Handheld photoacoustic microscopy to detect melanoma depth in vivo

Unsupervised deep learning enables real-time image registration of fast-scanning optical-resolution photoacoustic microscopy

A fast scanner of optical-resolution photoacoustic microscopy is inherently vulnerable to perturbation, leading to severe image distortion and significant misalignment among multiple 2D or 3D images. Restoration and registration of these images is critical for accurately quantifying dynamic information in long-term imaging. However, traditional registration algorithms face a great challenge in computational throughput. Here, we develop an unsupervised deep learning based registration network to achieve real-time image restoration and registration. This method can correct artifacts from B-scan distortion and remove misalignment among adjacent and repetitive images in real time. Compared with conventional intensity based registration algorithms, the throughput of the developed algorithm is improved by 50 times. After training, the new deep learning method performs better than conventional feature based image registration algorithms. The results show that the proposed method can accurately restore and register the images of fast-scanning photoacoustic microscopy in real time, offering a powerful tool to extract dynamic vascular structural and functional information.

Functional and molecular 3D mapping of angiosarcoma tumor using non-invasive laser speckle, hyperspectral, and photoacoustic imaging

PURPOSE

The gold standard for skin cancer diagnosis is surgical excisional biopsy and histopathological examination. Several non-invasive diagnostic techniques exist, although they have not yet translated into clinical use. This is a proof-of-concept study to assess the possibility of imaging an angiosarcoma in the periocular area.

METHODS

We use laser speckle, hyperspectral, and photoacoustic imaging to monitor blood perfusion and oxygen saturation, as well as the molecular composition of the tissue. The information obtained from each imaging modality was combined in order to yield a more comprehensive picture of the function, as well as molecular composition of a rapidly growing cutaneous angiosarcoma in the periocular area.

RESULTS

We found an increase in perfusion coupled with a reduction in oxygen saturation in the angiosarcoma. We could also extract the molecular composition of the angiosarcoma at a depth, depicting both the oxygen saturation and highlighting the presence of connective tissue via collagen.

CONCLUSIONS

We demonstrate the different physiological parameters that can be obtained with the different techniques and how these can be combined to provide detailed 3D maps of the functional and molecular properties of tumors useful in preoperative assessment.

Photoacoustic imaging for cutaneous melanoma assessment: a comprehensive review

Significance

Cutaneous melanoma (CM) has a high morbidity and mortality rate, but it can be cured if the primary lesion is detected and treated at an early stage. Imaging techniques such as photoacoustic (PA) imaging (PAI) have been studied and implemented to aid in the detection and diagnosis of CM.

Aim

Provide an overview of different PAI systems and applications for the study of CM, including the determination of tumor depth/thickness, cancer-related angiogenesis, metastases to lymph nodes, circulating tumor cells (CTCs), virtual histology, and studies using exogenous contrast agents.

Approach

A systematic review and classification of different PAI configurations was conducted based on their specific applications for melanoma detection. This review encompasses animal and preclinical studies, offering insights into the future potential of PAI in melanoma diagnosis in the clinic.

Results

PAI holds great clinical potential as a noninvasive technique for melanoma detection and disease management. PA microscopy has predominantly been used to image and study angiogenesis surrounding tumors and provide information on tumor characteristics. Additionally, PA tomography, with its increased penetration depth, has demonstrated its ability to assess melanoma thickness. Both modalities have shown promise in detecting metastases to lymph nodes and CTCs, and an all-optical implementation has been developed to perform virtual histology analyses. Animal and human studies have successfully shown the capability of PAI to detect, visualize, classify, and stage CM.

Conclusions

PAI is a promising technique for assessing the status of the skin without a surgical procedure. The capability of the modality to image microvasculature, visualize tumor boundaries, detect metastases in lymph nodes, perform fast and label-free histology, and identify CTCs could aid in the early diagnosis and classification of CM, including determination of metastatic status. In addition, it could be useful for monitoring treatment efficacy noninvasively.

Combined ultrasound and photoacoustic C-mode imaging system for skin lesion assessment

Accurate assessment of the size and depth of infiltration is critical for effectively treating and removing skin cancer, especially melanoma. However, existing methods such as skin biopsy and histologic examination are invasive, time-consuming, and may not provide accurate depth results. We present a novel system for simultaneous and co-localized ultrasound and photoacoustic imaging, with the application for non-invasive skin lesion size and depth measurement. The developed system integrates an acoustical mirror that is placed on an ultrasound transducer, which can be translated within a flexible water tank. This allows for 3D (C-mode) imaging, which is useful for mapping the skin structure and determine the invasion size and depth of lesions including skin cancer. For efficient reconstruction of photoacoustic images, we applied the open-source MUST library. The acquisition time per 2D image is <1 s and the pulse energies are below the legal Maximum Permissible Exposure (MPE) on human skin. We present the depth and resolution capabilities of the setup on several self-designed agar phantoms and demonstrate in vivo imaging on human skin. The setup also features an unobstructed optical window from the top, allowing for simple integration with other optical modalities. The perspective towards clinical application is demonstrated.

Thirty years of research on photoacoustic imaging in the field of cancer: A scientometric analysis of hotspots, bursts, and research trends

As a novel imaging modality based on photoacoustic effects, photoacoustic imaging (PAI) has shown great potential in biomedical applications, especially in the field of cancer. The purpose of our research was to identify collaborations between different institutions, authors, and countries, and to explore the hotspots and prospects of PAI research in the field of cancer. We downloaded publications on PAI research from the Science Citation Index-Expanded (SCI-E) of the Web of Science Core Collection database. Bibliometric analysis was performed using VOSviewer and CiteSpace software. A total of 2561 papers related to PAI research in the field of cancer were identified. A total of 10,105 authors participated in the PAI study, of which the majority (69.33%) authors participated in only 1 article. China (1638, 63.96%) was the country with the most articles in this field, and the Chinese Academy of Sciences (329, 12.85%) was the most productive institution. ACS Applied Materials & Interfaces (146, 5.70%) was the most productive journal and ACS Nano (7262 co-citations) was the most co-cited journal. Current hot topics of PAI research in the cancer field were the construction and development of multifunctional photoacoustic nanoprobes to achieve the integration of tumor detection and treatment. The application of photoacoustic imaging in the field of cancer is in the vigorous development stage and has a bright prospect. There was a wealth of cooperation between authors, countries, and institutions. Our findings can provide information about the future direction of funding agencies and research groups.

