Optical clearing-aided photoacoustic microscopy with enhanced resolution and imaging depth

Photoacoustic Imaging in Biomedicine and Life Sciences

Photo-acoustic imaging, also known as opto-acoustic imaging, has become a widely popular modality for biomedical applications. This hybrid technique possesses the advantages of high optical contrast and high ultrasonic resolution. Due to the distinct optical absorption properties of tissue compartments and main chromophores, photo-acoustics is able to non-invasively observe structural and functional variations within biological tissues including oxygenation and deoxygenation, blood vessels and spatial melanin distribution. The detection of acoustic waves produced by a pulsed laser source yields a high scaling range, from organ level photo-acoustic tomography to sub-cellular or even molecular imaging. This review discusses significant novel technical solutions utilising photo-acoustics and their applications in the fields of biomedicine and life sciences.

Optical clearing of tissues: Issues of antimicrobial phototherapy and drug delivery

This review presents principles and novelties in the field of tissue optical clearing (TOC) technology, as well as application for optical monitoring of drug delivery and effective antimicrobial phototherapy. TOC is based on altering the optical properties of tissue through the introduction of immersion optical cleaning agents (OCA), which impregnate the tissue of interest. We also analyze various methods and kinetics of delivery of photodynamic agents, nanoantibiotics and their mixtures with OCAs into the tissue depth in the context of antimicrobial and antifungal phototherapy. In vitro and in vivo studies of antimicrobial phototherapies, such as photodynamic, photothermal plasmonic and photocatalytic, are summarized, and the prospects of a new TOC technology for effective killing of pathogens are discussed.

Stokes polarization imaging applied for monitoring dynamic tissue optical clearing

We propose a continuous Stokes imaging system with a refresh rate of several seconds, instead of a traditional Mueller measurement setup, to quickly track the microstructural changes of tissues during the optical clearing process. The effectiveness of this fast Stokes imaging applied in monitoring the dynamic process is first validated by three designed experiments with a polarization state that changes continuously and rapidly, and is further confirmed by gradual changes in polarization image contrast and resolution with clearing. By comparison with experiments from different tissue samples with the same agent, the fast Stokes response curve can improve the analysis ability of photon polarization behavior connected with the complicated changes of tissue characteristics.

Recent progress in near-infrared photoacoustic imaging

The emergence of the photoacoustic imaging (PAI) expands the application of biomolecules bioimaging in cells, various tissues, and living body to monitor multiple physiological processes in complex internal environments. The PAI possesses intriguing properties such as non-invasive, highly selective excitation, and weak signal attenuation. Especially, the near-infrared (NIR) PAI displays low optical absorption and scattering, good temporal or spatial resolution and deep penetration, holds great potential in biomedical applications. We briefly compare different imaging modalities to provide a comprehensive understanding of their characteristics and related applications, highlighting the feature of the PAI. The principle of PAI is then delineated and the emerging NIR-PAI is discussed. We then focus on elaboration of the recent achievement of typical NIR-PAI contrast and their biomedical applications, especially the strategies used to improve contrast rational design and PAI performance are summarized. The PAI-related multimodal imaging approaches for improving imaging accuracy are also covered in the review. Finally, the challenges and prospective are pointed out for attracting more researchers to accelerate the development of PAI.

Chronic cranial window for photoacoustic imaging: a mini review

Photoacoustic (PA) microscopy is being increasingly used to visualize the microcirculation of the brain cortex at the micron level in living rodents. By combining it with long-term cranial window techniques, vasculature can be monitored over a period of days extending to months through a field of view. To fulfill the requirements of long-term in vivo PA imaging, the cranial window must involve a simple and rapid surgical procedure, biological compatibility, and sufficient optical-acoustic transparency, which are major challenges. Recently, several cranial window techniques have been reported for longitudinal PA imaging. Here, the development of chronic cranial windows for PA imaging is reviewed and its technical details are discussed, including window installation, imaging quality, and longitudinal stability.

Penetration-enhanced optical coherence tomography angiography with optical clearing agent for clinical evaluation of human skin

BACKGROUND

Optical coherence tomography angiography (OCTA) is an emerging imaging technique which shows its advantages over visualizing microcirculation with free label. However, its shortcomings in imaging depth limit its development in dermatological field. Nowadays, the newly optical clearing agent (OCA) designed for skin optical imaging demonstrates its potential. In our study, whether this OCA can improve the imaging ability of OCTA in healthy human skin and whether the combination of them is beneficial to compare the lesions and the contralateral normal skins in the patients with port wine stains (PWS) have been investigated.

