Estimating chromophore distributions from multiwavelength photoacoustic images

Near-infrared multispectral photoacoustic analysis of lipids and intraplaque hemorrhage in human carotid artery atherosclerosis

Spectral photoacoustic imaging in combination with unmixing techniques may be applied to retrieve information about high-risk features present in atherosclerotic plaques, possibly providing prognostic insights into future stroke events. We present the photoacoustic spectral contrast found in 12 systematically scanned advanced atherosclerotic plaques in the near-infrared wavelength range (850-1250 nm). The main absorbers are lipid, water, and hemoglobin, with the highest photoacoustic intensities at the lipid's second overtone at 1190 and 1210 nm. Linear unmixing resulted in visualizing regions with high lipid and hemoglobin absorption, corresponding to the histological presence of lipid and intraplaque hemorrhage. A non-negative matrix factorization approach reveals differences in lipid spectral contrast, providing potential insights into the vulnerability of atherosclerotic plaque. These results provide a reference for future, more complex, in vivo photoacoustic imaging of carotid artery atherosclerosis, potentially contributing to assessing the risk of future events and treatment decision.

Deep learning acceleration of iterative model-based light fluence correction for photoacoustic tomography

Photoacoustic tomography (PAT) is a promising imaging technique that can visualize the distribution of chromophores within biological tissue. However, the accuracy of PAT imaging is compromised by light fluence (LF), which hinders the quantification of light absorbers. Currently, model-based iterative methods are used for LF correction, but they require extensive computational resources due to repeated LF estimation based on differential light transport models. To improve LF correction efficiency, we propose to use Fourier neural operator (FNO), a neural network specially designed for estimating partial differential equations, to learn the forward projection of light transport in PAT. Trained using paired finite-element-based LF simulation data, our FNO model replaces the traditional computational heavy LF estimator during iterative correction, such that the correction procedure is considerably accelerated. Simulation and experimental results demonstrate that our method achieves comparable LF correction quality to traditional iterative methods while reducing the correction time by over 30 times.

Single-stage approach for estimating optical parameters in spectral quantitative photoacoustic tomography

In quantitative photoacoustic tomography, the optical parameters of a target, most importantly the concentrations of chromophores such as deoxygenated and oxygenated hemoglobin, are estimated from photoacoustic data measured on the boundary of the target. In this work, a numerical approximation of a forward model for spectral quantitative photoacoustic tomography is constructed by utilizing the diffusion approximation for light propagation, the acoustic wave equation for ultrasound propagation, and spectral models of optical absorption and scattering to describe the wavelength dependence of the optical parameters. The related inverse problem is approached in the framework of Bayesian inverse problems. Concentrations of four chromophores (deoxygenated and oxygenated hemoglobin, water, and lipid), two scattering parameters (reference scattering and scattering power), and the Grüneisen parameter are estimated in a single-stage from photoacoustic data. The methodology is evaluated using numerical simulations in different full-view and limited-view imaging settings. The results show that, utilizing spectral data and models, the spectral optical parameters and the Grüneisen parameter can be simultaneously estimated. Furthermore, the approach can also be utilized in limited-view imaging situations.

Photoacoustic clinical applications: Musculoskeletal and abdominal imaging

Photoacoustic (PA) imaging has been extensively investigated in application in biomedicine over the last decade. This article reviews the motivation, significance, and system configuration of a few ongoing studies of implementing photoacoustic technology in musculoskeletal imaging, abdominal imaging, and interstitial sensing. The review then summarizes the methodologies and latest progress of relevant projects. Finally, we discuss our expectations for the future of translation research in PA imaging.

Pixel-wise reconstruction of tissue absorption coefficients in photoacoustic tomography using a non-segmentation iterative method

In Photoacoustic Tomography (PAT), the acquired image represents a light energy deposition map of the imaging object. For quantitative imaging, the PAT image is converted into an absorption coefficient (μ a ) map by dividing the light fluence (LF). Previous methods usually assume a uniform tissueμ a distribution, and consequently degrade the LF correction results. Here, we propose a simple method to reconstruct the pixel-wiseμ a map. Our method is based on a non-segmentation-based iterative algorithm, which alternately optimizes the LF distribution and theμ a map. Using simulation data, as well as phantom and animal data, we implemented our algorithm and compared it to segmentation-based correction methods. The results show that our method can obtain accurate estimation of the LF distribution and therefore improve the image quality and feature visibility of theμ a map. Our method may facilitate efficient calculation of the concentration distributions of endogenous and exogenous agents in vivo.

Motion Compensation for 3D Multispectral Handheld Photoacoustic Imaging

Three-dimensional (3D) handheld photoacoustic (PA) and ultrasound (US) imaging performed using mechanical scanning are more useful than conventional 2D PA/US imaging for obtaining local volumetric information and reducing operator dependence. In particular, 3D multispectral PA imaging can capture vital functional information, such as hemoglobin concentrations and hemoglobin oxygen saturation (sO₂), of epidermal, hemorrhagic, ischemic, and cancerous diseases. However, the accuracy of PA morphology and physiological parameters is hampered by motion artifacts during image acquisition. The aim of this paper is to apply appropriate correction to remove the effect of such motion artifacts. We propose a new motion compensation method that corrects PA images in both axial and lateral directions based on structural US information. 3D PA/US imaging experiments are performed on a tissue-mimicking phantom and a human wrist to verify the effects of the proposed motion compensation mechanism and the consequent spectral unmixing results. The structural motions and sO₂ values are confirmed to be successfully corrected by comparing the motion-compensated images with the original images. The proposed method is expected to be useful in various clinical PA imaging applications (e.g., breast cancer, thyroid cancer, and carotid artery disease) that are susceptible to motion contamination during multispectral PA image analysis.

Photoacoustic imaging to monitor outcomes during hyperbaric oxygen therapy: validation in a small cohort and case study in a bilateral chronic ischemic wound

Hyperbaric oxygen therapy (HBO2) is a common therapeutic modality that drives oxygen into hypoxic tissue to promote healing. Here, ten patients undergoing HBO2 underwent PA oximetry of the left radial artery and forearm pre- and post-HBO2; this cohort validated the use of PA imaging in HBO2. There was a significant increase in radial artery oxygenation after HBO2 (p = 0.002) in the validation cohort. We also include a case study: a non-diabetic male in his 50s (HB 010) presenting with bilateral ischemic and gangrenous wounds. HB 010 showed higher perfusion and oxygen saturation on the right foot than the left after HBO2 which correlated with independent surgical observations. Imaging assisted with limb salvage treatment. Hence, this work shows that PA imaging can measure changes in arterial oxygen saturation due to HBO2; it can also produce 3D maps of tissue oxygenation and evaluate response to therapy during HBO2.