Sensing of triglyceride concentration in blood solution using photoacoustic microscopy

The level of triglyceride (TG) in blood is essential to human health, and hypertriglyceridemia (TG level > 150 mg/dL) would lead to cardiovascular disease and acute pancreatitis that threaten human life. Routine methods for measuring the TG level in blood depend on a lipid panel blood test, which is invasive and not convenient. Here, we use photoacoustic (PA) microscopy to test the PA amplitude of blood solutions (based on hemoglobin powder as well as flowing sheep blood) with different TG concentrations. Interestingly, we observe that the PA amplitude increases with increasing TG concentration in blood solutions, which is attributed to the increase of the Grüneisen coefficient. The preliminary in vitro study shows that the PA methodology is able to detect the TG level down to 450 mg/dL. This finding provides an opportunity for using photoacoustics to noninvasively diagnose hypertriglyceridemia.

Efficient label-free in vivo photoacoustic imaging of melanoma cells using a condensed NIR-I spectral window

In this paper, we propose an efficient label-free in vivo photoacoustic (PA) imaging of melanoma using a condensed near infrared-I (NIR-I) supercontinuum light source. Although NIR-II spectral window is advantageous such as longer penetration depth compared to the NIR-I region, supercontinuum light sources emitting both NIR-I and NIR-II region could lower the efficiency to target melanoma because of low optical power density in the melanoma's absorption spectra. To exploit efficient in vivo PA imaging of melanoma, we demonstrated the light source emitting from visible (532-600 nm) to NIR-I (600-1000 nm) by optimizing stimulated Raman scattering induced supercontinuum generation. The melanoma's structure is successfully differentiated from blood vessels at a high pulse energy of 2.5 µJ and a flexible pulse repetition rate (PRR) of 5-50 kHz. The proposed light source with the microjoules energies and tens of kHz of PRR can potentially accelerate clinical trials such as early diagnosis of melanoma.

Optical-resolution photoacoustic microscopy with a needle-shaped beam

Optical-resolution photoacoustic microscopy (OR-PAM) can visualize wavelength-dependent optical absorption at the cellular level. However, OR-PAM suffers from a limited depth of field (DOF) due to the tight focus of the optical excitation beam, making it challenging to acquire high-resolution images of samples with uneven surfaces or high-quality volumetric images without z-scanning. To overcome this limitation, we propose needle-shaped beam photoacoustic microscopy (NB-PAM), which can extend the DOF to up to ~28-fold Rayleigh lengths via customized diffractive optical elements (DOEs). The DOE generate a needle beam with a well-maintained beam diameter, a uniform axial intensity distribution, and negligible sidelobes. The advantage of using NB-PAM is demonstrated by both histology-like imaging of fresh slide-free organs using a 266 nm laser and in vivo mouse brain vasculature imaging using a 532 nm laser. The approach provides new perspectives for slide-free intraoperative pathological imaging and in-vivo organ-level imaging.

Photoacoustic imaging for microcirculation

Microcirculation facilitates the blood-tissue exchange of nutrients and regulates blood perfusion. It is, therefore, essential in maintaining tissue health. Aberrations in microcirculation are potentially indicative of underlying cardiovascular and metabolic pathologies. Thus, quantitative information about it is of great clinical relevance. Photoacoustic imaging (PAI) is a capable technique that relies on the generation of imaging contrast via the absorption of light and can image at micron-scale resolution. PAI is especially desirable to map microvasculature as hemoglobin strongly absorbs light and can generate a photoacoustic signal. This paper reviews the current state of the art for imaging microvascular networks using photoacoustic imaging. We further describe how quantitative information about blood dynamics such as the total hemoglobin concentration, oxygen saturation, and blood flow rate is obtained using PAI. We also discuss its importance in understanding key pathophysiological processes in neurovascular, cardiovascular, ophthalmic, and cancer research fields. We then discuss the current challenges and limitations of PAI and the approaches that can help overcome these limitations. Finally, we provide the reader with an overview of future trends in the field of PAI for imaging microcirculation.

A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery

This article proposes a novel intra-operative navigation and sensing system that optimizes the functional accuracy of spinal pedicle screw implantation. It does so by incorporating radiation-free and multi-scale macroscopic 3D ultrasound (US) imaging and local tissue-awareness from in situ photoacoustic (PA) sensing at a clinically relevant mesoscopic scale. More specifically, 3D US imaging is employed for online status updates of spinal segment posture to determine the appropriate entry point and coarse drilling path once non-negligible or relative patient motion occurs between inter-vertebral segments in the intra-operative phase. Furthermore, a sophisticated sensor-enhanced drilling probe has been developed to facilitate fine-grained local navigation that integrates a PA endoscopic imaging component for in situ tissue sensing. The PA signals from a sideways direction to differentiate cancellous bone from harder cortical bone, or to indicate weakened osteoporotic bone within the vertebrae. In so doing it prevents cortical breaches, strengthens implant stability, and mitigates iatrogenic injuries of the neighboring artery and nerves. To optimize this PA-enhanced endoscopic probe design, the light absorption spectrum of cortical bone and cancellous bone are measured in vitro, and the associated PA signals are characterized. Ultimately, a pilot study is performed on an ex vivo bovine spine to validate our developed multi-scale navigation and sensing system. The experimental results demonstrate the clinical feasibility, and hence the great potential, for functionally accurate screw implantation in complex spinal stabilization interventions.