METHODS

Five healthy volunteers and 3 PWS patients were recruited in this study. In terms of healthy people, the opisthenar area which has same structure information as facial skin was taken for investigating the OCA's ability of enhancing OCTA imaging depth on healthy human skin, besides, in order to verifying whether the exists of skin corneum interfere OCA's function, we compared the effect of only using OCA with that of comprehensive using pre-processing skin and OCA. There are one physical removing corneum method by using medical tape to strip opisthenar skin for over 20-time and one chemical way through applying exfoliating cream. For PWS patient, the combining using OCA and OCTA was applied at the lesion area and the contralateral normal area for the purpose of verifying their ability to provide the information of vessels.

RESULTS

This novel OCA had excellent efficacy to increase the penetration depth of human opisthenar skin for the OCTA imaging by approximately 0.16 ± 0.03 mm. Pre-processing of stratum corneum with an exfoliating cream or medical tape stripping did not further benefit the penetrating efficacy of the OCA. Moreover, according to a comprehensive analysis of the OCTA images enhanced by the OCA, the PWS lesions usually have larger density and diameter of the vessels which located in deep layers (beyond 0.21 mm) than the contralateral normal skin.

CONCLUSIONS

The OCTA imaging depth and contrast were significantly improved by the OCA. The OCA application is a simple and efficient clinical procedure for OCTA enhancement. Moreover, it demonstrated great clinical value to compare the normal skin and the PWS lesions in the patients by the enhanced OCTA imaging.

Methods for Optical Skin Clearing in Molecular Optical Imaging in Dermatology

This short review describes recent progress in using optical clearing (OC) technique in skin studies. Optical clearing is an efficient tool for enhancing the probing depth and data quality in multiphoton microscopy and Raman spectroscopy. Here, we discuss the main mechanisms of OC, its safety, advantages, and limitations. The data on the OC effect on the skin water content are presented. It was demonstrated that 70% glycerol and 100% Omnipaque^TM 300 reduce the water content in the skin. Both OC agents (OCAs) significantly affect the strongly bound and weakly bound water. However, Omnipaque^TM 300 causes considerably less skin dehydration than glycerol. In addition, the results of examination of the OC effect on autofluorescence in two-photon excitation and background fluorescence in Raman scattering at different skin depths are presented. It is shown that Omnipaque^TM 300 is a promising OCA due to its ability to reduce background fluorescence in the upper skin layers. The possibility of multimodal imaging combining optical methods and OC technique is discussed.

Visualization of skin microvascular dysfunction of type 1 diabetic mice using in vivo skin optical clearing method

To realize visualization of the skin microvascular dysfunction of type 1 diabetic mice, we combined laser speckle contrast imaging and hyperspectral imaging to simultaneously monitor the noradrenaline (NE)-induced responses of vascular blood flow and blood oxygen with the development of diabetes through optical clearing skin window. The main results showed that venous and arterious blood flow decreased without recovery after injection of NE; furthermore, the decrease of arterious blood oxygen induced by NE greatly weakened, especially for 2- and 4-week diabetic mice. This change in vasoconstricting effect of NE was related to the expression of α1-adrenergic receptor. This study demonstrated that skin microvascular function was a potential research biomarker for early warning in the occurrence and development of diabetes. The in vivo skin optical clearing method provides a feasible solution to realize visualization of cutaneous microvessels for monitoring microvascular reactivity under pathological conditions. In addition, visual monitoring of skin microvascular function response has guiding significance for early diagnosis of diabetes and clinical research.

Visualization of skin microvascular dysfunction of type 1 diabetic mice using in vivo skin optical clearing method

To realize visualization of the skin microvascular dysfunction of type 1 diabetic mice, we combined laser speckle contrast imaging and hyperspectral imaging to simultaneously monitor the noradrenaline (NE)-induced responses of vascular blood flow and blood oxygen with the development of diabetes through optical clearing skin window. The main results showed that venous and arterious blood flow decreased without recovery after injection of NE; furthermore, the decrease of arterious blood oxygen induced by NE greatly weakened, especially for 2- and 4-week diabetic mice. This change in vasoconstricting effect of NE was related to the expression of α1-adrenergic receptor. This study demonstrated that skin microvascular function was a potential research biomarker for early warning in the occurrence and development of diabetes. The in vivo skin optical clearing method provides a feasible solution to realize visualization of cutaneous microvessels for monitoring microvascular reactivity under pathological conditions. In addition, visual monitoring of skin microvascular function response has guiding significance for early diagnosis of diabetes and clinical research.