Adaptive stochastic Gauss-Newton method with optical Monte Carlo for quantitative photoacoustic tomography

SIGNIFICANCE

The image reconstruction problem in quantitative photoacoustic tomography (QPAT) is an ill-posed inverse problem. Monte Carlo method for light transport can be utilized in solving this image reconstruction problem.

AIM

The aim was to develop an adaptive image reconstruction method where the number of photon packets in Monte Carlo simulation is varied to achieve a sufficient accuracy with reduced computational burden.

APPROACH

The image reconstruction problem was formulated as a minimization problem. An adaptive stochastic Gauss-Newton (A-SGN) method combined with Monte Carlo method for light transport was developed. In the algorithm, the number of photon packets used on Gauss-Newton (GN) iteration was varied utilizing a so-called norm test.

RESULTS

The approach was evaluated with numerical simulations. With the proposed approach, the number of photon packets needed for solving the inverse problem was significantly smaller than in a conventional approach where the number of photon packets was fixed for each GN iteration.

CONCLUSIONS

The A-SGN method with a norm test can be utilized in QPAT to provide accurate and computationally efficient solutions.

Segmentation and Quantitative Analysis of Photoacoustic Imaging: A Review

Photoacoustic imaging is an emerging biomedical imaging technique that combines optical contrast and ultrasound resolution to create unprecedented light absorption contrast in deep tissue. Thanks to its fusional imaging advantages, photoacoustic imaging can provide multiple structural and functional insights into biological tissues such as blood vasculatures and tumors and monitor the kinetic movements of hemoglobin and lipids. To better visualize and analyze the regions of interest, segmentation and quantitative analyses were used to extract several biological factors, such as the intensity level changes, diameter, and tortuosity of the tissues. Over the past 10 years, classical segmentation methods and advances in deep learning approaches have been utilized in research investigations. In this review, we provide a comprehensive review of segmentation and quantitative methods that have been developed to process photoacoustic imaging in preclinical and clinical experiments. We focus on the parametric reliability of quantitative analysis for semantic and instance-level segmentation. We also introduce the similarities and alternatives of deep learning models in qualitative measurements using classical segmentation methods for photoacoustic imaging.

Automatic 3-D segmentation and volumetric light fluence correction for photoacoustic tomography based on optimal 3-D graph search

Preclinical imaging with photoacoustic tomography (PAT) has attracted wide attention in recent years since it is capable of providing molecular contrast with deep imaging depth. The automatic extraction and segmentation of the animal in PAT images is crucial for improving image analysis efficiency and enabling advanced image post-processing, such as light fluence (LF) correction for quantitative PAT imaging. Previous automatic segmentation methods are mostly two-dimensional approaches, which failed to conserve the 3-D surface continuity because the image slices were processed separately. This discontinuity problem further hampers LF correction, which, ideally, should be carried out in 3-D due to spatially diffused illumination. Here, to solve these problems, we propose a volumetric auto-segmentation method for small animal PAT imaging based on the 3-D optimal graph search (3-D GS) algorithm. The 3-D GS algorithm takes into account the relation among image slices by constructing a 3-D node-weighted directed graph, and thus ensures surface continuity. In view of the characteristics of PAT images, we improve the original 3-D GS algorithm on graph construction, solution guidance and cost assignment, such that the accuracy and smoothness of the segmented animal surface were guaranteed. We tested the performance of the proposed method by conducting in vivo nude mice imaging experiments with a commercial preclinical cross-sectional PAT system. The results showed that our method successfully retained the continuous global surface structure of the whole 3-D animal body, as well as smooth local subcutaneous tumor boundaries at different development stages. Moreover, based on the 3-D segmentation result, we were able to simulate volumetric LF distribution of the entire animal body and obtained LF corrected PAT images with enhanced structural visibility and uniform image intensity.

A scalable open-source MATLAB toolbox for reconstruction and analysis of multispectral optoacoustic tomography data

Multispectral photoacoustic tomography enables the resolution of spectral components of a tissue or sample at high spatiotemporal resolution. With the availability of commercial instruments, the acquisition of data using this modality has become consistent and standardized. However, the analysis of such data is often hampered by opaque processing algorithms, which are challenging to verify and validate from a user perspective. Furthermore, such tools are inflexible, often locking users into a restricted set of processing motifs, which may not be able to accommodate the demands of diverse experiments. To address these needs, we have developed a Reconstruction, Analysis, and Filtering Toolbox to support the analysis of photoacoustic imaging data. The toolbox includes several algorithms to improve the overall quantification of photoacoustic imaging, including non-negative constraints and multispectral filters. We demonstrate various use cases, including dynamic imaging challenges and quantification of drug effect, and describe the ability of the toolbox to be parallelized on a high performance computing cluster.

Photoacoustic computed tomography for functional human brain imaging [Invited]

The successes of magnetic resonance imaging and modern optical imaging of human brain function have stimulated the development of complementary modalities that offer molecular specificity, fine spatiotemporal resolution, and sufficient penetration simultaneously. By virtue of its rich optical contrast, acoustic resolution, and imaging depth far beyond the optical transport mean free path (∼1 mm in biological tissues), photoacoustic computed tomography (PACT) offers a promising complementary modality. In this article, PACT for functional human brain imaging is reviewed in its hardware, reconstruction algorithms, in vivo demonstration, and potential roadmap.

Automatic threshold selection algorithm to distinguish a tissue chromophore from the background in photoacoustic imaging

The adaptive matched filter (AMF) is a method widely used in spectral unmixing to classify different tissue chromophores in photoacoustic images. However, a threshold needs to be applied to the AMF detection image to distinguish the desired tissue chromophores from the background. In this study, we propose an automatic threshold selection (ATS) algorithm capable of differentiating a target from the background, based on the features of the AMF detection image. The mean difference between the estimated thickness, using the ATS algorithm, and the known values was 0.17 SD (0.24) mm for the phantom inclusions and -0.05 SD (0.21) mm for the tissue samples of malignant melanoma. The evaluation shows that the thickness and the width of the phantom inclusions and the tumors can be estimated using AMF in an automatic way after applying the ATS algorithm.