High-speed optical resolution photoacoustic microscopy with MEMS scanner using a novel and simple distortion correction method

Optical resolution photoacoustic microscopy (OR-PAM) is a remarkable biomedical imaging technique that can selectively visualize microtissues with optical-dependent high resolution. However, traditional OR-PAM using mechanical stages provides slow imaging speed, making it difficult to biologically interpret in vivo tissue. In this study, we developed a high-speed OR-PAM using a recently commercialized MEMS mirror. This system (MEMS-OR-PAM) consists of a 1-axis MEMS mirror and a mechanical stage. Furthermore, this study proposes a novel calibration method that quickly removes the spatial distortion caused by fast MEMS scanning. The proposed calibration method can easily correct distortions caused by both the scan geometry of the MEMS mirror and its nonlinear motion by running an image sequence only once using a ruler target. The combination of MEMS-OR-PAM and distortion correction method was verified using three experiments: (1) leaf skeleton phantom imaging to test the distortion correction efficacy; (2) spatial resolution and depth of field (DOF) measurement for system performance; (3) in-vivo finger capillary imaging to verify their biomedical use. The results showed that the combination could achieve a high-speed (32 s in 2 × 4 mm) and high lateral resolution (~ 6 µm) imaging capability and precisely visualize the circulating structure of the finger capillaries.

Self-made transparent optoacoustic detector for measurement of skin lesion thicknessin vivo

In skin cancer diagnosis and treatment, one of the key factors is tumor depth, which is connected to the severity and the required excision depth. Optoacoustical (OA) imaging is a relatively popular technique that provides information based on the optical absorption of the sample. Although often demonstrated withex vivomeasurements orin vivoimaging on parts of small animals,in vivomeasurements on humans are more challenging. This is presumably because it is too time consuming and the required excitation pulse energies and their number exceed the allowed maximum permissible exposure (MPE). Here, we demonstrate thickness measurements with a transparent optoacoustical detector of different suspicious skin lesionsin vivoon patients. We develop the signal processing technique to automatically convert the raw signal into thickness via deconvolution with the impulse response function. The transparency of the detector allows optical excitation with the pulsed laser to be performed perpendicularly on the lesion, in contrast to the conventional illumination from the side. For validation, the measured results were compared to the histological thickness determined after excision. We show that this simple transparent detector allows to determine the thickness of a lesion and thus, aid the dermatologist to estimate the excision depth in the future.

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.

Photoacoustic imaging of periorbital skin cancer ex vivo: unique spectral signatures of malignant melanoma, basal, and squamous cell carcinoma

Radical excision of periorbital skin tumors is difficult without sacrificing excessive healthy tissue. Photoacoustic (PA) imaging is an emerging non-invasive biomedical imagi--ng modality that has potential for intraoperative micrographic control of surgical margins. This is the first study to assess the feasibility of PA imaging for the detection of periocular skin cancer. Eleven patients underwent surgical excision of periocular skin cancer, one of which was a malignant melanoma (MM), eight were basal cell carcinomas (BCCs), and two squamous cell carcinomas (SCCs). Six tumors were located in the eyelid, and five in periocular skin. The excised samples, as well as healthy eyelid samples, were scanned with PA imaging postoperatively, using 59 wavelengths in the range 680-970 nm, to generate 3D multispectral images. Spectral unmixing was performed using endmember spectra for oxygenated and deoxygenated Hb, melanin, and collagen, to iden--tify the chromophore composition of tumors and healthy eyelid tissue. After PA scanning, the tumor samples were examined histopathologically using standard hematoxylin and eosin staining. The PA spectra of healthy eyelid tissue were dominated by melanin in the skin, oxygenated and deoxygenated hemoglobin in the orbicularis oculi muscle, and collagen in the tarsal plate. Multiwavelength 3D scanning provided spectral information on the three tumor types. The spectrum from the MM was primarily reconstructed by the endmember melanin, while the SCCs showed contributions primarily from melanin, but also HbR and collagen. BCCs showed contributions from all four endmembers with a predominance of HbO₂ and HbR. PA imaging may be used to distinguish different kinds of periocular skin tumors, paving the way for future intraoperative micrographic control.

Acoustics at the nanoscale (nanoacoustics): A comprehensive literature review.: Part II: Nanoacoustics for biomedical imaging and therapy

In the past decade, acoustics at the nanoscale (i.e., nanoacoustics) has evolved rapidly with continuous and substantial expansion of capabilities and refinement of techniques. Motivated by research innovations in the last decade, for the first time, recent advancements of acoustics-associated nanomaterials/nanostructures and nanodevices for different applications are outlined in this comprehensive review, which is written in two parts. As part II of this two-part review, this paper concentrates on nanoacoustics in biomedical imaging and therapy applications, including molecular ultrasound imaging, photoacoustic imaging, ultrasound-mediated drug delivery and therapy, and photoacoustic drug delivery and therapy. Firstly, the recent developments of nanosized ultrasound and photoacoustic contrast agents as well as their various imaging applications are examined. Secondly, different types of nanomaterials/nanostructures as nanocarriers for ultrasound and photoacoustic therapies are discussed. Finally, a discussion of challenges and future research directions are provided for nanoacoustics in medical imaging and therapy.

A Comparative Study of Four Total Variational Regularization Reconstruction Algorithms for Sparse-View Photoacoustic Imaging

Photoacoustic imaging (PAI) is a new nonionizing, noninvasive biomedical imaging technology that has been employed to reconstruct the light absorption characteristics of biological tissues. The latest developments in compressed sensing (CS) technology have shown that it is possible to accurately reconstruct PAI images from sparse data, which can greatly reduce scanning time. This study focuses on the comparative analysis of different CS-based total variation regularization reconstruction algorithms, aimed at finding a method suitable for PAI image reconstruction. The performance of four total variation regularization algorithms is evaluated through the reconstruction experiment of sparse numerical simulation signal and agar phantom signal data. The evaluation parameters include the signal-to-noise ratio and normalized mean absolute error of the PAI image and the CPU time. The comparative results demonstrate that the TVAL3 algorithm can well balance the quality and efficiency of the reconstruction. The results of this study can provide some useful guidance for the development of the PAI sparse reconstruction algorithm.

