Three-dimensional photoacoustic endoscopic imaging of the rabbit esophagus

Perspectives on endoscopic functional photoacoustic microscopy

Endoscopy, enabling high-resolution imaging of deep tissues and internal organs, plays an important role in basic research and clinical practice. Recent advances in photoacoustic microscopy (PAM), demonstrating excellent capabilities in high-resolution functional imaging, have sparked significant interest in its integration into the field of endoscopy. However, there are challenges in achieving functional PAM in the endoscopic setting. This Perspective article discusses current progress in the development of endoscopic PAM and the challenges related to functional measurements. Then, it points out potential directions to advance endoscopic PAM for functional imaging by leveraging fiber optics, microfabrication, optical engineering, and computational approaches. Finally, it highlights emerging opportunities for functional endoscopic PAM in basic and translational biomedicine.

A Mathematical Model for Simulating Photoacoustic Signal Generation Process in Biological Tissues.. [DOI: 10.21203/rs.3.rs-2928563/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: Biomedical photoacoustic imaging (PAI) is a hybrid imaging modality based on the laser-generated ultrasound waves due to the photoacoustic (PA) effect physical phenomenon that has been reported firstly by A. G. Bell in 1880. Numerical modeling-based simulation for the PA signal generation process in biological tissues helps researchers for decreasing error trials in-vitro and hence decreasing error rates for in-vivo experiments. Numerical modeling methods help in obtaining a rapid modeling procedure comparable to pure mathematics. However, if a proper simplified mathematical model can be founded before applying numerical modeling techniques, it will be a great advantage for the overall numerical model. Most scientific theories, equations, and assumptions, been proposed to mathematically model the complete PA signal generation and propagation process in biological tissues, are so complicated. Hence, the researchers, especially the beginners, will find a hard difficulty to explore and obtain a proper simplified mathematical model describing the process. That’s why this paper is introduced. Methods: In this paper we have tried to simplify understanding for the biomedical PA wave’s generation and propagation process, deducing a simplified mathematical model for the whole process. The proposed deduced model is based on three steps: a- pulsed laser irradiance, b- diffusion of light through biological tissue, and c- acoustic pressure wave generation and propagation from the target tissue to the ultrasound transducer surface. COMSOL Multiphysics, which is founded due to the finite element method (FEM) numerical modeling principle, has been utilized to validate the proposed deduced mathematical model on a simulated biological tissue including a tumor inside. Results and Conclusion: The time-dependent study been applied by COMSOL has assured that the proposed deduced mathematical model may be considered as a simplified, easy, and fast startup base for scientific researchers to numerically model and simulate biomedical PA signals’ generation and propagation process utilizing any proper software like COMSOL.

A Mathematical Model for Simulating Photoacoustic Signal Generation Process in Biological Tissues.. [DOI: 10.21203/rs.3.rs-2928563/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background Biomedical photoacoustic imaging (PAI) is a hybrid imaging modality based on the laser-generated ultrasound waves due to the photoacoustic (PA) effect physical phenomenon that has been reported firstly by A. G. Bell in 1880. Numerical modeling based simulation for PA signal generation process in biological tissues helps researchers for decreasing error trials in-vitro and hence decreasing error rates for in-vivo experiments. Numerical modeling methods help in obtaining a rapid modeling procedure comparable to pure mathematics. However, if a proper simplified mathematical model can be founded before applying numerical modeling techniques, it will be a great advantage for the overall numerical model. More scientific theories, equations, and assumptions through the biomedical PA imaging research literature have been proposed trying to mathematically model the complete PA signal generation and propagation process in biological tissues. However, most of them have so complicated details. Hence, the researchers, especially the beginners, will find a hard difficulty to explore and obtain a proper simplified mathematical model describing the process. That’s why this paper is introduced. Methods In this paper we have tried to simplify understanding for the biomedical PA wave’s generation and propagation process, deducing a simplified mathematical model for the whole process. The proposed deduced model is based on three steps: a- pulsed laser irradiance, b- diffusion of light through biological tissue, and c- acoustic pressure wave generation and propagation from the target tissue to the ultrasound transducer surface.