Measurement of tissue optical properties in the context of tissue optical clearing

Nowadays, dynamically developing optical (photonic) technologies play an ever-increasing role in medicine. Their adequate and effective implementation in diagnostics, surgery, and therapy needs reliable data on optical properties of human tissues, including skin. This paper presents an overview of recent results on the measurements and control of tissue optical properties. The issues reported comprise a brief review of optical properties of biological tissues and efficacy of optical clearing (OC) method in application to monitoring of diabetic complications and visualization of blood vessels and microcirculation using a number of optical imaging technologies, including spectroscopic, optical coherence tomography, and polarization- and speckle-based ones. Molecular modeling of immersion OC of skin and specific technique of OC of adipose tissue by its heating and photodynamic treatment are also discussed.

Current status, pitfalls and future directions in the diagnosis and therapy of lymphatic malformation

Lymphatic malformations are complex congenital vascular lesions composed of dilated, abnormal lymphatic channels of varying size that can result in significant esthetic and physical impairment due to relentless growth. Lymphatic malformations comprised of micro-lymphatic channels (microcystic) integrate and infiltrate normal soft tissue, leading to a locally invasive mass. Ultrasonography and magnetic resonance imaging assist in the diagnosis but are unable to detect microvasculature present in microcystic lymphatic malformations. In this review, we examine existing tools and elaborate on alternative diagnostic methods in assessing lymphatic malformations. In particular, photoacoustics, low-toxicity nanoparticles and optical clearing can overcome existing challenges in the examination of lymphatic channels in vivo. In combination with photothermal scanning and flow cytometry, Photoacoustic techniques may provide a versatile tool for lymphatic-related clinical applications, potentially leading to a single diagnostic and therapeutic platform to overcome limitations in current imaging techniques and permit targeted theranostics of microcystic lymphatic malformations.

In vivo imaging the motility of monocyte/macrophage during inflammation in diabetic mice

Diabetes, as a chronic metabolic disease, can impair the immune function of monocytes/macrophages (MMs). However, it is unclear how MM immune response to inflammation with the development of diabetes, and whether immune response around the inflammatory foci depends on the depth in tissue. Footpad provides a classical physiological site for monitoring cellular behavior during inflammation, but limited to the superficial dermis due to the strong scattering of footpad. Herein, we used confocal microscopy to monitor the motility of MMs in deeper tissue around inflammatory foci with the development of type 1 diabetic (T1D) mice through a switchable footpad skin optical clearing window. Delayed-type hypersensitivity (DTH) model was elicited on the footpad of T1D. Results demonstrated that progressive T1D led to the gradually potentiated MM recruitment and increased expression of monocyte chemoattractant protein-1 during DTH, but MM migration displacement, motion velocity and motility coefficient were significantly attenuated. Besides, MMs from the deeper dermis had a much larger migration displacement than those from superficial dermis at early stages of DTH but an opposite tendency at late stages for non-T1D, while progressive T1D obscured this difference gradually. This study will be helpful for investigating the influences of progressive metabolic diseases on immune response. MM motion trajectory at depth of superficial dermis and the deeper dermis at AOVA (heat-aggregated ovalbumin)-4 hours and AOVA-72 hours on non-T1D (A) and T1D-4 weeks (B). Mean motility coefficient (C) at the 2 depths. Data were pooled from 6 mice per group. *P < .05 and **P < .01 compared among different T1D disease durations. #P < .05 compared between different depths.

Low Temperature-Mediated Enhancement of Photoacoustic Imaging Depth

We study the temperature dependence of the underlying mechanisms related to the signal strength and imaging depth in photoacoustic imaging. The presented theoretical and experimental results indicate that imaging depth can be improved by lowering the temperature of the intermediate medium that the laser passes through to reach the imaging target. We discuss the temperature dependency of optical and acoustic properties of the intermediate medium and their changes due to cooling. We demonstrate that the SNR improvement of the photoacoustic signal is mainly due to the reduction of Grüneisen parameter of the intermediate medium which leads to a lower level of background noise. These findings may open new possibilities toward the application of biomedical laser refrigeration.