Photoacoustic imaging for monitoring of stroke diseases: A review

Stroke is the leading cause of death and disability after ischemic heart disease. However, there is lacking a non-invasive long-time monitoring technique for stroke diagnosis and therapy. The photoacoustic imaging approach reconstructs images of an object based on the energy excitation by optical absorption and its conversion to acoustic waves, due to corresponding thermoelastic expansion, which has optical resolution and acoustic propagation. This emerging functional imaging method is a non-invasive technique. Due to its precision, this method is particularly attractive for stroke monitoring purpose. In this paper, we review the achievements of this technology and its applications on stroke, as well as the development status in both animal and human applications. Also, various photoacoustic systems and multi-modality photoacoustic imaging are introduced as for potential clinical applications. Finally, the challenges of photoacoustic imaging for monitoring stroke are discussed.

New contrast agents for photoacoustic imaging and theranostics: Recent 5-year overview on phthalocyanine/naphthalocyanine-based nanoparticles

The phthalocyanine (Pc) and naphthalocyanine (Nc) nanoagents have drawn much attention as contrast agents for photoacoustic (PA) imaging due to their large extinction coefficients and long absorption wavelengths in the near-infrared region. Many investigations have been conducted to enhance Pc/Ncs' photophysical properties and address their poor solubility in an aqueous solution. Many diverse strategies have been adopted, including centric metal chelation, structure modification, and peripheral substitution. This review highlights recent advances on Pc/Nc-based PA agents and their extended use for multiplexed biomedical imaging, multimodal diagnostic imaging, and image-guided phototherapy.

Comparison of photoacoustic imaging and histopathological examination in determining the dimensions of 52 human melanomas and nevi ex vivo

Surgical excision followed by histopathological examination is the gold standard for the diagnosis and staging of melanoma. Reoperations and unnecessary removal of healthy tissue could be reduced if non-invasive imaging techniques were available for presurgical tumor delineation. However, no technique has gained widespread clinical use to date due to shallow imaging depth or the absence of functional imaging capability. Photoacoustic (PA) imaging is a novel technology that combines the strengths of optical and ultrasound imaging to reveal the molecular composition of tissue at high resolution. Encouraging results have been obtained from previous animal and human studies on melanoma, but there is still a lack of clinical data. This is the largest study of its kind to date, including 52 melanomas and nevi. 3D multiwavelength PA scanning was performed ex vivo, using 59 excitation wavelengths from 680 nm to 970 nm. Spectral unmixing over this broad wavelength range, accounting for the absorption of several tissue chromophores, provided excellent contrast between healthy tissue and tumor. Combining the results of spectral analysis with spatially resolved information provided a map of the tumor borders in greater detail than previously reported. The tumor dimensions determined with PA imaging were strongly correlated with those determined by histopathological examination for both melanomas and nevi.

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

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

Centimeter-scale wide-field-of-view laser-scanning photoacoustic microscopy for subcutaneous microvasculature in vivo

We developed a simple and compact laser-scanning photoacoustic microscopy (PAM) for imaging large areas of subcutaneous microvasculature in vivo. The reflection-mode PAM not only retains the advantage of high scanning speed for optical scanning, but also offers an imaging field-of-view (FOV) up to 20 × 20 mm², which is the largest FOV available in laser-scanning models so far. The lateral resolution of the PAM system was measured to be 17.5 µm. Image experiments on subcutaneous microvasculature in in vivo mouse ears and abdomen demonstrate the system's potential for fast and high-resolution imaging for injuries and diseases of large tissues and organs.

In-vivo imaging of melanoma with simultaneous dual-wavelength acoustic-resolution-based photoacoustic/ultrasound microscopy

Melanoma is a common, highly fatal skin cancer. Photoacoustic imaging can achieve highly sensitive and high-contrast detection of melanin molecules in tissues, also inheriting the high penetration depth and high spatial resolution characteristics of ultrasound imaging, thus it is a very promising non-invasive diagnostic tool for early melanoma. In this work, we built an acoustic-resolution-based photoacoustic microscopy system, using 1064 nm/532 nm pulsed light to observe melanoma in the back of a mouse with simultaneous photoacoustic/ultrasound imaging. Through the fusion of multi-modal images, accurate positioning of melanoma and its surrounding normal tissues were realized. This work will further promote the application of photoacoustic imaging in the clinical diagnosis of early melanoma.

Another decade of photoacoustic imaging

Photoacoustic imaging - a hybrid biomedical imaging modality finding its way to clinical practices. Although the photoacoustic phenomenon was known more than a century back, only in the last two decades it has been widely researched and used for biomedical imaging applications. In this review we focus on the development and progress of the technology in the last decade (2010-2020). From becoming more and more user friendly, cheaper in cost, portable in size, photoacoustic imaging promises a wide range of applications, if translated to clinic. The growth of photoacoustic community is steady, and with several new directions researchers are exploring, it is inevitable that photoacoustic imaging will one day establish itself as a regular imaging system in the clinical practices.

Feasibility Study of Precise Balloon Catheter Tracking and Visualization with Fast Photoacoustic Microscopy

Correct guiding of the catheter is a critical issue in almost all balloon catheter applications, including arterial stenosis expansion, coronary arterial diseases, and gastrointestinal tracking. To achieve safe and precise guiding of the balloon catheter, a novel imaging method with high-resolution, sufficient depth of penetration, and real-time display is required. Here, we present a new balloon catheter guiding method using fast photoacoustic microscopy (PAM) technique for precise balloon catheter tracking and visualization as a feasibility study. We implemented ex vivo and in vivo experiments with three different medium conditions of balloon catheter: no air, air, and water. Acquired cross-sectional, maximum amplitude projection (MAP), and volumetric 3D PAM images demonstrated its capability as a new imaging guiding tool for balloon catheter tracking and visualization.