Spectroscopic photoacoustic/ultrasound/optical-microscopic multimodal intrarectal endoscopy for detection of centimeter-scale deep lesions

The inadequacy of existing colorectal imaging tools has significantly obstructed the efficient detection of colorectal cancer. To address this issue, this work presents the cross-scale endoscopic imaging of rectal tumors with a combined photoacoustic/ultrasound tomography system and wide-field optical microscopy. This multimodal system combines the merits of centimeter-scale deep penetration, multi-spectral imaging, cross-scale imaging ability, low system cost, and 360° view in a single modality. Results indicated that the proposed system could reliably depict the location of the cancer invasion depth spectroscopically with indocyanine green The tumor angiogenesis can be well identified in the wide-field optical imaging mode, which helps to localize the tumors and guide the following photoacoustic/ultrasound scan. This work may facilitate the accurate characterization of colorectal cancer and promote the clinical translation of photoacoustic-based colorectal endoscopy.

Acoustic-resolution-based spectroscopic photoacoustic endoscopy towards molecular imaging in deep tissues

Due to many technical difficulties, the study of molecular photoacoustic endoscopic (PAE) imaging in deep tissues is limited. In this work, we have set up a multimodal acoustic-resolution-based PAE (AR-PAE) system to image the rabbit rectum and preliminarily explored the potential of molecular PAE for deep-seated targets in proof-of-concept. We developed an improved back-projection (IBP) algorithm for focused detection over the centimeter-scale imaging depth. We also developed a deep-learning-based algorithm to remove the electrical noise from the step motor to prevent data averaging for reduced scanning time. We injected a dose of indocyanine green (ICG) near the rabbit rectum and compared 2D and 3D photoacoustic/ultrasound (PA/US) images at different wavelengths. We proposed incorporating a small camera to guide the slow PA/US endoscopic scan. Results show that this system has achieved a lateral resolution of about 0.77/0.65 mm for PA/US images with a signal-to-noise ratio (SNR) of 25/38 dB at an imaging depth of 1.4 cm. We found that the rectum wall and the ICG can be well distinguished spectroscopically. Results also show that the PA images at 532 nm have higher signal intensity and reflection artifacts from pelvic tendons and bones than those at longer wavelengths such as 800 nm. The proposed methods and the intuitive findings in this work may guide and promote the development of high-penetration molecular PAE.

Photoacoustic/Ultrasound Endoscopic Imaging Reconstruction Algorithm Based on the Approximate Gaussian Acoustic Field

This paper aims to propose a new photoacoustic/ultrasound endoscopic imaging reconstruction algorithm based on the approximate Gaussian acoustic field which significantly improves the resolution and signal-to-noise ratio (SNR) of the out-of-focus region. We demonstrated the method by numerical calculations and investigated the applicability of the algorithm in a chicken breast phantom. The validation was finally performed by the rabbit rectal endoscopy experiment. Simulation results show that the lateral resolution of the target point in the out-of-focus region can be well optimized with this new algorithm. Phantom experimental results show that the lateral resolution of the indocyanine green (ICG) tube in the photoacoustic image is reduced from 3.975 mm to 1.857 mm by using our new algorithm, which is a 52.3% improvement. Ultrasound images also show a significant improvement in lateral resolution. The results of the rabbit rectal endoscopy experiment prove that the algorithm we proposed is capable of providing higher-quality photoacoustic/ultrasound images. In conclusion, the algorithm enables fast acoustic resolution photoacoustic/ ultrasonic dynamic focusing and effectively improves the imaging quality of the system, which has significant guidance for the design of acoustic resolution photoacoustic/ultrasound endoscopy systems.

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.

Photoacoustic imaging of fresh human surgically and endoscopically resected gastrointestinal specimens

Objective

Photoacoustic (PA) imaging is a novel noninvasive technique that offers high‐contrast tomographic imaging with ultrasound‐like resolution at depths of centimeters, enabling visualization of deep small vessels. The aim of this pilot study was to survey the characteristics of deep vessel networks in the mucosa of neoplastic gastrointestinal (GI) lesions using PA imaging.

Methods

Specimens of patients who had undergone surgical and endoscopic resection for GI lesions were included in this study. The PA/ultrasound imaging system for clinical research is characterized by a technology that can superimpose a PA image over an ultrasound image. Three‐dimensional PA images were acquired for the resected specimen before fixation. The stomach and colon of live pigs were incised, and the walls were scanned from the mucosa.