(An overview of) Synergistic reconstruction for multimodality/multichannel imaging methods

Imaging is omnipresent in modern society with imaging devices based on a zoo of physical principles, probing a specimen across different wavelengths, energies and time. Recent years have seen a change in the imaging landscape with more and more imaging devices combining that which previously was used separately. Motivated by these hardware developments, an ever increasing set of mathematical ideas is appearing regarding how data from different imaging modalities or channels can be synergistically combined in the image reconstruction process, exploiting structural and/or functional correlations between the multiple images. Here we review these developments, give pointers to important challenges and provide an outlook as to how the field may develop in the forthcoming years. This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 1'.

Nonlinear iterative perturbation scheme with simplified spherical harmonics (SP3 ) light propagation model for quantitative photoacoustic tomography

When using quantitative photoacoustic tomography (q-PAT) reconstruction to recover the optical absorption coefficients of tissue, the commonly used diffusion equation has several limitations in the case of the objects that have small geometries and high-absorption or low-scattering areas. Furthermore, the conventional perturbation reconstruction strategy is unsatisfactory when the target tissue containing large heterogeneous features. We herein present a modified q-PAT implementation that employs the higher-order photon migration model achieving the tradeoff between mathematical rigidity and computational efficiency. Besides, a nonlinear iterative method is proposed to obtain the perturbations of optical absorption considering the updating of the sensitivity matrix in calculating the fluence perturbations. Consequently, the distribution of tissue optical properties can be recovered in a robust way even if the targets with high absorption are included. The proposed approach has been validated by simulation, phantom and in vivo experiments, exhibiting promising performances in image fidelity and quantitative feasibility for practical applications.

Deep Learning-Based Spectral Unmixing for Optoacoustic Imaging of Tissue Oxygen Saturation

Label free imaging of oxygenation distribution in tissues is highly desired in numerous biomedical applications, but is still elusive, in particular in sub-epidermal measurements. Eigenspectra multispectral optoacoustic tomography (eMSOT) and its Bayesian-based implementation have been introduced to offer accurate label-free blood oxygen saturation (sO2) maps in tissues. The method uses the eigenspectra model of light fluence in tissue to account for the spectral changes due to the wavelength dependent attenuation of light with tissue depth. eMSOT relies on the solution of an inverse problem bounded by a number of ad hoc hand-engineered constraints. Despite the quantitative advantage offered by eMSOT, both the non-convex nature of the optimization problem and the possible sub-optimality of the constraints may lead to reduced accuracy. We present herein a neural network architecture that is able to learn how to solve the inverse problem of eMSOT by directly regressing from a set of input spectra to the desired fluence values. The architecture is composed of a combination of recurrent and convolutional layers and uses both spectral and spatial features for inference. We train an ensemble of such networks using solely simulated data and demonstrate how this approach can improve the accuracy of sO2 computation over the original eMSOT, not only in simulations but also in experimental datasets obtained from blood phantoms and small animals (mice) in vivo. The use of a deep-learning approach in optoacoustic sO2 imaging is confirmed herein for the first time on ground truth sO2 values experimentally obtained in vivo and ex vivo.

Evaluating online filtering algorithms to enhance dynamic multispectral optoacoustic tomography

Multispectral optoacoustic tomography (MSOT) is an emerging imaging modality, which is able to capture data at high spatiotemporal resolution using rapid tuning of the excitation laser wavelength. However, owing to the necessity of imaging one wavelength at a time to the exclusion of others, forming a complete multispectral image requires multiple excitations over time, which may introduce aliasing due to underlying spectral dynamics or noise in the data. In order to mitigate this limitation, we have applied kinematic α and α β filters to multispectral time series, providing an estimate of the underlying multispectral image at every point in time throughout data acquisition. We demonstrate the efficacy of these methods in suppressing the inter-frame noise present in dynamic multispectral image time courses using a multispectral Shepp-Logan phantom and mice bearing distinct renal cell carcinoma tumors. The gains in signal to noise ratio provided by these filters enable higher-fidelity downstream analysis such as spectral unmixing and improved hypothesis testing in quantifying the onset of signal changes during an oxygen gas challenge.

Improving vascular imaging with co-planar mutually guided photoacoustic and diffuse optical tomography: a simulation study

Diffuse optical tomography (DOT) and photoacoustic tomography (PAT) are functional imaging modalities that provide absorption coefficient maps of the tissue. Spatial resolution of DOT is relatively low due to light scattering characteristics of the tissue. On the other hand, although PAT can resolve regions of different absorptions with a high spatial resolution, measuring the absolute value of optical absorptions using PAT is challenging due to unknown light fluence distribution in the tissue. Development of image guidance techniques using a priori information of imaging target structure has been shown to increase the accuracy of DOT. PAT is one such method that can be used as a complementary modality to serve as a guide for DOT image reconstruction. On the other hand, estimated fluence map provided by DOT can be used to quantitatively correct PAT images. In this study we introduce a mutually-guided imaging system for fast and simultaneous optical and photoacoustic measurements of tissue absorption map, where DOT is guided by the PAT image and vice versa. Using the obtained absorption map of the tissue, we then estimate the tissue scattering map. We conducted this study using a series of simulations on digital phantoms and demonstrated the effectiveness of the proposed method.

Simultaneous transrectal ultrasound and photoacoustic human prostate imaging

Imaging technologies that simultaneously provide anatomical, functional, and molecular information are emerging as an attractive choice for disease screening and management. Since the 1980s, transrectal ultrasound (TRUS) has been routinely used to visualize prostatic anatomy and guide needle biopsy, despite limited specificity. Photoacoustic imaging (PAI) provides functional and molecular information at ultrasonic resolution based on optical absorption. Combining the strengths of TRUS and PAI approaches, we report the development and bench-to-bedside translation of an integrated TRUS and photoacoustic (TRUSPA) device. TRUSPA uses a miniaturized capacitive micromachined ultrasonic transducer array for simultaneous imaging of anatomical and molecular optical contrasts [intrinsic: hemoglobin; extrinsic: intravenous indocyanine green (ICG)] of the human prostate. Hemoglobin absorption mapped vascularity of the prostate and surroundings, whereas ICG absorption enhanced the intraprostatic photoacoustic contrast. Future work using the TRUSPA device for biomarker-specific molecular imaging may enable a fundamentally new approach to prostate cancer diagnosis, prognostication, and therapeutic monitoring.

