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Baker C, Xochicale M, Lin FY, Mathews S, Joubert F, Shakir DI, Miles R, Mosse CA, Zhao T, Liang W, Kunpalin Y, Dromey B, Mistry T, Sebire NJ, Zhang E, Ourselin S, Beard PC, David AL, Desjardins AE, Vercauteren T, Xia W. Intraoperative Needle Tip Tracking with an Integrated Fibre-Optic Ultrasound Sensor. SENSORS (BASEL, SWITZERLAND) 2022; 22:9035. [PMID: 36501738 PMCID: PMC9739176 DOI: 10.3390/s22239035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
Ultrasound is an essential tool for guidance of many minimally-invasive surgical and interventional procedures, where accurate placement of the interventional device is critical to avoid adverse events. Needle insertion procedures for anaesthesia, fetal medicine and tumour biopsy are commonly ultrasound-guided, and misplacement of the needle may lead to complications such as nerve damage, organ injury or pregnancy loss. Clear visibility of the needle tip is therefore critical, but visibility is often precluded by tissue heterogeneities or specular reflections from the needle shaft. This paper presents the in vitro and ex vivo accuracy of a new, real-time, ultrasound needle tip tracking system for guidance of fetal interventions. A fibre-optic, Fabry-Pérot interferometer hydrophone is integrated into an intraoperative needle and used to localise the needle tip within a handheld ultrasound field. While previous, related work has been based on research ultrasound systems with bespoke transmission sequences, the new system-developed under the ISO 13485 Medical Devices quality standard-operates as an adjunct to a commercial ultrasound imaging system and therefore provides the image quality expected in the clinic, superimposing a cross-hair onto the ultrasound image at the needle tip position. Tracking accuracy was determined by translating the needle tip to 356 known positions in the ultrasound field of view in a tank of water, and by comparison to manual labelling of the the position of the needle in B-mode US images during an insertion into an ex vivo phantom. In water, the mean distance between tracked and true positions was 0.7 ± 0.4 mm with a mean repeatability of 0.3 ± 0.2 mm. In the tissue phantom, the mean distance between tracked and labelled positions was 1.1 ± 0.7 mm. Tracking performance was found to be independent of needle angle. The study demonstrates the performance and clinical compatibility of ultrasound needle tracking, an essential step towards a first-in-human study.
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Affiliation(s)
- Christian Baker
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Miguel Xochicale
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Fang-Yu Lin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Sunish Mathews
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Francois Joubert
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Dzhoshkun I. Shakir
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Richard Miles
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Charles A. Mosse
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Tianrui Zhao
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Weidong Liang
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Yada Kunpalin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Brian Dromey
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Talisa Mistry
- NIHR Great Ormond Street BRC and Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Neil J. Sebire
- NIHR Great Ormond Street BRC and Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Edward Zhang
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Paul C. Beard
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Anna L. David
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK
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Wen Y, Guo D, Zhang J, Liu X, Liu T, Li L, Jiang S, Wu D, Jiang H. Clinical photoacoustic/ultrasound dual-modal imaging: Current status and future trends. Front Physiol 2022; 13:1036621. [PMID: 36388111 PMCID: PMC9651137 DOI: 10.3389/fphys.2022.1036621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/05/2022] [Indexed: 08/24/2023] Open
Abstract
Photoacoustic tomography (PAT) is an emerging biomedical imaging modality that combines optical and ultrasonic imaging, providing overlapping fields of view. This hybrid approach allows for a natural integration of PAT and ultrasound (US) imaging in a single platform. Due to the similarities in signal acquisition and processing, the combination of PAT and US imaging creates a new hybrid imaging for novel clinical applications. Over the recent years, particular attention is paid to the development of PAT/US dual-modal systems highlighting mutual benefits in clinical cases, with an aim of substantially improving the specificity and sensitivity for diagnosis of diseases. The demonstrated feasibility and accuracy in these efforts open an avenue of translating PAT/US imaging to practical clinical applications. In this review, the current PAT/US dual-modal imaging systems are discussed in detail, and their promising clinical applications are presented and compared systematically. Finally, this review describes the potential impacts of these combined systems in the coming future.