Results

A total of 32 specimens (nine esophageal, 12 gastric, 11 colorectal) were scanned. The pathological diagnoses were adenomas (n = 2), intramucosal cancers (n = 14), and invasive cancers (n = 16). The deep vessel networks of all lesions could be visualized. In the intramucosal lesions, the deep vessel network was similar to that of a normal tissue. In invasive cancers, the thick and prominent vessel network was visible in the surface layer of esophageal cancers, infiltrated area of gastric cancers, and surface layer and infiltrated area of colorectal cancers. In the images of living pigs, visualizing the vascular network deeper than the submucosa in both the stomach and large intestine was possible.

Conclusion

Our study confirmed that the deep vessel networks of neoplastic GI lesions were visible by PA imaging.

The emerging role of photoacoustic imaging in clinical oncology

Clinical oncology can benefit substantially from imaging technologies that reveal physiological characteristics with multiscale observations. Complementing conventional imaging modalities, photoacoustic imaging (PAI) offers rapid imaging (for example, cross-sectional imaging in real time or whole-breast scanning in 10-15 s), scalably high levels of spatial resolution, safe operation and adaptable configurations. Most importantly, this novel imaging modality provides informative optical contrast that reveals details on anatomical, functional, molecular and histological features. In this Review, we describe the current state of development of PAI and the emerging roles of this technology in cancer screening, diagnosis and therapy. We comment on the performance of cutting-edge photoacoustic platforms, and discuss their clinical applications and utility in various clinical studies. Notably, the clinical translation of PAI is accelerating in the areas of macroscopic and mesoscopic imaging for patients with breast or skin cancers, as well as in microscopic imaging for histopathology. We also highlight the potential of future developments in technological capabilities and their clinical implications, which we anticipate will lead to PAI becoming a desirable and widely used imaging modality in oncological research and practice.

3D acoustic resolution-based photoacoustic endoscopy with dynamic focusing

Background

Acoustic resolution-based photoacoustic endoscopy (ARPAE) is a non-invasive potential tool for imaging gastrointestinal and urogenital tracts. However, current ARPAE systems usually only provide 2D sectorial B-mode images, and have the limitation of the image quality significantly deteriorating out-of-focus regions due to transducers with fixed focus in these systems. To overcome these limitations, we put forward a modified back-projection method that can provide 3D images with dynamic focusing in ARPAE.

Methods

A graphics processing unit (GPU)-based parallel computation technique was adopted for efficient computation. Both simulated and phantom/ex-vivo experiments were conducted to validate our method.

Results

The findings indicated that our proposed method can effectively improve the lateral resolution and signal-to-noise ratio (SNR) in the out-of-focus regions. For a target 3 mm from the transducer focus, the new method can improve 11 times in the lateral resolution, along with an improvement of up to 37 dB in the SNR.

Conclusions

3D ARPAE provides high-quality imaging in both focus and out-of-focus regions.

Evaluation of Reconstruction Methodology for Helical Scan Guided Photoacoustic Endoscopy

Photoacoustic endoscopy (PAE), combining both advantages of optical contrast and acoustic resolution, can visualize the chemical-specific optical information of tissues inside human-body. Recently, its corresponding reconstruction methods have been extensively researched. However, most of them are limited on cylindrical scan trajectories, rather than a helical scan which is more clinically practical. On this note, this article proposes a methodology of imaging reconstruction and evaluation for helical scan guided PAE. Different from traditional reconstruction method, synthetic aperture focusing technique (SAFT), our method reconstructs image using wavefield extrapolation which significantly improves computational efficiency and even takes only 0.25 seconds for 3-D reconstructions. In addition, the proposed evaluation methodology can estimate the resolutions and deviations of reconstructed images in advance, and then can be used to optimize the PAE scan parameters. Groups of simulations as well as ex-vivo experiments with different scan parameters are provided to fully demonstrate the performance of the proposed techniques. The quantitatively measured angular resolutions and deviations agree well with our theoretical derivation results D√{r_s² +h²} / [1.25(r_s r_d +h²)] (rad) and -h l / (r_s r_d +h²) (rad), respectively D,r_d, r_s,h and l represent transducer diameter, radius of scan trajectory, radius of source position, unit helical pitch and the distance from targets to helical scan plane, respectively). This theoretical result also suits for circular and cylindrical scan in case of h = 0 .