High-Resolution Photoacoustic Tomography for Early-Stage Cancer Detection and Its Clinical Translation

Diagnosing cancer during early stages can substantially increase the cure rate, decrease the recurrence rate, and reduce health care costs. Over the past few decades, the continual development of new medical imaging modalities has been an important factor for diagnosing cancer, selecting therapies, and monitoring response to treatment. Photoacoustic tomography (PAT) is a hybrid imaging modality combining optical contrast from absorption of light with the outstanding spatiotemporal resolution of US imaging, providing biomedical morphologic and functional information of early-stage cancer. In this review, the basics and modalities of PAT, as well as a summary of its state-of-art applications in early-stage cancer (breast cancer, melanoma, and prostate cancer) detection and treatment guidance will be introduced. The potential clinical translation in cancer detection of PAT and prospects for the possibilities to lead to further clinical breakthroughs will also be discussed. Keywords: Molecular Imaging-Cancer, Photoacoustic Imaging © RSNA, 2020.

Cutaneous optical coherence tomography for longitudinal volumetric assessment of intradermal volumes in a mouse model

Clinical evaluation of skin lesions requires precise and reproducible technologies for their qualitative and quantitative assessment. In this study, we investigate the applicability of a custom-built dermatologic OCT system for longitudinal assessment of intradermal volumes in a mouse model. The OCT, based on an akinetic swept laser working at 1310 nm was employed for visualization and quantification of intradermal deposits of three different hyaluronic acid-based hydrogel formulations - one commercial and two test substances. Hydrogels were applied in 22 BALB/c mice, and measurements were performed over a six-month time period. All hydrogels increased in volume within the first weeks and degraded steadily thereafter. The half-lifes of the test hydrogels (27.2 ± 13.6 weeks for Hydrogel 1, 31.5 ± 17.2 weeks for Hydrogel 2) were higher in comparison to the commercially available HA hydrogel (21.4 ± 12.0 weeks), although differences were not significant. The sphericity parameter was used for evaluation of the deposit geometry. While on the injection day the sphericities were similar (~0.75 ± 0.04), at later time points significant differences between the different test substances were found (T24: PRV 0.59 ± 0.09, Hydrogel 1 0.70 ± 0.11, Hydrogel 2 0.78 ± 0.07; p ≤ 0.012 for all pairs). This study shows the applicability of OCT imaging for quantitative assessment of the volumetric behavior of intradermal deposits in vivo.

Live feedback and 3D photoacoustic remote sensing

Background

As photoacoustic (PA) techniques progress towards clinical adoption, providing a high-speed live feedback becomes a high priority. To keep up with the instantaneous optical feedback of conventional light microscopes, PA imaging would need to provide a high-resolution video-rate live feed to the user. However, conventional PA microscopy typically trades resolution, sensitivity and imaging speed when optically scanning due to the difficult opto-acoustic confocal geometry. Here, we employ photoacoustic remote sensing (PARS), an all-optical technique that relies on optical confocal geometry, to provide a high-resolution live display in a reflection-mode PA architecture.

Methods

Employing a conventional x-y galvanometer scanner and a 600 KHz pulse repetition rate laser we implement a system capable of acquiring 2.5 frames per second in 2D. To complement this fast scanning optical system, we implement a computationally inexpensive image reconstruction method that is able to render the frames with minimal overhead, providing a live display.

Results

Employing the proposed method, we demonstrate a live feedback with frame rates as high as 2.5 Hz in 2D and also report the first results of 3D imaging with a non-contact label-free reflection-mode technique. The method is validated with phantom studies and in-vivo imaging. Employing a repetition rate of 600 KHz, a live feed of carbon fibers is realized with a C-scan rate of 2.5 Hz. The imaging resolution was measured to be 1.2 µm, the highest reported for a real-time reflection-mode architecture. The mean and peak SNR were measured to be 44 and 62 dB respectively in-vivo. 3D visualizations of carbon fiber phantoms and mouse ear microvasculature structure are also demonstrated.

Conclusions

In summary, we present a method that has a small computational overhead for image rendering, resulting in a live display capable of real-time frame rates. We also report the first 3D imaging with a non-contact label-free reflection-mode PA technique. The all-optical confocal geometry required by PARS is significantly easier to implement and maintain than the opto-acoustic geometry of conventional PA microscopy techniques. This results in a system capable of high resolution and sensitivity, imaging at real-time rates. The authors believe this work represents a vital step towards a clinical high-resolution reflection-mode video-rate PA imaging system.

Recent Progress on Near-Infrared Photoacoustic Imaging: Imaging Modality and Organic Semiconducting Agents

Over the past few decades, the photoacoustic (PA) effect has been widely investigated, opening up diverse applications, such as photoacoustic spectroscopy, estimation of chemical energies, or point-of-care detection. Notably, photoacoustic imaging (PAI) has also been developed and has recently received considerable attention in bio-related or clinical imaging fields, as it now facilitates an imaging platform in the near-infrared (NIR) region by taking advantage of the significant advancement of exogenous imaging agents. The NIR PAI platform now paves the way for high-resolution, deep-tissue imaging, which is imperative for contemporary theragnosis, a combination of precise diagnosis and well-timed therapy. This review reports the recent progress on NIR PAI modality, as well as semiconducting contrast agents, and outlines the trend in current NIR imaging and provides further direction for the prospective development of PAI systems.