Dictionary learning-based reverberation removal enables depth-resolved photoacoustic microscopy of cortical microvasculature in the mouse brain

Photoacoustic microscopy (PAM) capitalizes on the optical absorption of blood hemoglobin to enable label-free high-contrast imaging of the cerebral microvasculature in vivo. Although time-resolved ultrasonic detection equips PAM with depth-sectioning capability, most of the data at depths are often obscured by acoustic reverberant artifacts from superficial cortical layers and thus unusable. In this paper, we present a first-of-a-kind dictionary learning algorithm to remove the reverberant signal while preserving underlying microvascular anatomy. This algorithm was validated in vitro, using dyed beads embedded in an optically transparent polydimethylsiloxane phantom. Subsequently, we demonstrated in the live mouse brain that the algorithm can suppress reverberant artifacts by 21.0 ± 5.4 dB, enabling depth-resolved PAM up to 500 µm from the brain surface.

FSOCA-induced switchable footpad skin optical clearing window for blood flow and cell imaging in vivo

The mouse footpad for its feature of hairlessness provides an available window for imaging vascular and cellular structure and function in vivo. Unfortunately, the strong scattering of its skin limits the penetration of light and reduces the imaging contrast and depth. Herein, an innovative footpad skin optical clearing agent (FSOCA) was developed to make the footpad skin transparent quickly by topical application. The results demonstrate that FSOCA treatment not only allowed the cutaneous blood vessels and blood flow distribution to be monitored by laser speckle contrast imaging technique with higher contrast, but also permitted the fluorescent cells to be imaged by laser scanning confocal microscopy with higher fluorescence signal intensity and larger imaging depth. In addition, the physiological saline-treatment could make the footpad skin recover to the initial turbid status, and reclearing would not induce any adverse effects on the distributions and morphologies of blood vessels and cells, which demonstrated a safe and switchable window for biomedical imaging. This switchable footpad skin optical clearing window will be significant for studying blood flow dynamics and cellular immune function in vivo in some vascular and immunological diseases. Picture: Repeated cell imaging in vivo before (a) and after (b) FSOCA treatment. (c) Merged images of 4 h (cyan border) or 72 h (magenta border) over 0 h. (d) Zoom of ROI in 4 h (yellow rectangle) or 72 h (red rectangle).

Motionless volumetric photoacoustic microscopy with spatially invariant resolution

Photoacoustic microscopy (PAM) is uniquely positioned for biomedical applications because of its ability to visualize optical absorption contrast in vivo in three dimensions. Here we propose motionless volumetric spatially invariant resolution photoacoustic microscopy (SIR-PAM). To realize motionless volumetric imaging, SIR-PAM combines two-dimensional Fourier-spectrum optical excitation with single-element depth-resolved photoacoustic detection. To achieve spatially invariant lateral resolution, propagation-invariant sinusoidal fringes are generated by a digital micromirror device. Further, SIR-PAM achieves 1.5 times finer lateral resolution than conventional PAM. The superior performance was demonstrated in imaging both inanimate objects and animals in vivo with a resolution-invariant axial range of 1.8 mm, 33 times the depth of field of the conventional PAM counterpart. Our work opens new perspectives for PAM in biomedical sciences.

Photoacoustic microscopy allows for label-free 3D in vivo imaging by detecting the acoustic response of a photoexcited material. Here, Yang et. al use a digital-micromirror-device based structured illumination scheme to both improve resolution and greatly increase the depth of field, enabling 3D volumetric imaging.