Photoacoustic endoscopy: A progress review

Endoscopy has been widely used in biomedical imaging and integrated with various optical and acoustic imaging modalities. Photoacoustic imaging (PAI), one of the fastest growing biomedical imaging modalities, is a noninvasive and nonionizing method that owns rich optical contrast, deep acoustic penetration depth, multiscale and multiparametric imaging capability. Hence, it is preferred to miniaturize the volume of PAI and develop an emerged endoscopic imaging modality referred to as photoacoustic endoscopy (PAE). It has been developed for more than one decade since the first report of PAE. Unfortunately, until now, there is no mature photoacoustic endoscopic technique recognized in clinic due to various technical limitations. To address this concern, recent development of new scanning mechanisms, adoption of novel optical/acoustic devices, utilization of superior computation methods and exploration of multimodality strategies have significantly promoted the progress of PAE toward clinic. In this review, we comprehensively reviewed recent progresses in single- and multimodality PAE with new physics, mechanisms and strategies to achieve practical devices for potential applicable scenarios including esophageal, gastrointestinal, urogenital and intravascular imaging. We ended this review with challenges and prospects for future development of PAE.

Side-viewing photoacoustic waveguide endoscopy

Side-viewing hollow optical waveguides allow for minimally invasive endoscopy by concentrically guiding light and sound for photoacoustic generation and detection. Here, we characterize the side-viewing photoacoustic waveguide (PWG) endoscope by scanning 7.2 μm diameter carbon fiber threads within phantom tissues and animal tissues. Photoacoustic signals are carried along the 5.5 and 10.0 cm length of the PWG with minimal attenuation. Thus, this technology enables 360°, deep-tissue photoacoustic imaging. Photoacoustic signals were identified up to 8.0 mm from the PWG imaging window in an optically clear medium. The outer diameter of this device is measured as just over 1.0 mm, with the potential to be further miniaturized due to its unique design. The PWG is an ideal candidate for a myriad of pre-clinical and clinical applications where typical photoacoustic endoscopy systems are impractical, due to their size. Presented here, is the first side-viewing photoacoustic waveguide endoscope.

Towards a Low-Cost and Portable Photoacoustic Microscope for Point-of-Care and Wearable Applications

Several breakthrough applications in biomedical imaging have been reported in the recent years using advanced photoacoustic microscopy imaging systems. While two photon and other optical microscopy systems have recently emerged in portable and wearable form, there is much less work reported on the portable and wearable photoacoustic microscopy (PAM) systems. Working towards this goal, we report our studies on a low-cost and portable photoacoustic microscopy system that uses a custom fabricated 2.5 mm diameter ring ultrasound transducer integrated with a fiber-coupled laser diode. The ultrasound transducer is centered at 17.25 MHz, and shows ~ 45% and ~ 100% fractional bandwidths for ultrasound pulse-echo and photoacoustic A-line signals respectively. To achieve overall system portability, besides the imaging head, other backend imaging system components need to be readily portable as well. In this direction, we have studied the potential use of compact pre-amplifiers, scanning stages and microcontroller based data acquisition and reconstruction for photoacoustic imaging. The portable PAM system is validated by imaging phantoms embedded with light absorbing targets. Future directions that will likely help achieve a completely portable and wearable photoacoustic microscopy system are discussed.

