoacoustic/ultrasound-tomography in medical routine.

High-resolution Episcopic Microscopy (HREM) - Simple and Robust Protocols for Processing and Visualizing Organic Materials

We provide simple protocols for generating digital volume data with the high-resolution episcopic microscopy (HREM) method. HREM is capable of imaging organic materials with volumes up to 5 x 5 x 7 mm³ in typical numeric resolutions between 1 x 1 x 1 and 5 x 5 x 5 µm³. Specimens are embedded in methacrylate resin and sectioned on a microtome. After each section an image of the block surface is captured with a digital video camera that sits on the phototube connected to the compound microscope head. The optical axis passes through a green fluorescent protein (GFP) filter cube and is aligned with a position, at which the bock holder arm comes to rest after each section. In this way, a series of inherently aligned digital images, displaying subsequent block surfaces are produced. Loading such an image series in three-dimensional (3D) visualization software facilitates the immediate conversion to digital volume data, which permit virtual sectioning in various orthogonal and oblique planes and the creation of volume and surface rendered computer models. We present three simple, tissue specific protocols for processing various groups of organic specimens, including mouse, chick, quail, frog and zebra fish embryos, human biopsy material, uncoated paper and skin replacement material.

Handheld optical-resolution photoacoustic microscopy

Optical-resolution photoacoustic microscopy (OR-PAM) offers label-free Collapse

Key Words

• photoacoustic handheld probe
• optical-resolution photoacoustic microscopy
• two-axis microelectromechanical system mirror
• confocal scanning
• human skin imaging

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MESH Headings

• Animals
• Capillaries/diagnostic imaging
• Ear/blood supply
• Ear/diagnostic imaging
• Humans
• Mice
• Micro-Electrical-Mechanical Systems
• Microscopy, Acoustic
• Nevus/blood supply
• Nevus/diagnostic imaging
• Photoacoustic Techniques/instrumentation
• Spectrum Analysis

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Grants

• DP1 EB016986 NIBIB NIH HHS
• R01 CA159959 NCI NIH HHS
• R01 CA186567 NCI NIH HHS

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Affiliation(s)

Li Lin Washington University in St. Louis, Optical Imaging Laboratory, Department of Biomedical Engineering, One Brookings Drive, St. Louis, Missouri 63130, United States
Pengfei Zhang Washington University in St. Louis, Optical Imaging Laboratory, Department of Biomedical Engineering, One Brookings Drive, St. Louis, Missouri 63130, United States
Song Xu Texas A&M University, Institute for Solid State Electronics, Electrical Engineering Department, 400 Bizzell Street, College Station, Texas 77840, United States
Junhui Shi Washington University in St. Louis, Optical Imaging Laboratory, Department of Biomedical Engineering, One Brookings Drive, St. Louis, Missouri 63130, United States
Lei Li Washington University in St. Louis, Optical Imaging Laboratory, Department of Biomedical Engineering, One Brookings Drive, St. Louis, Missouri 63130, United States
Junjie Yao Washington University in St. Louis, Optical Imaging Laboratory, Department of Biomedical Engineering, One Brookings Drive, St. Louis, Missouri 63130, United States
Lidai Wang Washington University in St. Louis, Optical Imaging Laboratory, Department of Biomedical Engineering, One Brookings Drive, St. Louis, Missouri 63130, United States
Jun Zou Texas A&M University, Institute for Solid State Electronics, Electrical Engineering Department, 400 Bizzell Street, College Station, Texas 77840, United States
Lihong V. Wang Washington University in St. Louis, Optical Imaging Laboratory, Department of Biomedical Engineering, One Brookings Drive, St. Louis, Missouri 63130, United States

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Inverse problems of combined photoacoustic and optical coherence tomography

Optical coherence tomography (OCT) and photoacoustic tomography are emerging non-invasive biological and medical imaging techniques. It is a recent trend in experimental science to design experiments that perform photoacoustic tomography and OCT imaging at once. In this paper, we present a mathematical model describing the dual experiment. Because OCT is mathematically modelled by Maxwell's equations or some simplifications of it, whereas the light propagation in quantitative photoacoustics is modelled by (simplifications of) the radiative transfer equation, the first step in the derivation of a mathematical model of the dual experiment is to obtain a unified mathematical description, which in our case are Maxwell's equations. As a by-product, we therefore derive a new mathematical model of photoacoustic tomography based on Maxwell's equations. It is well known by now that without additional assumptions on the medium, it is not possible to uniquely reconstruct all optical parameters from either one of these modalities alone. We show that in the combined approach, one has additional information, compared with a single modality, and the inverse problem of reconstruction of the optical parameters becomes feasible. © 2016 The Authors. Mathematical Methods in the Applied Sciences Published by John Wiley & Sons Ltd.

Optical Detection of Ultrasound in Photoacoustic Imaging

OBJECTIVE

Photoacoustic (PA) imaging emerges as a unique tool to study biological samples based on optical absorption contrast. In PA imaging, piezoelectric transducers are commonly used to detect laser-induced ultrasonic waves. However, they typically lack adequate broadband sensitivity at ultrasonic frequency higher than 100 MHz, whereas their bulky size and optically opaque nature cause technical difficulties in integrating PA imaging with conventional optical imaging modalities. To overcome these limitations, optical methods of ultrasound detection were developed and shown their unique applications in PA imaging.

METHODS

We provide an overview of recent technological advances in optical methods of ultrasound detection and their applications in PA imaging. A general theoretical framework describing sensitivity, bandwidth, and angular responses of optical ultrasound detection is also introduced.

RESULTS

Optical methods of ultrasound detection can provide improved detection angle and sensitivity over significantly extended bandwidth. In addition, its versatile variants also offer additional advantages, such as device miniaturization, optical transparency, mechanical flexibility, minimal electrical/mechanical crosstalk, and potential noncontact PA imaging.

CONCLUSION

The optical ultrasound detection methods discussed in this review and their future evolution may play an important role in PA imaging for biomedical study and clinical diagnosis.

In vivo deep tissue imaging using wavefront shaping optical coherence tomography

Multiple light scattering in tissue limits the penetration of optical coherence tomography (OCT) imaging. Here, we present in vivo OCT imaging of a live mouse using wavefront shaping (WS) to enhance the penetration depth. A digital micromirror device was used in a spectral-domain OCT system for complex WS of an incident beam which resulted in the optimal delivery of light energy into deep tissue. Ex vivo imaging of chicken breasts and mouse ear tissues showed enhancements in the strength of the image signals and the penetration depth, and in vivo imaging of the tail of a live mouse provided a multilayered structure inside the tissue.