A useful way to develop effective in vivo skin optical clearing agents

Skin optical clearing has shown tremendous potential in improving various optical imaging performances, but there is some certain blindness in screening out high-efficiency in vivo optical clearing methods. In this work, three optical clearing agents: sucrose (Suc), fructose (Fruc) and PEG-400 (PEG), and two chemical penetration enhancers: propylene glycol (PG) and thiazone (Thiaz) were used. PEG was firstly mixed with the two penetration enhancers, respectively, and then mixed with Fruc and Suc, respectively, to obtain six kinds of skin optical clearing agents (SOCAs). Optical coherence tomography angiography was applied to monitor SOCAs-induced changes in imaging performances, skin optical properties, refractive index mismatching extent, and permeability rate. Experimental results demonstrated that PEG+Thiaz+Suc has the optimal capacity in enhancing the imaging performances, decreasing the scattering and the refractive index mismatching since Thiaz is superior to PG, and Suc is superior to Fruc. This study indicates that the optimal SOCA can be obtained directly by means of additionally adding or replacing the similar category substance in preexisting SOCAs with some more effective reagents. It not only provides an optimal SOCA, but also provides a useful way to develop more effective SOCAs. Cross-section skin structural texture (a), reconstructed blood flow distribution information (b), before or after treated with different SOCAs.

Enhancement of short coherence digital holographic microscopy by optical clearing

In this work, we used a short coherence digital holographic microscopy system to demonstrate cross-talk noise suppression and imaging performance enhancement by optical clearing. Performance of the system on both phantom and in vitro porcine skin tissues before and after the treatment of 70% v./v. glycerol-saline solution was investigated. Our results showed that optical clearing effectively inhibits the cross-talk noise and improves the image quality in the deep of the in vitro porcine skin tissues. The imaging depth was increased by about 30% after topical application of the glycerol-saline solution for 30 min.

Lookup-table-based inverse model for mapping oxygen concentration of cutaneous microvessels using hyperspectral imaging

Hyperspectral imaging combining with skin optical clearing technique provides a possible way to non-invasively monitor hemodynamics of cutaneous microvessels. In order to estimate microvascular blood oxygen saturation, in this work, a lookup-table-based inverse model was developed to extract the microvascular optical and physiological properties using hyperspectral analysis. This approach showed a higher fitting degree than currently existing hyperspectral analysis methods (i.e. multiple linear regression and non-negative least square fit) in estimating blood oxygen saturation. Hypoxic stimulation experiment showed that calculated results were in accordance with physiological changes, and the relative changes of estimated oxygen saturation indicated this method appeared to be more sensitive to blood oxygen fluctuation. And a simulated blood model was used for verification here, indicating this method also showed a good accuracy in determining oxygen saturation from the simulated spectra.

Photoacoustic imaging of the eye: A mini review

The eye relies on the synergistic cooperation of many different ocular components, including the cornea, crystalline lens, photoreceptors, and retinal neurons, to precisely sense visual information. Complications with a single ocular component can degrade vision and sometimes cause blindness. Immediate treatment and long-term monitoring are paramount to alleviate symptoms, restore vision, and cure ocular diseases. However, successful treatment requires understanding ocular pathological mechanisms, precisely detecting and monitoring the diseases. The investigation and diagnosis of ocular diseases require advanced medical tools. In this mini review, we discuss non-invasive photoacoustic (PA) imaging as a potential research tool and medical screening device. In the research setting, PA imaging can provide valuable information on the disease progression. In the clinical setting, PA imaging can potentially aid in disease detection and treatment monitoring.

Optical coherence tomography angiography offers comprehensive evaluation of skin optical clearing in vivo by quantifying optical properties and blood flow imaging simultaneously

Tissue optical clearing (TOC) is helpful for reducing scattering and enhancing the penetration depth of light, and shows promising potential in optimizing optical imaging performances. A mixture of fructose with PEG-400 and thiazone (FPT) is used as an optical clearing agent in mouse dorsal skin and evaluated with OCT angiography (Angio-OCT) by quantifying optical properties and blood flow imaging simultaneously. It is observed that FPT leads to an improved imaging performance for the deeper tissues. The imaging performance improvement is most likely caused by the FPT-induced dehydration of skin, and the reduction of scattering coefficient (more than ∼ 40.5%) and refractive-index mismatching (more than ∼ 25.3%) in the superficial (epidermal, dermal, and hypodermal) layers. A high correlation (up to ∼ 90%) between the relative changes in refractive-index mismatching and Angio-OCT signal strength is measured. The optical clearing rate is ∼ 5.83 × 10(-5) cm/s. In addition, Angio-OCT demonstrates enhanced performance in imaging cutaneous hemodynamics with satisfactory spatiotemporal resolution and contrast when combined with TOC, which exhibits a powerful practical application in studying microcirculation.