Ultra-Compact Microsystems-Based Confocal Endomicroscope

Point-of-care medical diagnosis demands immediate feedback on tissue pathology. Confocal endomicroscopy can provide real-time in vivo images with histology-like features. The working channel in medical endoscopes are becoming smaller in dimension. Microsystems methods can produce tiny mechanical scanners. We demonstrate a flexible fiber instrument for in vivo imaging as an endoscope accessory. The optical path is folded on-axis to reduce length while allowing the beam to expand and achieve a numerical aperture of 0.41. A high-speed parametric resonance mirror produces large deflection angles > 13°, and is mounted on a 2 mm diameter chip designed with clamp structures for reduced space. A compact lens assembly provides diffraction-limited lateral and axial resolution of 1.5 and [Formula: see text], respectively. A working distance of [Formula: see text] and field-of-view of [Formula: see text] m are achieved. Miniature apparatus is fabricated to assemble and align the scanhead components. The optics and scanner are packaged in a distal tip with 2.4 mm diameter and 10 mm rigid length. These dimensions allow the endomicroscope to pass forward easily through the 2.8 mm diameter working channel in medical endoscopes commonly used in clinical practice. Fluorescence images are collected in vivo at 10 frames per second in the colon of genetically-engineered mice that spontaneously develop adenomas. A FITC-labeled peptide heterodimer is administered intravenously to provide specific contrast. Sub-cellular structures are visualized to distinguish pre-malignant from normal mucosa. These results demonstrate use of microsystems methods to produce an ultra-compact instrument with sufficiently small dimensions for broad use.

Optical Biopsy of the Upper GI Tract Using Fluorescence Lifetime and Spectra

Screening and surveillance for gastrointestinal (GI) cancers by endoscope guided biopsy is invasive, time consuming, and has the potential for sampling error. Tissue endogenous fluorescence spectra contain biochemical and physiological information, which may enable real-time, objective diagnosis. We first briefly reviewed optical biopsy modalities for GI cancer diagnosis with a focus on fluorescence-based techniques. In an ex vivo pilot clinical study, we measured fluorescence spectra and lifetime on fresh biopsy specimens obtained during routine upper GI screening procedures. Our results demonstrated the feasibility of rapid acquisition of time-resolved fluorescence (TRF) spectra from fresh GI mucosal specimens. We also identified spectroscopic signatures that can differentiate between normal mucosal samples obtained from the esophagus, stomach, and duodenum.

Minimally invasive photoacoustic imaging: Current status and future perspectives

Photoacoustic imaging (PAI) is an emerging biomedical imaging modality that is based on optical absorption contrast, capable of revealing distinct spectroscopic signatures of tissue at high spatial resolution and large imaging depths. However, clinical applications of conventional non-invasive PAI systems have been restricted to examinations of tissues at depths less than a few cm due to strong light attenuation. Minimally invasive photoacoustic imaging (miPAI) has greatly extended the landscape of PAI by delivering excitation light within tissue through miniature fibre-optic probes. In the past decade, various miPAI systems have been developed with demonstrated applicability in several clinical fields. In this article, we present an overview of the current status of miPAI and our thoughts on future perspectives.

Capsule optoacoustic endoscopy for esophageal imaging

Detection and monitoring of esophageal cancer severity require an imaging technique sensitive enough to detect early pathological changes in the esophagus and capable of analyzing the esophagus over 360 °in a non-invasive manner. Optoacoustic endoscopy (COE) has been shown to resolve superficial vascular structure of the esophageal lumen in rats and rabbits using catheter-type probes. Although these systems can work well in small animals, they are unsuitable for larger lumens with thicker walls as required for human esophageal screening, due to their lack of position stability along the full organ circumference, sub-optimal acoustic coupling and limited signal-to-noise ratio (SNR). In this work, we introduce a novel capsule COE system that provides high-quality 360° images of the entire lumen, specifically designed for typical dimensions of human esophagus. The pill-shaped encapsulated probe consists of a novel and highly sensitive ultrasound transducer fitted with an integrated miniature pre-amplifier, which increases SNR of 10 dB by minimizing artifacts during signal transmission compared to the configuration without the preamplifier. The scanner rotates helically around the central axis of the probe to capture three-dimensional images with uniform quality. We demonstrate for the first time ex vivo volumetric vascular network images to a depth of 2 mm in swine esophageal lining using COE. Vascular information can be resolved within the mucosa and submucosa layers as confirmed by histology of samples stained with hematoxylin and eosin and with antibody against vascular marker CD31. COE creates new opportunities for optoacoustic screening of esophageal cancer in humans.