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Affiliation(s)
- Yanting Wen
- Department of Ultrasound Imaging, The Fifth People’s Hospital of Chengdu, Chengdu, China
- School of Computer Science and Technology, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Dan Guo
- Department of Ultrasound Imaging, The Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Jing Zhang
- Department of Ultrasound Imaging, The Fifth People’s Hospital of Chengdu, Chengdu, China
- School of Computer Science and Technology, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Xiaotian Liu
- Department of Ultrasound Imaging, The Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Ting Liu
- Department of Ultrasound Imaging, The Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Lu Li
- Department of Ultrasound Imaging, The Fifth People’s Hospital of Chengdu, Chengdu, China
| | - Shixie Jiang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Dan Wu
- School of Computer Science and Technology, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Huabei Jiang
- Department of Medical Engineering, University of South Florida, Tampa, FL, United States
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Gonzalez EA, Jain A, Bell MAL. Combined Ultrasound and Photoacoustic Image Guidance of Spinal Pedicle Cannulation Demonstrated With Intact ex vivo Specimens. IEEE Trans Biomed Eng 2021; 68:2479-2489. [PMID: 33347403 PMCID: PMC8345233 DOI: 10.1109/tbme.2020.3046370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Spinal fusion surgeries require accurate placement of pedicle screws in anatomic corridors without breaching bone boundaries. We are developing a combined ultrasound and photoacoustic image guidance system to avoid pedicle screw misplacement and accidental bone breaches, which can lead to nerve damage. METHODS Pedicle cannulation was performed on a human cadaver, with co-registered photoacoustic and ultrasound images acquired at various time points during the procedure. Bony landmarks obtained from coherence-based ultrasound images of lumbar vertebrae were registered to post-operative CT images. Registration methods were additionally tested on an ex vivo caprine vertebra. RESULTS Locally weighted short-lag spatial coherence (LW-SLSC) ultrasound imaging enhanced the visualization of bony structures with generalized contrast-to-noise ratios (gCNRs) of 0.99 and 0.98-1.00 in the caprine and human vertebrae, respectively. Short-lag spatial coherence (SLSC) and amplitude-based delay-and-sum (DAS) ultrasound imaging generally produced lower gCNRs of 0.98 and 0.84, respectively, in the caprine vertebra and 0.84-0.93 and 0.34-0.99, respectively, in the human vertebrae. The mean ± standard deviation of the area of -6 dB contours created from DAS photoacoustic images acquired with an optical fiber inserted in prepared pedicle holes (i.e., fiber surrounded by cancellous bone) and holes created after intentional breaches (i.e., fiber exposed to cortical bone) was 10.06 ±5.22 mm 2 and 2.47 ±0.96 mm 2, respectively (p 0.01). CONCLUSIONS Coherence-based LW-SLSC and SLSC beamforming improved visualization of bony anatomical landmarks for ultrasound-to-CT registration, while amplitude-based DAS beamforming successfully distinguished photoacoustic signals within the pedicle from less desirable signals characteristic of impending bone breaches. SIGNIFICANCE These results are promising to improve visual registration of ultrasound and photoacoustic images with CT images, as well as to assist surgeons with identifying and avoiding impending bone breaches during pedicle cannulation in spinal fusion surgeries.
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Wiacek A, Lediju Bell MA. Photoacoustic-guided surgery from head to toe [Invited]. BIOMEDICAL OPTICS EXPRESS 2021; 12:2079-2117. [PMID: 33996218 PMCID: PMC8086464 DOI: 10.1364/boe.417984] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 05/04/2023]
Abstract
Photoacoustic imaging-the combination of optics and acoustics to visualize differences in optical absorption - has recently demonstrated strong viability as a promising method to provide critical guidance of multiple surgeries and procedures. Benefits include its potential to assist with tumor resection, identify hemorrhaged and ablated tissue, visualize metal implants (e.g., needle tips, tool tips, brachytherapy seeds), track catheter tips, and avoid accidental injury to critical subsurface anatomy (e.g., major vessels and nerves hidden by tissue during surgery). These benefits are significant because they reduce surgical error, associated surgery-related complications (e.g., cancer recurrence, paralysis, excessive bleeding), and accidental patient death in the operating room. This invited review covers multiple aspects of the use of photoacoustic imaging to guide both surgical and related non-surgical interventions. Applicable organ systems span structures within the head to contents of the toes, with an eye toward surgical and interventional translation for the benefit of patients and for use in operating rooms and interventional suites worldwide. We additionally include a critical discussion of complete systems and tools needed to maximize the success of surgical and interventional applications of photoacoustic-based technology, spanning light delivery, acoustic detection, and robotic methods. Multiple enabling hardware and software integration components are also discussed, concluding with a summary and future outlook based on the current state of technological developments, recent achievements, and possible new directions.