Photoacoustic Imaging with Capacitive Micromachined Ultrasound Transducers: Principles and Developments

Photoacoustic imaging (PAI) is an emerging imaging technique that bridges the gap between pure optical and acoustic techniques to provide images with optical contrast at the acoustic penetration depth. The two key components that have allowed PAI to attain high-resolution images at deeper penetration depths are the photoacoustic signal generator, which is typically implemented as a pulsed laser and the detector to receive the generated acoustic signals. Many types of acoustic sensors have been explored as a detector for the PAI including Fabry-Perot interferometers (FPIs), micro ring resonators (MRRs), piezoelectric transducers, and capacitive micromachined ultrasound transducers (CMUTs). The fabrication technique of CMUTs has given it an edge over the other detectors. First, CMUTs can be easily fabricated into given shapes and sizes to fit the design specifications. Moreover, they can be made into an array to increase the imaging speed and reduce motion artifacts. With a fabrication technique that is similar to complementary metal-oxide-semiconductor (CMOS), CMUTs can be integrated with electronics to reduce the parasitic capacitance and improve the signal to noise ratio. The numerous benefits of CMUTs have enticed researchers to develop it for various PAI purposes such as photoacoustic computed tomography (PACT) and photoacoustic endoscopy applications. For PACT applications, the main areas of research are in designing two-dimensional array, transparent, and multi-frequency CMUTs. Moving from the table top approach to endoscopes, some of the different configurations that are being investigated are phased and ring arrays. In this paper, an overview of the development of CMUTs for PAI is presented.

Photoacoustic/Ultrasound/Optical Coherence Tomography Evaluation of Melanoma Lesion and Healthy Skin in a Swine Model

The marked increase in the incidence of melanoma coupled with the rapid drop in the survival rate after metastasis has promoted the investigation into improved diagnostic methods for melanoma. High-frequency ultrasound (US), optical coherence tomography (OCT), and photoacoustic imaging (PAI) are three potential modalities that can assist a dermatologist by providing extra information beyond dermoscopic features. In this study, we imaged a swine model with spontaneous melanoma using these modalities and compared the images with images of nearby healthy skin. Histology images were used for validation.

Photoacoustic imaging with low-cost sources; A review

Benefitting from advantages of optical and ultrasound imaging, photoacoustic imaging (PAI) has demonstrated potentials in a wide range of medical applications. In order to facilitate clinical applications of PAI and encourage its application in low-resource settings, research on low-cost photoacoustic imaging with inexpensive optical sources has gained attention. Here, we review the advances made in photoacoustic imaging with low-cost sources.

Photoacoustic clinical imaging

Photoacoustic is an emerging biomedical imaging modality, which allows imaging optical absorbers in the tissue by acoustic detectors (light in - sound out). Such a technique has an immense potential for clinical translation since it allows high resolution, sufficient imaging depth, with diverse endogenous and exogenous contrast, and is free from ionizing radiation. In recent years, tremendous developments in both the instrumentation and imaging agents have been achieved. These opened avenues for clinical imaging of various sites allowed applications such as brain functional imaging, breast cancer screening, diagnosis of psoriasis and skin lesions, biopsy and surgery guidance, the guidance of tumor therapies at the reproductive and urological systems, as well as imaging tumor metastases at the sentinel lymph nodes. Here we survey the various clinical and pre-clinical literature and discuss the potential applications and hurdles that still need to be overcome.

Quantitative analysis on in vivo tumor-microvascular images from optical-resolution photoacoustic microscopy

Optical-resolution photoacoustic microscopy (OR-PAM) has been shown to be an excellent imaging modality for monitoring and study of tumor microvasculature. However, previous studies focused mainly on the normal tissues and did not quantify the tumor microvasculature. In this study, we present an in vivo OR-PAM imaging of the melanomas and hepatoma implanted in the mouse ear. We quantify the vessel growth by extracting the skeletons of both dense and thin branches of the tumor microvasculature obtained by Hessian matrix enhancement followed by improved two-step multistencils fast marching method. Compared with the previous methods of using OR-PAM for normal tissues, our method was more effective in extracting the binary vascular network in the tumor images and in obtaining the complete and continuous microvascular skeleton maps. Our demonstration of using OR-PAM in improving microvasculature of tumors and quantification of tumor growth would push deep this technology for the early diagnosis and treatment of cancers.

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

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

Optoacoustic mesoscopy for biomedicine

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

Listening for the therapeutic window: Advances in drug delivery utilizing photoacoustic imaging

The preclinical landscape of photoacoustic imaging has experienced tremendous growth in the past decade. This non-invasive imaging modality augments the spatiotemporal capabilities of ultrasound with optical contrast. While it has principally been investigated for diagnostic applications, many recent reports have described theranostic delivery systems and drug monitoring strategies using photoacoustics. Here, we provide an overview of the progress to date while highlighting work in three specific areas: theranostic nanoparticles, real-time drug monitoring, and stem cell ("living drug") tracking. Additionally, we discuss the challenges that remain to be addressed in this burgeoning field.

Multispectral photoacoustic imaging for the detection of subclinical melanoma

BACKGROUND

Photoacoustic imaging (PAI) is a noninvasive technique for melanin detection within melanoma metastases. While ex vivo and early studies suggest promising clinical application, there are no standardized parameters for defining presence of melanoma metastases.

METHODS

Following flank/hindlimb melanoma induction in BRaf-PTEN transgenic mice, bilateral inguinal lymph nodes (LN) were imaged in vivo at 4 to 8 weeks using PAI. Fourteen diagnostic parameters for in vivo detection of LN metastases were compared using the receiver operating characteristic and area-under-the-curve (AUC). Limits of detectability were assessed in ex vivo and in vitro phantom studies.

RESULTS

Forty-nine LNs were imaged in 25 mice. Among metastatic LNs, tumor size ranged from scattered cells to 2.8 mm. The strongest predictor of LN metastasis was the ratio of peak 10% PA melanin signal in the LN compared with adjacent soft tissue (median 4.22 for positive LNs vs 1.07 for negative LNs, P < 0.0001). The AUC was 0.95 (95% CI, 0.90-1.00). In phantom studies, B16 tumor cells were detectable at a concentration of 10 to 25 cells/μL and at a tissue depth of 2.5-3 cm.