Functional endoscopy techniques for tracking stem cell fate

Tracking and monitoring implanted stem cells are essential to maximize benefits and to minimize the side effects of stem cell therapy for personalized or "precision" medicine. Previously, we proposed a comprehensive biological Global Positioning System (bGPS) to track and monitor stem cells in vivo. Magnetic resonance imaging (MRI), positron emission tomography (PET), bioluminescent imaging, fluorescence imaging, and single-photon emission computerized tomography (SPECT) have been utilized to track labeled or genetically-modified cells in vivo in rats and humans. A large amount of research has been dedicated to the design of reporter genes and molecular probes for imaging and the visualization of the biodistribution of the implanted cells in high resolution. On the other hand, optical-based functional imaging, such as photoacoustic imaging (PAI), optical coherence tomography (OCT), and multiphoton microscopy (MPM), has been implemented into small endoscopes to image cells inside the body. The optical fiber allows miniaturization of the imaging probe while maintaining high resolution due to light-based imaging. Upon summarizing the recent progress in the design and application of functional endoscopy techniques for stem cell monitoring, we offer perspectives for the future development of endoscopic molecular imaging tools for in vivo tracking of spatiotemporal changes in subclonal evolution at the single cell level.

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.

All-optical dual photoacoustic and optical coherence tomography intravascular probe

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

Intrauterine photoacoustic and ultrasound imaging probe

Intrauterine photoacoustic and ultrasound imaging are probe-based imaging modalities with translational potential for use in detecting endometrial diseases. This deep-tissue imaging probe design allows for the retrofitting of commercially available endometrial sampling curettes. The imaging probe presented here has a 2.92-mm diameter and approximate length of 26 cm, which allows for entry into the human endometrial cavity, making it possible to use photoacoustic imaging and high-resolution ultrasound to characterize the uterus. We demonstrate the imaging probes' ability to provide structural information of an excised pig uterus using ultrasound imaging and detect photoacoustic signals at a radial depth of 1 cm.

EUS and related technologies for the diagnosis and treatment of pancreatic disease: research gaps and opportunities-Summary of a National Institute of Diabetes and Digestive and Kidney Diseases workshop

A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to address the research gaps and opportunities in pancreatic EUS. The event occurred on July 26, 2017 in 4 sessions: (1) benign pancreatic diseases, (2) high-risk pancreatic diseases, (3) diagnostic and therapeutics, and (4) new technologies. The current state of knowledge was reviewed, with identification of numerous gaps in knowledge and research needs. Common themes included the need for large multicenter consortia of various pancreatic diseases to facilitate meaningful research of these entities; to standardize EUS features of different pancreatic disorders, the technique of sampling pancreatic lesions, and the performance of various therapeutic EUS procedures; and to identify high-risk disease early at the cellular level before macroscopic disease develops. The need for specialized tools and accessories to enable the safe and effective performance of therapeutic EUS procedures also was discussed.

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.

Endoscopic Ultrasound and Related Technologies for the Diagnosis and Treatment of Pancreatic Disease - Research Gaps and Opportunities: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop

A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to address the research gaps and opportunities in pancreatic endoscopic ultrasound (EUS). The event occurred on July 26, 2017 in 4 sessions: (1) benign pancreatic diseases, (2) high-risk pancreatic diseases, (3) diagnostic and therapeutics, and (4) new technologies. The current state of knowledge was reviewed, with identification of numerous gaps in knowledge and research needs. Common themes included the need for large multicenter consortia of various pancreatic diseases to facilitate meaningful research of these entities; to standardize EUS features of different pancreatic disorders, the technique of sampling pancreatic lesions, and the performance of various therapeutic EUS procedures; and to identify high-risk disease early at the cellular level before macroscopic disease develops. The need for specialized tools and accessories to enable the safe and effective performance of therapeutic EUS procedures also was discussed.

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.

Photoacoustic Molecular Imaging: From Multiscale Biomedical Applications Towards Early-Stage Theranostics

Photoacoustic imaging (PAI) has ushered in a new era of observational biotechnology and has facilitated the exploration of fundamental biological mechanisms and clinical translational applications, which has attracted tremendous attention in recent years. By converting laser into ultrasound emission, PAI combines rich optical contrast, high ultrasonic spatial resolution, and deep penetration depth in a single modality. This evolutional technique enables multiscale and multicontrast visualization from cells to organs, anatomy to function, and molecules to metabolism with high sensitivity and specificity. The state-of-the-art developments and applications of PAI are described in this review. Future prospects for clinical use are also highlighted. Collectively, PAI holds great promise to drive biomedical applications towards early-stage theranostics.