One-step fluorescence photoacoustic tomography with the optical radiative transfer model

We present adjoint-based Jacobian as well as gradient evaluations and corresponding reconstruction schemes to solve the fully nonlinear, optical radiative transfer modeled one-step fluorescence photoacoustic tomographic (FPAT) problem, which aims to reconstruct the map of absorption coefficient of the exogenous fluorophore from boundary photoacoustic data. The radiative transport equation (RTE) and frequency-domain photoacoustic equation have been employed to model light and photoacoustic wave propagation, respectively. Levenberg-Marquardt and Broyden-Fletcher-Goldfarb-Shanno reconstruction schemes have been used corresponding to the evaluated Jacobians and gradients, respectively. Numerical reconstructions obtained from the two schemes have been validated for scattering-dominant as well as nonscattering-dominant media in 2D. To the best of our knowledge, these are the first one-step FPAT reconstruction results in literature based on the optical RTE model.

An Automatic Unmixing Approach to Detect Tissue Chromophores from Multispectral Photoacoustic Imaging

Multispectral photoacoustic imaging has been widely explored as an emerging tool to visualize and quantify tissue chromophores noninvasively. This modality can capture the spectral absorption signature of prominent tissue chromophores, such as oxygenated, deoxygenated hemoglobin, and other biomarkers in the tissue by using spectral unmixing methods. Currently, most of the reported image processing algorithms use standard unmixing procedures, which include user interaction in the form of providing the expected spectral signatures. For translational research with patients, these types of supervised spectral unmixing can be challenging, as the spectral signature of the tissues can differ with respect to the disease condition. Imaging exogenous contrast agents and accessing their biodistribution can also be problematic, as some of the contrast agents are susceptible to change in spectral properties after the tissue interaction. In this work, we investigated the feasibility of an unsupervised spectral unmixing algorithm to detect and extract the tissue chromophores without any a-priori knowledge and user interaction. The algorithm has been optimized for multispectral photoacoustic imaging in the spectral range of 680-900 nm. The performance of the algorithm has been tested on simulated data, tissue-mimicking phantom, and also on the detection of exogenous contrast agents after the intravenous injection in mice. Our finding shows that the proposed automatic, unsupervised spectral unmixing method has great potential to extract and quantify the tissue chromophores, and this can be used in any wavelength range of the multispectral photoacoustic images.

Gradient-based one-step fluorescence photoacoustic tomography

We propose a gradient-based scheme to solve the fluorescence photoacoustic tomographic (FPAT) problem in a fully nonlinear one-step setting, which aims to reconstruct the map of the absorption coefficient of an exogenous fluorophore from boundary photoacoustic pressure data. Adjoint-based gradient evaluation is presented for the FPAT problem in a frequency-domain photoacoustic equation setting. Numerical validations of the resulting Broyden-Fletcher-Goldfarb-Shanno (BFGS) reconstruction scheme are carried out in two dimensions for full- as well as limited-data test cases, and the results are compared with existing Jacobian-based one-step FPAT reconstructions. The reasonably comparable results of the one-step gradient- and Jacobian-based FPAT reconstruction schemes, coupled with the significant computational savings of the former, potentially set up the one-step gradient-based schemes as an advantageous method of choice for FPAT reconstructions. Further reconstruction studies carried out using quantitative photoacoustic tomography (QPAT)-based chromophore reconstructions as inputs to the FPAT inversions show a robustness of fluorophore absorption coefficient reconstructions to the QPAT-obtained inputs.

Quantitative PA tomography of high resolution 3-D images: Experimental validation in a tissue phantom

Quantitative photoacoustic tomography aims to recover the spatial distribution of absolute chromophore concentrations and their ratios from deep tissue, high-resolution images. In this study, a model-based inversion scheme based on a Monte-Carlo light transport model is experimentally validated on 3-D multispectral images of a tissue phantom acquired using an all-optical scanner with a planar detection geometry. A calibrated absorber allowed scaling of the measured data during the inversion, while an acoustic correction method was employed to compensate the effects of limited view detection. Chromophore- and fluence-dependent step sizes and Adam optimization were implemented to achieve rapid convergence. High resolution 3-D maps of absolute concentrations and their ratios were recovered with high accuracy. Potential applications of this method include quantitative functional and molecular photoacoustic tomography of deep tissue in preclinical and clinical studies.

Development of a blood oxygenation phantom for photoacoustic tomography combined with online pO2 detection and flow spectrometry

Photoacoustic tomography (PAT) is intrinsically sensitive to blood oxygen saturation (sO2) in vivo. However, making accurate sO2 measurements without knowledge of tissue- and instrumentation-related correction factors is extremely challenging. We have developed a low-cost flow phantom to facilitate validation of PAT systems. The phantom is composed of a flow circuit of tubing partially embedded within a tissue-mimicking material, with independent sensors providing online monitoring of the optical absorption spectrum and partial pressure of oxygen in the tube. We first test the flow phantom using two small molecule dyes that are frequently used for photoacoustic imaging: methylene blue and indocyanine green. We then demonstrate the potential of the phantom for evaluating sO2 using chemical oxygenation and deoxygenation of blood in the circuit. Using this dynamic assessment of the photoacoustic sO2 measurement in phantoms in relation to a ground truth, we explore the influence of multispectral processing and spectral coloring on accurate assessment of sO2. Future studies could exploit this low-cost dynamic flow phantom to validate fluence correction algorithms and explore additional blood parameters such as pH and also absorptive and other properties of different fluids.

Three-dimensional quantitative photoacoustic tomography using an adjoint radiance Monte Carlo model and gradient descent

Quantitative photoacoustic tomography aims to recover maps of the local concentrations of tissue chromophores from multispectral images. While model-based inversion schemes are promising approaches, major challenges to their practical implementation include the unknown fluence distribution and the scale of the inverse problem. We describe an inversion scheme based on a radiance Monte Carlo model and an adjoint-assisted gradient optimization that incorporates fluence-dependent step sizes and adaptive moment estimation. The inversion is shown to recover absolute chromophore concentrations, blood oxygen saturation, and the Grüneisen parameter from in silico three-dimensional phantom images for different radiance approximations. The scattering coefficient is assumed to be homogeneous and known a priori.