CONCLUSIONS

We identified a simple, objective diagnostic parameter for identifying melanoma LN metastases in vivo. These findings may help inform the design of future clinical trials.

Cylindrical illumination with angular coupling for whole-prostate photoacoustic tomography

Current diagnosis of prostate cancer relies on histological analysis of tissue samples acquired by biopsy, which could benefit from real-time identification of suspicious lesions. Photoacoustic tomography has the potential to provide real-time targets for prostate biopsy guidance with chemical selectivity, but light delivered from the rectal cavity has been unable to penetrate to the anterior prostate. To overcome this barrier, a urethral device with cylindrical illumination is developed for whole-prostate imaging, and its performance as a function of angular light coupling is evaluated with a prostate-mimicking phantom.

Switchable Photoacoustic Imaging of Glutathione Using MnO2 Nanotubes for Cancer Diagnosis

Glutathione is overexpressed in tumor cells and regulates cancer growth, metastasis, and drug resistance. Therefore, detecting glutathione levels may greatly facilitate cancer diagnosis and treatment response monitoring. Photoacoustic (PA) imaging is a noninvasive modality for high-sensitivity, high-resolution, deep-tissue optical imaging. Switchable PA probes that offer signal on/off responses to tumor targets would further improve the detection sensitivity and signal-to-noise ratio of PA imaging. Here, we explore the use of MnO₂ nanotubes as a switchable and biodegradable PA probe for dynamic imaging of glutathione in cancer. Glutathione reduces black MnO₂ nanotubes into colorless Mn²⁺ ions, leading to decreased and signal off PA amplitude. In phantoms, we observed a linear response of reduced PA signals of MnO₂ nanotubes to increased glutathione concentrations. Using melanoma as the disease model, we demonstrated that MnO₂ nanotube-based PA imaging of glutathione successfully distinguished B16F10 melanoma cells from BEAS-2B normal cells and discriminated B16F10 tumors from healthy skin tissues. Our results showed that MnO₂ nanotubes are a potent switchable and biodegradable PA probe for glutathione imaging in cancer diagnosis.

Characterization of healthy and nonmelanoma-induced mouse utilizing the Stokes-Mueller decomposition

Skin cancer is one of the most common cancers, including melanoma and nonmelanoma cancer. Melanoma can be easily detected by the observation of abnormal moles, but nonmelanoma signs and symptoms are not apparent in the early stages. We use the Stokes-Mueller matrix decomposition method to detect nonmelanoma at the early stage by decomposing the characteristics of polarized light interacting with normal and cancerous tissues. With this decomposition method, we extract nine optical parameters from biological tissues, namely the LB orientation angle (α), the LB phase retardance (β), the CB optical rotation angle (γ), the LD orientation angle (θd), the linear dichroism (D), the circular dichroism (R), the degrees of linear depolarization (e1 and e2), the degree of circular depolarization (e3), and the depolarization index (Δ). The healthy skin and the induced nonmelanoma skin cancer of mice are analyzed and compared based on their optical parameters. We find distinctive ranges of values for normal skin tissue and nonmelanoma skin cancer, in which β and D in cancerous tissue are larger and nonmelanoma skin becomes less depolarized. This research creates an innovative solid foundation for the diagnosis of skin cancer in the future.

A Handheld Real-Time Photoacoustic Imaging System for Animal Neurological Disease Models: From Simulation to Realization

This article provides a guide to design and build a handheld, real-time photoacoustic (PA) imaging system from simulation to realization for animal neurological disease models. A pulsed laser and array-based ultrasound (US) platform were utilized to develop the system for evaluating vascular functions in rats with focal ischemia or subcutaneous tumors. To optimize the laser light delivery, finite element (FE)-based simulation models were developed to provide information regarding light propagation and PA wave generation in soft tissues. Besides, simulations were also conducted to evaluate the ideal imaging resolution of the US system. As a result, a PA C-scan image of a designed phantom in 1% Lipofundin was reconstructed with depth information. Performance of the handheld PA system was tested in an animal ischemia model, which revealed that cerebral blood volume (CBV) changes at the cortical surface could be monitored immediately after ischemia induction. Another experiment on subcutaneous tumors showed the anomalous distribution of the total hemoglobin concentration (HbT) and oxygen saturation (SO₂), while 3D and maximum intensity projection (MIP) PA images of the subcutaneous tumors are also presented in this article. Overall, this system shows promise for monitoring disease progression in vascular functional impairments.

Recent Progress on Photoacoustic Imaging Enhanced with Microelectromechanical Systems (MEMS) Technologies

Photoacoustic imaging (PAI) is a new biomedical imaging technology currently in the spotlight providing a hybrid contrast mechanism and excellent spatial resolution in the biological tissues. It has been extensively studied for preclinical and clinical applications taking advantage of its ability to provide anatomical and functional information of live bodies noninvasively. Recently, microelectromechanical systems (MEMS) technologies, particularly actuators and sensors, have contributed to improving the PAI system performance, further expanding the research fields. This review introduces cutting-edge MEMS technologies for PAI and summarizes the recent advances of scanning mirrors and detectors in MEMS.

Electromagnetic⁻Acoustic Sensing for Biomedical Applications

This paper reviews the theories and applications of electromagnetic⁻acoustic (EMA) techniques (covering light-induced photoacoustic, microwave-induced thermoacoustic, magnetic-modulated thermoacoustic, and X-ray-induced thermoacoustic) belonging to the more general area of electromagnetic (EM) hybrid techniques. The theories cover excitation of high-power EM field (laser, microwave, magnetic field, and X-ray) and subsequent acoustic wave generation. The applications of EMA methods include structural imaging, blood flowmetry, thermometry, dosimetry for radiation therapy, hemoglobin oxygen saturation (SO₂) sensing, fingerprint imaging and sensing, glucose sensing, pH sensing, etc. Several other EM-related acoustic methods, including magnetoacoustic, magnetomotive ultrasound, and magnetomotive photoacoustic are also described. It is believed that EMA has great potential in both pre-clinical research and medical practice.