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Affiliation(s)
- Alycen Wiacek
- Department of Electrical and Computer Engineering, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
| | - Muyinatu A. Lediju Bell
- Department of Electrical and Computer Engineering, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Biomedical Engineering, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Computer Science, 3400 N. Charles St., Johns Hopkins University, Baltimore, MD 21218, USA
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Huang J, Wiacek A, Kempski KM, Palmer T, Izzi J, Beck S, Lediju Bell MA. Empirical assessment of laser safety for photoacoustic-guided liver surgeries. BIOMEDICAL OPTICS EXPRESS 2021; 12:1205-1216. [PMID: 33796347 PMCID: PMC7984790 DOI: 10.1364/boe.415054] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 05/03/2023]
Abstract
Photoacoustic imaging is a promising technique to provide guidance during multiple surgeries and procedures. One challenge with this technique is that major blood vessels in the liver are difficult to differentiate from surrounding tissue within current safety limits, which only exist for human skin and eyes. In this paper, we investigate the safety of raising this limit for liver tissue excited with a 750 nm laser wavelength and approximately 30 mJ laser energy (corresponding to approximately 150 mJ/cm2 fluence). Laparotomies were performed on six swine to empirically investigate potential laser-related liver damage. Laser energy was applied for temporal durations of 1 minute, 10 minutes, and 20 minutes. Lasered liver lobes were excised either immediately after laser application (3 swine) or six weeks after surgery (3 swine). Cell damage was assessed using liver damage blood biomarkers and histopathology analyses of 41 tissue samples total. The biomarkers were generally normal over a 6 week post-surgical in vivo study period. Histopathology revealed no cell death, although additional pathology was present (i.e., hemorrhage, inflammation, fibrosis) due to handling, sample resection, and fibrous adhesions as a result of the laparotomy. These results support a new protocol for studying laser-related liver damage, indicating the potential to raise the safety limit for liver photoacoustic imaging to approximately 150 mJ/cm2 with a laser wavelength of 750 nm and for imaging durations up to 10 minutes without causing cell death. This investigation and protocol may be applied to other tissues and extended to additional wavelengths and energies, which is overall promising for introducing new tissue-specific laser safety limits for photoacoustic-guided surgery.
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Affiliation(s)
- Jiaqi Huang
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
| | - Alycen Wiacek
- Department of Electrical and Computer
Engineering, Johns Hopkins University,
Baltimore, MD 21218, USA
| | - Kelley M. Kempski
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
| | - Theron Palmer
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
| | - Jessica Izzi
- Department of Molecular and Comparative
Pathobiology, Johns Hopkins University,
Baltimore, MD 21218, USA
| | - Sarah Beck
- Department of Molecular and Comparative
Pathobiology, Johns Hopkins University,
Baltimore, MD 21218, USA
| | - Muyinatu A. Lediju Bell
- Department of Biomedical Engineering,
Johns Hopkins University, Baltimore, MD
21218, USA
- Department of Electrical and Computer
Engineering, Johns Hopkins University,
Baltimore, MD 21218, USA
- Department of Computer Science,
Johns Hopkins University, Baltimore, MD
21218, USA
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Yang H, Jüstel D, Prakash J, Karlas A, Helfen A, Masthoff M, Wildgruber M, Ntziachristos V. Soft ultrasound priors in optoacoustic reconstruction: Improving clinical vascular imaging. PHOTOACOUSTICS 2020; 19:100172. [PMID: 32280585 PMCID: PMC7139114 DOI: 10.1016/j.pacs.2020.100172] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 05/06/2023]
Abstract
Using the same ultrasound detector, hybrid optoacoustic-ultrasound (OPUS) imaging provides concurrent scans of tissue slices or volumes and visualizes complementary sound- and light-based contrast at similar resolutions. In addition to the benefit of hybrid contrast, spatial co-registration enables images from one modality to be employed as prior information for improving an aspect of the performance of the other modality. We consider herein a handheld OPUS system and utilize structural information from ultrasound images to guide regional Laplacian regularization-based reconstruction of optoacoustic images. Using phantoms and data from OPUS scans of human radial and carotid arteries, we show that ultrasound-driven optoacoustic inversion reduces limited-view artefacts and improves image contrast. In phantoms, prior-integrated reconstruction leads to a 50 % higher contrast-to-noise ratio (CNR) of the image than standard reconstruction, and a 17 % higher structural similarity (SSIM) index. In clinical data, prior-integrated reconstruction detects deep-seated radial arteries with higher CNR than the standard method at three different depths. In this way, the prior-integrated method offers unique insights into atherosclerotic carotid plaques in humans (with p<0.01 between patients and healthy volunteers), potentially paving the way for new abilities in vascular imaging and more generally in optoacoustic imaging.