Linearized reconstruction for diffuse optical spectroscopic imaging

In this paper, we present a novel reconstruction method for diffuse optical spectroscopic imaging with a commonly used tissue model of optical absorption and scattering. It is based on linearization and group sparsity, which allows the diffusion coefficient and absorption coefficient to be recovered simultaneously, provided that their spectral profiles are incoherent and a sufficient number of wavelengths are judiciously taken for the measurements. We also discuss the reconstruction for an imperfectly known boundary and show that, with multi-wavelength data, the method can reduce the influence of modelling errors and still recover the absorption coefficient. Extensive numerical experiments are presented to support our analysis.

Image Reconstruction with Reliability Assessment in Quantitative Photoacoustic Tomography

Quantitative photoacoustic tomography is a novel imaging method which aims to reconstruct optical parameters of an imaged target based on initial pressure distribution, which can be obtained from ultrasound measurements. In this paper, a method for reconstructing the optical parameters in a Bayesian framework is presented. In addition, evaluating the credibility of the estimates is studied. Furthermore, a Bayesian approximation error method is utilized to compensate the modeling errors caused by coarse discretization of the forward model. The reconstruction method and the reliability of the credibility estimates are investigated with two-dimensional numerical simulations. The results suggest that the Bayesian approach can be used to obtain accurate estimates of the optical parameters and the credibility estimates of these parameters. Furthermore, the Bayesian approximation error method can be used to compensate for the modeling errors caused by a coarse discretization, which can be used to reduce the computational costs of the reconstruction procedure. In addition, taking the modeling errors into account can increase the reliability of the credibility estimates.

Impact of depth-dependent optical attenuation on wavelength selection for spectroscopic photoacoustic imaging

An optical wavelength selection method based on the stability of the absorption cross-section matrix to improve spectroscopic photoacoustic (sPA) imaging was recently introduced. However, spatially-varying chromophore concentrations cause the wavelength- and depth-dependent variations of the optical fluence, which degrades the accuracy of quantitative sPA imaging. This study introduces a depth-optimized method that determines an optimal wavelength set minimizing an inverse of the multiplication of absorption cross-section matrix and fluence matrix to minimize the errors in concentration estimation. This method assumes that the optical fluence distribution is known or can be attained otherwise. We used a Monte Carlo simulation of light propagation in tissue with various depths and concentrations of deoxy-/oxy-hemoglobin. We quantitatively compared the developed and current approaches, indicating that the choice of wavelength is critical and our approach is effective especially when quantifying deeper imaging targets.

A Bayesian Approach to Eigenspectra Optoacoustic Tomography

The quantification of hemoglobin oxygen saturation (sO2) with multispectral optoacoustic (OA) (photoacoustic) tomography (MSOT) is a complex spectral unmixing problem, since the OA spectra of hemoglobin are modified with tissue depth due to depth (location) and wavelength dependencies of optical fluence in tissue. In a recent work, a method termed eigenspectra MSOT (eMSOT) was proposed for addressing the dependence of spectra on fluence and quantifying blood sO2 in deep tissue. While eMSOT offers enhanced sO2 quantification accuracy over conventional unmixing methods, its performance may be compromised by noise and image reconstruction artifacts. In this paper, we propose a novel Bayesian method to improve eMSOT performance in noisy environments. We introduce a spectral reliability map, i.e., a method that can estimate the level of noise superimposed onto the recorded OA spectra. Using this noise estimate, we formulate eMSOT as a Bayesian inverse problem where the inversion constraints are based on probabilistic graphical models. Results based on numerical simulations indicate that the proposed method offers improved accuracy and robustness under high noise levels due the adaptive nature of the Bayesian method.

Estimating relative chromophore concentrations from multiwavelength photoacoustic images using independent component analysis

Independent component analysis (ICA) is an unmixing method based on a linear model. It has previously been applied in in vivo multiwavelength photoacoustic imaging studies to unmix the components representing individual chromophores by assuming that they are statistically independent. Numerically simulated and experimentally acquired two-dimensional images of tissue-mimicking phantoms are used to investigate the conditions required for ICA to give accurate estimates of the relative chromophore concentrations. A simple approximate fluence correction was applied to reduce but not completely remove the nonlinear fluence distortion, as might be possible in practice. The results show that ICA is robust against the residual effect of the partially corrected fluence distortion. ICA is shown to provide accurate unmixing of the chromophores when the absorption coefficient is within a certain range of values, where the upper absorption threshold is comparable to the absorption of blood. When the absorption is increased beyond these thresholds, ICA abruptly fails to unmix the chromophores accurately. The ICA approach was compared to a linear spectroscopic inversion (SI) with known absorption spectra. In cases where the mixing matrix with the specific absorption spectra is ill-conditioned, ICA is able to provide accurate unmixing when SI results in large errors.

Modulus design multiwavelength polarization microscope for transmission Mueller matrix imaging

We have developed a polarization microscope based on a commercial transmission microscope. We replace the halogen light source by a collimated LED light source module of six different colors. We use achromatic polarized optical elements that can cover the six different wavelength ranges in the polarization state generator (PSG) and polarization state analyzer (PSA) modules. The dual-rotating wave plate method is used to measure the Mueller matrix of samples, which requires the simultaneous rotation of the two quarter-wave plates in both PSG and PSA at certain angular steps. A scientific CCD detector is used as the image receiving module. A LabView-based software is developed to control the rotation angels of the wave plates and the exposure time of the detector to allow the system to run fully automatically in preprogrammed schedules. Standard samples, such as air, polarizers, and quarter-wave plates, are used to calibrate the intrinsic Mueller matrix of optical components, such as the objectives, using the eigenvalue calibration method. Errors due to the images walk-off in the PSA are studied. Errors in the Mueller matrices are below 0.01 using air and polarizer as standard samples. Data analysis based on Mueller matrix transformation and Mueller matrix polarization decomposition is used to demonstrate the potential application of this microscope in pathological diagnosis.

Quantitative photoacoustic imaging of two-photon absorption

Photoacoustic tomography (PAT) is a hybrid imaging modality where we intend to reconstruct optical properties of heterogeneous media from measured ultrasound signals generated by the photoacoustic effect. In recent years, there have been considerable interests in using PAT to image two-photon absorption, in addition to the usual single-photon absorption, inside diffusive media. We present a mathematical model for quantitative image reconstruction in two-photon photoacoustic tomography (TP-PAT). We propose a computational strategy for the reconstruction of the optical absorption coefficients and provide some numerical evidences based on synthetic photoacoustic acoustic data to demonstrate the feasibility of quantitative reconstructions in TP-PAT.