Skull Optical Clearing Solution for Enhancing Ultrasonic and Photoacoustic Imaging

The performance of photoacoustic microscopy (PAM) degrades due to the turbidity of the skull that introduces attenuation and distortion of both laser and stimulated ultrasound. In this manuscript, we demonstrated that a newly developed skull optical clearing solution (SOCS) could enhance not only the transmittance of light, but also that of ultrasound in the skull in vitro. Thus the photoacoustic signal was effectively elevated, and the relative strength of the artifacts induced by the skull could be suppressed. Furthermore in vivo studies demonstrated that SOCS could drastically enhance the performance of photoacoustic microscopy for cerebral microvasculature imaging.

Tutorial on photoacoustic tomography

Photoacoustic tomography (PAT) has become one of the fastest growing fields in biomedical optics. Unlike pure optical imaging, such as confocal microscopy and two-photon microscopy, PAT employs acoustic detection to image optical absorption contrast with high-resolution deep into scattering tissue. So far, PAT has been widely used for multiscale anatomical, functional, and molecular imaging of biological tissues. We focus on PAT’s basic principles, major implementations, imaging contrasts, and recent applications.

Handheld photoacoustic probe to detect both melanoma depth and volume at high speed in vivo

We applied a linear-array-based photoacoustic probe to detect melanin-containing melanoma tumor depth and volume in nude mice in vivo. This system can image melanomas at five frames per second (fps), which is much faster than our previous handheld single transducer system (0.1 fps). We first theoretically show that, in addition to the higher frame rate, almost the entire boundary of the melanoma can be detected by the linear-array-based probe, while only the horizontal boundary could be detected by the previous system. Then we demonstrate the ability of this linear-array-based system in measuring both the depth and volume of melanoma through phantom, ex vivo, and in vivo experiments. The volume detection ability also enables us to accurately calculate the rate of growth of the tumor, which is an important parameter in quantifying the tumor activity. Our results show that this system can be used for clinical melanoma diagnosis and treatment in humans at the bedside. Linear-array-based PA images of melanoma acquired in vivo on day 3 (a) and day 6 (b).

Accessing to arteriovenous blood flow dynamics response using combined laser speckle contrast imaging and skin optical clearing

Laser speckle contrast imaging (LSCI) shows a great potential for monitoring blood flow, but the spatial resolution suffers from the scattering of tissue. Here, we demonstrate the capability of a combination method of LSCI and skin optical clearing to describe in detail the dynamic response of cutaneous vasculature to vasoactive noradrenaline injection. Moreover, the superior resolution, contrast and sensitivity make it possible to rebuild arteries-veins separation and quantitatively assess the blood flow dynamical changes in terms of flow velocity and vascular diameter at single artery or vein level.

Optimal flushing agents for integrated optical and acoustic imaging systems

An increasing number of integrated optical and acoustic intravascular imaging systems have been developed and hold great promise for accurately diagnosing vulnerable plaques and guiding atherosclerosis treatment. However, in any intravascular environment, the vascular lumen is filled with blood, a high-scattering source for optical and high-frequency ultrasound signals. Blood must be flushed away to provide clearer images. To our knowledge, no research has been performed to find the ideal flushing agent for combined optical and acoustic imaging techniques. We selected three solutions as potential flushing agents for their image-enhancing effects: mannitol, dextran, and iohexol. Testing of these flushing agents was performed in a closed-loop circulation model and in vivo on rabbits. We found that a high concentration of dextran was the most useful for simultaneous intravascular ultrasound and optical coherence tomography imaging.

Noninvasive photoacoustic microscopy of methemoglobin in vivo

Due to the various causes of methemoglobinemia and its potential to be confused with other diseases, in vivo measurements of methemoglobin have significant applications in the clinic. Using photoacoustic microscopy (PAM), we quantified the average and the distributed percentage of methemoglobin both in vitro and in vivo. Based on the absorption spectra of methemoglobin, oxyhemoglobin, and deoxyhemoglobin, three wavelengths were chosen to differentiate methemoglobin from the others. The methemoglobin concentrations calculated from the photoacoustic signals agreed well with the preset concentrations. Then we imaged the methemoglobin percentage in microtubes that mimicked blood vessels. Average percentages calculated for five samples with different methemoglobin concentrations also agreed well with the preset values. Finally, we demonstrated the ability of PAM to detect methemoglobin in vivo in a mouse ear. Our results show that PAM can quantitatively image methemoglobin distribution in vivo.