Biodegradable Contrast Agents for Photoacoustic Imaging

Over the past twenty years, photoacoustics—also called optoacoustics—have been widely investigated and, in particular, extensively applied in biomedical imaging as an emerging modality. Photoacoustic imaging (PAI) detects an ultrasound wave that is generated via photoexcitation and thermoelastic expansion by a short nanosecond laser pulse, which significantly reduces light and acoustic scattering, more than in other typical optical imaging and renders high-resolution tomographic images with preserving high absorption contrast with deep penetration depth. In addition, PAI provides anatomical and physiological parameters in non-invasive manner. Over the past two decades, this technique has been remarkably developed in the sense of instrumentation and contrast agent materials. In this review, we briefly introduce state-of-the-art multiscale imaging systems and summarize recent progress on exogenous bio-compatible and -degradable agents that address biomedical application and clinical practice.

Hand-held optoacoustic imaging: A review

Optoacoustic imaging is a medical imaging modality that uses optical excitation and acoustic detection to generate images of tissue structures based up optical absorption within a tissue sample. This imaging modality has been widely explored as a tool for a number of clinical applications, including cancer diagnosis and wound healing tracking. Recently, the optoacoustic imaging community has published a number of reports of hand-held optoacoustic imaging devices and platforms; these hand-held configurations improve the modality's potential for commercial clinical implementation. Here, we review recent advancements in hand-held optoacoustic imaging platforms and methods, including recent pre-clinical applications, and we present an overview of the remaining limitations in optoacoustic imaging that must be addressed to increase the translation of the modality into commercial and clinical use.

Laser scanning laser diode photoacoustic microscopy system

The development of low-cost and fast photoacoustic microscopy systems enhances the clinical applicability of photoacoustic imaging systems. To this end, we present a laser scanning laser diode-based photoacoustic microscopy system. In this system, a 905 nm, 325 W maximum output peak power pulsed laser diode with 50 ns pulsewidth is utilized as the light source. A combination of aspheric and cylindrical lenses is used for collimation of the laser diode beam. Two galvanometer scanning mirrors steer the beam across a focusing aspheric lens. The lateral resolution of the system was measured to be ∼21 μm using edge spread function estimation. No averaging was performed during data acquisition. The imaging speed is ∼370 A-lines per second. Photoacoustic microscopy images of human hairs, ex vivo mouse ear, and ex vivo porcine ovary are presented to demonstrate the feasibility and potentials of the proposed system.

All-optical forward-viewing photoacoustic probe for high-resolution 3D endoscopy

A miniature forward-viewing endoscopic probe that provides high-resolution 3D photoacoustic images is demonstrated. The probe is of outer diameter 3.2 mm and comprised of a transparent Fabry-Pérot (FP) polymer-film ultrasound sensor that is located at the distal end of a rigid optical fiber bundle. Excitation laser pulses are coupled simultaneously into all cores of the bundle and are transmitted through the FP sensor to provide wide-field tissue illumination at the distal end. The resulting photoacoustic waves are mapped in 2D by sequentially scanning the input end of the bundle with an interrogation laser beam in order to individually address different points on the FP sensor. In this way, the sensor acts as a high-density ultrasound array that is comprised of 50,000 individual elements, each of which is 12 µm in diameter, within the 3.2 mm diameter footprint of the probe. The fine spatial sampling that this affords, along with the wide bandwidth (f _-3dB =34 MHz) of the sensor, enables a high-resolution photoacoustic image to be reconstructed. The measured on-axis lateral resolution of the probe was depth-dependent and ranged from 45-170 µm for depths between 1 and 7 mm, and the vertical resolution was 31 µm over the same depth range. The system was evaluated by acquiring 3D images of absorbing phantoms and the microvascular anatomies of a duck embryo and mouse skin. Excellent image fidelity was demonstrated. It is anticipated that this type of probe could find application as a tool for guiding laparoscopic procedures, fetal surgery and other minimally invasive interventions that require a millimeter-scale forward-viewing 3D photoacoustic imaging probe.

Spatiotemporal Optoacoustic Mapping of Tumor Hemodynamics in a Clinically Relevant Orthotopic Rabbit Model of Head and Neck Cancer

The purpose of this study was to investigate the usefulness of photoacoustic imaging (PAI) for spatiotemporal mapping of tumor hemodynamics in a rabbit model of head and neck carcinoma. Shope cottontail rabbit papilloma virus associated VX2 carcinomas were established in adult male New Zealand White rabbits (n = 9) by surgical transplantation of tumor tissue in the neck. Noninvasive PAI with co-registered ultrasound (US) was performed to longitudinally monitor tumor growth, oxygen saturation (%sO₂), and hemoglobin concentration (HbT). PAI findings were validated with Doppler sonography measures of percent vascularity (PV). Differences in tumor volumes, %sO₂, HbT, and PV values over time were analyzed using repeated-measures analysis of variance with multiple comparisons. Two-tailed Spearman correlation analysis was performed to determine the correlation coefficient (r) for comparisons between %sO₂, HbT, and tumor volume. US revealed a significant (P < .0001) increase in tumor volume over the 3-week period from 549 ± 260 mm³ on day 7 to 5055 ± 438 mm³ at 21 days postimplantation. Consistent with this aggressive tumor growth, PAI revealed a significant (P < .05) and progressive reduction in %sO₂ from day 7 (37.6 ± 7.4%) to day 21 (9.5 ± 2.1%). Corresponding Doppler images also showed a decrease in PV over time. PAI revealed considerable intratumoral spatial heterogeneity with the tumor rim showing two- to three-fold higher %sO₂ values compared to the core. Noninvasive PAI based on endogenous contrast provides a label-free method for longitudinal monitoring of temporal changes and spatial heterogeneity in thick head and neck tumors.