Statistical independence in nonlinear model-based inversion for quantitative photoacoustic tomography

The statistical independence between the distributions of different chromophores in tissue has previously been used for linear unmixing with independent component analysis (ICA). In this study, we propose exploiting this statistical property in a nonlinear model-based inversion method. The aim is to reduce the sensitivity of the inversion scheme to errors in the modelling of the fluence, and hence provide more accurate quantification of the concentration of independent chromophores. A gradient-based optimisation algorithm is used to minimise the error functional, which includes a term representing the mutual information between the chromophores in addition to the standard least-squares data error. Both numerical simulations and an experimental phantom study are conducted to demonstrate that, in the presence of experimental errors in the fluence model, the proposed inversion method results in more accurate estimation of the concentrations of independent chromophores compared to the standard model-based inversion.

Frequency Domain Analysis of Multiwavelength Photoacoustic Signals for Differentiating Among Malignant, Benign, and Normal Thyroids in an Ex Vivo Study With Human Thyroids

OBJECTIVES

This study investigated the capability of spectral parameters, extracted by frequency domain analysis of photoacoustic signals, to differentiate among malignant, benign, and normal thyroid tissue.

METHODS

We acquired multiwavelength photoacoustic images of freshly excised thyroid specimens collected from 50 patients who underwent thyroidectomy after having a diagnosis of suspected thyroid lesions. A thyroid cytopathologist marked histologic slides of each tissue specimen. These marked slides were used as ground truth to identify the regions of interest (ROIs) corresponding to malignant, benign, and normal thyroid tissue. Three spectral parameters: namely, slope, midband fit, and intercept, were extracted from photoacoustic signals corresponding to different ROIs.

RESULTS

Spectral parameters were extracted from a total of total of 65 ROIs. According to the ground truth, 12 of 65 ROIs belonged to malignant thyroids; 28 of 65 ROIs belonged to benign thyroids; and 25 of 65 ROIs belonged to normal thyroids. Besides slope, the other 2 spectral parameters and grayscale photoacoustic image pixel values were found to be significantly different (P < .05) between malignant and normal thyroids. Between benign and normal thyroids, all 3 spectral parameters and photoacoustic pixel values were significantly different (P < .05).

CONCLUSIONS

Preliminary results of our ex vivo human thyroid study show that the spectral parameters extracted from radiofrequency photoacoustic signals as well as the pixel values of 2-dimensional photoacoustic images can be used for differentiating among malignant, benign, and normal thyroid tissue.

Quantitative photoacoustic tomography augmented with surface light measurements

Quantitative photoacoustic tomography is an imaging modality in which distributions of optical parameters inside tissue are estimated from photoacoustic images. This optical parameter estimation is an ill-posed problem and it needs to be approached in the framework of inverse problems. In this work, utilising surface light measurements in quantitative photoacoustic tomography is studied. Estimation of absorption and scattering is formulated as a minimisation problem utilising both internal quantitative photoacoustic data and surface light data. The image reconstruction problem is studied with two-dimensional numerical simulations in various imaging situations using the diffusion approximation as the model for light propagation. The results show that quantitative photoacoustic tomography augmented with surface light data can improve both absorption and scattering estimates when compared to the conventional quantitative photoacoustic tomography.

Toward whole-body quantitative photoacoustic tomography of small-animals with multi-angle light-sheet illuminations

Several attempts to achieve the quantitative photoacoustic tomography (q-PAT) have been investigated using point sources or a single-angle wide-field illumination. However, these schemes normally suffer from low signal-to-noise ratio (SNR) or poor quantification in imaging applications on large-size domains, due to the limitation of ANSI-safety incidence and incompleteness in the data acquisition. We herein present a q-PAT implementation that uses multi-angle light-sheet illuminations and calibrated recovering-and-averaging iterations. The scheme can obtain more complete information on the intrinsic absorption from the multi-angle illumination mode, and collect SNR-boosted photoacoustic signals in the selected planes from the wide-field light-sheet excitation. Therefore, the sliced absorption maps over whole body of small-animals can be recovered in a measurement-flexible, noise-robust and computation-economic way. The proposed approach is validated by phantom, ex vivo and in vivo experiments, exhibiting promising performances in image fidelity and quantitative accuracy for practical applications.

A feasibility study of photoacoustic imaging of ex vivo endoscopic mucosal resection tissues from Barrett's esophagus patients

BACKGROUND AND STUDY AIMS

Accurate endoscopic detection of dysplasia in patients with Barrett's esophagus (BE) remains a major clinical challenge. The current standard is to take multiple biopsies under endoscopic image guidance, but this leaves the majority of the tissue unsampled, leading to significant risk of missing dysplasia. Furthermore, determining whether there is submucosal invasion is essential for proper staging. Hence, there is a clinical need for a rapid in vivo wide-field imaging method to identify dysplasia in BE, with the capability of imaging beyond the mucosal layer. We conducted an ex vivo feasibility study using photoacoustic imaging (PAI) in patients undergoing endoscopic mucosal resection (EMR) for known dysplasia. The objective was to characterize the esophageal microvascular pattern, with the long-term goal of performing in vivo endoscopic PAI for dysplasia detection and therapeutic guidance.

MATERIALS AND METHODS

 EMR tissues were mounted luminal side up. The tissues were scanned over a field of view of 14 mm (width) by 15 mm (depth) at 680, 750, and 850 nm (40 MHz acoustic central frequency). Ultrasound and photoacoustic images were simultaneously acquired. Tissues were then sliced and fixed in formalin for histopathology with hematoxylin and eosin staining. A total of 13 EMR specimens from eight patients were included in the analysis, which consisted of co-registration of the photoacoustic images with corresponding pathologist-classified histological images. We conducted mean difference test of the total hemoglobin distribution between tissue classes.

RESULTS

 Dysplastic and nondysplastic BE can be distinguished from squamous tissue in 84 % of region-of-interest comparisons (42/50). However, the ability of intrinsic PAI to distinguish dysplasia from NDBE, which is the clinically important challenge, was only about 33 % (10/30).

CONCLUSION

 We demonstrated the technical feasibility of this approach. Based on our ex vivo data, changes in total hemoglobin content from intrinsic PAI (i. e. without exogenous contrast) can differentiate BE from squamous esophageal mucosa. However, most likely intrinsic PAI is unable to differentiate dysplastic from nondysplastic BE with adequate sensitivity for clinical translation.