Study on the refractive index matching effect of ultrasound on optical clearing of bio-tissues based on the derivative total reflection method

In recent years, the tissue optical clearing (OC) technique in the biomedicine field has drawn lots of attention. Various physical and chemical methods have been introduced to improve the efficacy of OC. In this study, the effect of the combination of glycerol and ultrasound treatment on OC of in vitro porcine muscle tissues has been investigated. The refractive index (RI) matching mechanism of OC was directly observed based on the derivative total reflection method. A theoretical model was used to simulate the proportion of tissue fluid in the illuminated area. Moreover, the total transmittance spectra have been obtained by a spectrometer over the range from 450 nm to 700 nm. The administration of glycerol and ultrasound has led to an increase of the RI of background medium and a more RI matching environment was achieved. The experimental results support the validity of the ultrasound treatment for OC. The RI matching mechanism has been firstly quantitatively analyzed based on the derivative total reflection method.

Handheld photoacoustic microscopy to detect melanoma depth in vivo

We developed handheld photoacoustic microscopy (PAM) to detect melanoma and determine tumor depth in nude mice in vivo. Compared to our previous PAM system for melanoma imaging, a new light delivery mechanism is introduced to improve light penetration. We show that melanomas with 4.1 and 3.7 mm thicknesses can be successfully detected in phantom and in in vivo experiments, respectively. With its deep melanoma imaging ability and handheld design, this system can be tested for clinical melanoma diagnosis, prognosis, and surgical planning for patients at the bedside.

Microcirculatory changes identified by photoacoustic microscopy in patients with complex regional pain syndrome type I after stellate ganglion blocks

Complex regional pain syndrome (CRPS) is a chronic pain syndrome that causes intractable pain, disability, and poor quality of life for patients. The etiology and pathophysiology of CRPS are still poorly understood. Due to a lack of proper diagnostic tools, the prognosis of CRPS is primarily based on clinical observation. The objective of this work is to evaluate a new imaging modality, photoacoustic microscopy (PAM), for assisting diagnoses and monitoring the progress and treatment outcome of CRPS. Blood vasculature and oxygen saturation (sO₂) were imaged by PAM from eight adult patients with CRPS-1. Patients' hands and cuticles were imaged both before and after stellate ganglion block (SGB) for comparison. For all patients, both vascular structure and sO₂ could be assessed by PAM. In addition, more vessels and stronger signals were observed after SGB. The results show that PAM can help diagnose and monitor CRPS.

Calibration-free absolute quantification of particle concentration by statistical analyses of photoacoustic signals in vivo

Currently, laser fluence calibration is typically required for quantitative measurement of particle concentration in photoacoustic imaging. Here, we present a calibration-free method to quantify the absolute particle concentration by statistically analyzing photoacoustic signals. The proposed method is based on the fact that Brownian motion induces particle count fluctuation in the detection volume. If the count of particles in the detection volume is assumed to follow the Poisson distribution, its expected value can be calculated by the photoacoustic signal mean and variance. We first derived a theoretical model for photoacoustic signals. Then, we applied our method to quantitative measurement of different concentrations of various particles, including red blood cells. Finally, we performed in vivo experiments to demonstrate the potential of our method in biological applications. The experimental results agreed well with the predictions from the theoretical model suggesting that our method can be used for noninvasive measurement of absolute particle concentrations in deep tissue without fluence calibration.

Viscous optical clearing agent for in vivo optical imaging

By allowing more photons to reach deeper tissue, the optical clearing agent (OCA) has gained increasing attention in various optical imaging modalities. However, commonly used OCAs have high fluidity, limiting their applications in in vivo studies with oblique, uneven, or moving surfaces. In this work, we reported an OCA with high viscosity. We measured the properties of this viscous OCA, and tested its successful performances in the imaging of a living animal’s skin with two optical imaging modalities: photoacoustic microscopy and optical coherence tomography. Our results demonstrated that the viscous OCA has a great potential in the study of different turbid tissues using various optical imaging modalities.