Constrained Inversion and Spectral Unmixing in Multispectral Optoacoustic Tomography

Accurate extraction of physical and biochemical parameters from optoacoustic images is often impeded due to the use of unrigorous inversion schemes, incomplete tomographic detection coverage, or other experimental factors that cannot be readily accounted for during the image acquisition and reconstruction process. For instance, inaccurate assumptions in the physical forward model may lead to negative optical absorption values in the reconstructed images. Any artifacts present in the single wavelength optoacoustic images can be significantly aggravated when performing a two-step reconstruction consisting in acoustic inversion and spectral unmixing aimed at rendering the distributions of spectrally distinct absorbers. We investigate a number of algorithmic strategies with non-negativity constraints imposed at the different phases of the reconstruction process. Performance is evaluated in cross-sectional multispectral optoacoustic tomography recordings from tissue-mimicking phantoms and in vivo mice embedded with varying concentrations of contrast agents. Additional in vivo validation is subsequently performed with molecular imaging data involving subcutaneous tumors labeled with genetically expressed iRFP proteins and organ perfusion by optical contrast agents. It is shown that constrained reconstruction is essential for reducing the critical image artifacts associated with inaccurate modeling assumptions. Furthermore, imposing the non-negativity constraint directly on the unmixed distribution of the probe of interest was found to maintain the most robust and accurate reconstruction performance in all experiments.

Photoacoustic imaging using genetically encoded reporters: a review

Genetically encoded contrast in photoacoustic imaging (PAI) is complementary to the intrinsic contrast provided by endogenous absorbing chromophores such as hemoglobin. The use of reporter genes expressing absorbing proteins opens the possibility of visualizing dynamic cellular and molecular processes. This is an enticing prospect but brings with it challenges and limitations associated with generating and detecting different types of reporters. The purpose of this review is to compare existing PAI reporters and signal detection strategies, thereby offering a practical guide, particularly for the nonbiologist, to choosing the most appropriate reporter for maximum sensitivity in the biological and technological system of interest.

Photoacoustic pump-probe tomography of fluorophores in vivo using interleaved image acquisition for motion suppression

In fluorophores, the excited state lifetime can be modulated using pump-probe excitation. By generating photoacoustic (PA) signals using simultaneous and time-delayed pump and probe excitation pulses at fluences below the maximum permissible exposure, a modulation of the signal amplitude is observed in fluorophores but not in endogenous chromophores. This provides a highly specific contrast mechanism that can be used to recover the location of the fluorophore using difference imaging. The practical challenges in applying this method to in vivo PA tomography include the typically low concentrations of fluorescent contrast agents, and tissue motion. The former results in smaller PA signal amplitudes compared to those measured in blood, while the latter gives rise to difference image artefacts that compromise the unambiguous and potentially noise-limited detection of fluorescent contrast agents. To address this limitation, a method based on interleaved pump-probe image acquisition was developed. It relies on fast switching between simultaneous and time-delayed pump-probe excitation to acquire PA difference signals in quick succession, and to minimise the effects of tissue motion. The feasibility of this method is demonstrated in tissue phantoms and in initial experiments in vivo.

Towards Quantitative Evaluation of Tissue Absorption Coefficients Using Light Fluence Correction in Optoacoustic Tomography

Optoacoustic tomography is a fast developing imaging modality, combining the high contrast available from optical excitation of tissue with the high resolution and penetration depth of ultrasound detection. Light is subject to both absorption and scattering when traveling through tissue; adequate knowledge of tissue optical properties and hence the spatial fluence distribution is required to create an optoacoustic image that is directly proportional to chromophore concentrations at all depths. Using data from a commercial multispectral optoacoustic tomography (MSOT) system, we implemented an iterative optimization for fluence correction based on a finite-element implementation of the delta-Eddington approximation to the Radiative Transfer Equation (RTE). We demonstrate a linear relationship between the image intensity and absorption coefficients across multiple wavelengths and depths in phantoms. We also demonstrate improved feature visibility and spectral recovery at depth in phantoms and with in vivo measurements, suggesting our approach could in the future enable quantitative extraction of tissue absorption coefficients in biological tissue.

Quantitative photoacoustic tomography using forward and adjoint Monte Carlo models of radiance

Forward and adjoint Monte Carlo (MC) models of radiance are proposed for use in model-based quantitative photoacoustic tomography. A two-dimensional (2-D) radiance MC model using a harmonic angular basis is introduced and validated against analytic solutions for the radiance in heterogeneous media. A gradient-based optimization scheme is then used to recover 2-D absorption and scattering coefficients distributions from simulated photoacoustic measurements. It is shown that the functional gradients, which are a challenge to compute efficiently using MC models, can be calculated directly from the coefficients of the harmonic angular basis used in the forward and adjoint models. This work establishes a framework for transport-based quantitative photoacoustic tomography that can fully exploit emerging highly parallel computing architectures.

Statistical Molecular Target Detection Framework for Multispectral Optoacoustic Tomography

Statistical sub-pixel detection via the adaptive matched filter (AMF) has been shown to improve the molecular imaging sensitivity and specificity of optoacoustic (photoacoustic) imaging. Applied to multispectral optoacoustic tomography (MSOT), AMF assumes that the spatially-varying tissue spectra follow a multivariate Gaussian distribution, that the spectrum of the target molecule is precisely known and that the molecular target lies in "low probability" within the data. However, when these assumptions are violated, AMF may result in considerable performance degradation. The objective of this work is to develop a robust statistical detection framework that is appropriately suited to the characteristics of MSOT molecular imaging. Using experimental imaging data, we perform a statistical characterization of MSOT tissue images and conclude to a detector that is based on the t-distribution. More importantly, we introduce a method for estimating the covariance matrix of the background-tissue statistical distribution, which enables robust detection performance independently of the molecular target size or intensity. The performance of the statistical detection framework is assessed through simulations and experimental in vivo measurements and compared to previously used methods.