Circulating Tumor Cell Detection and Capture by Photoacoustic Flow Cytometry in Vivo and ex Vivo

Despite progress in detecting circulating tumor cells (CTCs), existing assays still have low sensitivity (1-10 CTC/mL) due to the small volume of blood samples (5-10 mL). Consequently, they can miss up to 103-104 CTCs, resulting in the development of barely treatable metastasis. Here we analyze a new concept of in vivo CTC detection with enhanced sensitivity (up to 102-103 times) by the examination of the entire blood volume in vivo (5 L in adults). We focus on in vivo photoacoustic (PA) flow cytometry (PAFC) of CTCs using label-free or targeted detection, photoswitchable nanoparticles with ultrasharp PA resonances, magnetic trapping with fiber-magnetic-PA probes, optical clearance, real-time spectral identification, nonlinear signal amplification, and the integration with PAFC in vitro. We demonstrate PAFC's capability to detect rare leukemia, squamous carcinoma, melanoma, and bulk and stem breast CTCs and its clusters in preclinical animal models in blood, lymph, bone, and cerebrospinal fluid, as well as the release of CTCs from primary tumors triggered by palpation, biopsy or surgery, increasing the risk of metastasis. CTC lifetime as a balance between intravasation and extravasation rates was in the range of 0.5-4 h depending on a CTC metastatic potential. We introduced theranostics of CTCs as an integration of nanobubble-enhanced PA diagnosis, photothermal therapy, and feedback through CTC counting. In vivo data were verified with in vitro PAFC demonstrating a higher sensitivity (1 CTC/40 mL) and throughput (up to 10 mL/min) than conventional assays. Further developments include detection of circulating cancer-associated microparticles, and super-rsesolution PAFC beyond the diffraction and spectral limits.

Optical clearing agents improve photoacoustic imaging in the optical diffusive regime

Acoustic resolution photoacoustic microscopy (AR-PAM) takes advantage of weak acoustic scattering to image fine structures, such as the subcutaneous microvasculature, providing a spatial resolution on the order of tens of micrometers. However, the amplitude of AR-PAM deteriorates sharply with depth, as a result of light scattering and acoustic attenuation caused by structures such as the skin. Optical clearing techniques can enhance optical transmittance by decreasing the scattering of light through tissues. However, it is unknown whether optical clearing agents (OCAs) can be used to improve AR-PAM. We applied different types of OCAs to rat dorsal skin in an ex vivo study to determine the effects of OCAs on photoacoustic detection. We identified three OCAs that improved the photoacoustic amplitude for further in vivo testing. With the use of an appropriate penetration enhancer, PEG-400 significantly improved the photoacoustic amplitude for detection of deep-sealed blood vessels, while glycerol alone improved the image quality of shallow vessels. In contrast, DMSO application resulted in decreased photoacoustic amplitude in the in vivo trials.

Calibration-free in vivo transverse blood flowmetry based on cross correlation of slow time profiles from photoacoustic microscopy

We propose a cross-correlation-based method to measure blood-flow velocity by using photoacoustic microscopy. Unlike in previous autocorrelation-based methods, the measured flow velocity here is independent of particle size. Thus an absolute flow velocity can be obtained without calibration. We first measured the flow velocity ex vivo, using defibrinated bovine blood. Then flow velocities in vessels with different structures in a mouse ear were quantified in vivo. We further measured the flow variation in the same vessel and at a vessel bifurcation. All the experimental results indicate that our method can be used to accurately quantify blood velocity in vivo.

Optical clearing in photoacoustic flow cytometry

Clinical applications of photoacoustic (PA) flow cytometry (PAFC) for detection of circulating tumor cells in deep blood vessels are hindered by laser beam scattering, that result in loss of PAFC sensitivity and resolution. We demonstrate biocompatible and rapid optical clearing (OC) of skin to minimize light scattering and thus, increase optical resolution and sensitivity of PAFC. OC effect was achieved in 20 min by sequent skin cleaning, microdermabrasion, and glycerol application enhanced by massage and sonophoresis. Using 0.8 mm mouse skin layer over a blood vessel in vitro phantom we demonstrated 1.6-fold decrease in laser spot blurring accompanied by 1.6-fold increase in PA signal amplitude from blood background. As a result, peak rate for B16F10 melanoma cells in blood flow increased 1.7-fold. By using OC we also demonstrated the feasibility of PA contrast improvement for human hand veins.