Direct Estimation of Optical Parameters From Photoacoustic Time Series in Quantitative Photoacoustic Tomography

Estimation of optical absorption and scattering of a target is an inverse problem associated with quantitative photoacoustic tomography. Conventionally, the problem is expressed as two folded. First, images of initial pressure distribution created by absorption of a light pulse are formed based on acoustic boundary measurements. Then, the optical properties are determined based on these photoacoustic images. The optical stage of the inverse problem can thus suffer from, for example, artefacts caused by the acoustic stage. These could be caused by imperfections in the acoustic measurement setting, of which an example is a limited view acoustic measurement geometry. In this work, the forward model of quantitative photoacoustic tomography is treated as a coupled acoustic and optical model and the inverse problem is solved by using a Bayesian approach. Spatial distribution of the optical properties of the imaged target are estimated directly from the photoacoustic time series in varying acoustic detection and optical illumination configurations. It is numerically demonstrated, that estimation of optical properties of the imaged target is feasible in limited view acoustic detection setting.

Quantitative photoacoustic image reconstruction improves accuracy in deep tissue structures

Photoacoustic imaging (PAI) is emerging as a potentially powerful imaging tool with multiple applications. Image reconstruction for PAI has been relatively limited because of limited or no modeling of light delivery to deep tissues. This work demonstrates a numerical approach to quantitative photoacoustic image reconstruction that minimizes depth and spectrally derived artifacts. We present the first time-domain quantitative photoacoustic image reconstruction algorithm that models optical sources through acoustic data to create quantitative images of absorption coefficients. We demonstrate quantitative accuracy of less than 5% error in large 3 cm diameter 2D geometries with multiple targets and within 22% error in the largest size quantitative photoacoustic studies to date (6cm diameter). We extend the algorithm to spectral data, reconstructing 6 varying chromophores to within 17% of the true values. This quantitiative PA tomography method was able to improve considerably on filtered-back projection from the standpoint of image quality, absolute, and relative quantification in all our simulation geometries. We characterize the effects of time step size, initial guess, and source configuration on final accuracy. This work could help to generate accurate quantitative images from both endogenous absorbers and exogenous photoacoustic dyes in both preclinical and clinical work, thereby increasing the information content obtained especially from deep-tissue photoacoustic imaging studies.

Evaluation of Frequency Domain Analysis of a Multiwavelength Photoacoustic Signal for Differentiating Malignant From Benign and Normal Prostates: Ex Vivo Study With Human Prostates

OBJECTIVES

The purpose of this study was to investigate the feasibility of differentiating malignant prostate from benign prostatic hyperplasia (BPH) and normal prostate tissue by performing frequency domain analysis of photoacoustic images acquired at 2 different wavelengths.

METHODS

We performed multiwavelength photoacoustic imaging on freshly excised human prostate specimens taken from a total of 30 patients undergoing prostatectomy for biopsy-confirmed prostate cancer. Histologic slides marked by a genitourinary pathologist were used as ground truth to define regions of interest (ROIs) in the photoacoustic images. Primarily, 3 different prostate tissue categories, namely malignant, BPH, and normal, were considered, while a fourth category named nonmalignant was formed by combining the ROIs corresponding to BPH and normal tissue together. We extracted 3 spectral parameters, namely slope, midband fit, and intercept, from power spectra of the radiofrequency photoacoustic signals corresponding to the 3 primary tissue categories.

RESULTS

We analyzed data from 53 ROIs selected from the photoacoustic images of 30 patients. According to the histopathologic analysis, 19 ROIs were malignant, 8 were BPH, and 26 were normal. All the 3 spectral parameters and C-scan grayscale photoacoustic image pixel values were found to be significantly different (P < .01) between malignant and nonmalignant prostate as well as malignant and normal prostate.

CONCLUSIONS

Preliminary results of our ex vivo human prostate study suggest that spectral parameters obtained by performing frequency domain analysis of photoacoustic signals can be used to differentiate between malignant and nonmalignant prostate.

Characterisation of a phantom for multiwavelength quantitative photoacoustic imaging

Quantitative photoacoustic imaging (qPAI) has the potential to provide high- resolution in vivo images of chromophore concentration, which may be indicative of tissue function and pathology. Many strategies have been proposed recently for extracting quantitative information, but many have not been experimentally verified. Experimental phantom-based validation studies can be used to test the robustness and accuracy of such algorithms in order to ensure reliable in vivo application is possible. The phantoms used in such studies must have well-characterised optical and acoustic properties similar to tissue, and be versatile and stable. Polyvinyl chloride plastisol (PVCP) has been suggested as a phantom for quality control and system evaluation. By characterising its multiwavelength optical properties, broadband acoustic properties and thermoelastic behaviour, this paper examines its potential as a phantom for qPAI studies too. PVCP's acoustic properties were assessed for various formulations, as well as its intrinsic optical absorption, and scattering with added TiO2, over a range of wavelengths from 400-2000 nm. To change the absorption coefficient, pigment-based chromophores that are stable during the phantom fabrication process, were used. These yielded unique spectra analogous to tissue chromophores and linear with concentration. At the high peak powers typically used in photoacoustic imaging, nonlinear optical absorption was observed. The Grüneisen parameter was measured to be [Formula: see text]  =  1.01  ±  0.05, larger than typically found in tissue, though useful for increased PA signal. Single and multiwavelength 3D PA imaging of various fabricated PVCP phantoms were demonstrated.

High resolution functional photoacoustic tomography of breast cancer

PURPOSE

To evaluate the feasibility of functional photoacoustic tomography (fPAT) for high resolution detection and characterization of breast cancer and to demonstrate for the first time quantitative hemoglobin concentration and oxygen saturation images of breasts that were formed with model-based reconstruction of tomographic photoacoustic data.

METHODS

The study was HIPAA compliant and was approved by the university institutional review board. Written informed consents were obtained from all the participants. Ten cases, including six cancer and four healthy (mean age = 50 yr; age range = 41-66 yr), were examined. Functional images of breast tissue including absolute total hemoglobin concentration (HbT) and oxygen saturation (StO2%) were obtained by fPAT and cross validated with magnetic resonance imaging (MRI) readings and/or histopathology.

RESULTS

HbT and StO2% maps from all six pathology-confirmed cancer cases (60%) show clear detection of tumor, while MR images indicate clear detection of tumor for five of six cancer cases; one small tumor was read as near-complete-resolution by MRI. The average HbT and StO2% value of suspicious lesion area for the cancer cases was 61.6 ± 18.9 μM/l and 67.5% ± 5.2% compared to 25.6 ± 7.4 μM/l and 65.2% ± 3.8% for background normal tissue.

CONCLUSIONS

fPAT has the potential to be a significant add-on in breast cancer detection and characterization as it provides submillimeter resolution functional images of breast lesions.