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Affiliation(s)
- Hong Yang
- Institute of Biological and Medical Imaging (IBMI), Helmholtz Zentrum München, Ingolstädter Landstr. 1, D-85764, Neuherberg, Germany
- Chair of Biological Imaging and TranslaTUM, Technical University of Munich, Ismaninger Str. 22, 81675, München, Germany
| | - Dominik Jüstel
- Institute of Biological and Medical Imaging (IBMI), Helmholtz Zentrum München, Ingolstädter Landstr. 1, D-85764, Neuherberg, Germany
- Chair of Biological Imaging and TranslaTUM, Technical University of Munich, Ismaninger Str. 22, 81675, München, Germany
| | - Jaya Prakash
- Dept. of Instrumentation and Applied Physics, Indian Institute of Science, C. V. Raman Road, 560012, Bangalore, India
| | - Angelos Karlas
- Institute of Biological and Medical Imaging (IBMI), Helmholtz Zentrum München, Ingolstädter Landstr. 1, D-85764, Neuherberg, Germany
- Chair of Biological Imaging and TranslaTUM, Technical University of Munich, Ismaninger Str. 22, 81675, München, Germany
- Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Ismaninger Str. 22, D-81675, München, Germany
| | - Anne Helfen
- Department of Clinical Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, A16, 49149, Muenster, Germany
| | - Max Masthoff
- Department of Clinical Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, A16, 49149, Muenster, Germany
| | - Moritz Wildgruber
- Department of Clinical Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, A16, 49149, Muenster, Germany
- Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Munich, Germany
| | - Vasilis Ntziachristos
- Institute of Biological and Medical Imaging (IBMI), Helmholtz Zentrum München, Ingolstädter Landstr. 1, D-85764, Neuherberg, Germany
- Chair of Biological Imaging and TranslaTUM, Technical University of Munich, Ismaninger Str. 22, 81675, München, Germany
- Corresponding author at: Institute of Biological and Medical Imaging (IBMI), Helmholtz Zentrum München, Ingolstädter Landstr. 1, D-85764, Neuherberg, Germany.
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Gonzalez EA, Bell MAL. GPU implementation of photoacoustic short-lag spatial coherence imaging for improved image-guided interventions. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-19. [PMID: 32713168 PMCID: PMC7381831 DOI: 10.1117/1.jbo.25.7.077002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/29/2020] [Indexed: 05/04/2023]
Abstract
SIGNIFICANCE Photoacoustic-based visual servoing is a promising technique for surgical tool tip tracking and automated visualization of photoacoustic targets during interventional procedures. However, one outstanding challenge has been the reliability of obtaining segmentations using low-energy light sources that operate within existing laser safety limits. AIM We developed the first known graphical processing unit (GPU)-based real-time implementation of short-lag spatial coherence (SLSC) beamforming for photoacoustic imaging and applied this real-time algorithm to improve signal segmentation during photoacoustic-based visual servoing with low-energy lasers. APPROACH A 1-mm-core-diameter optical fiber was inserted into ex vivo bovine tissue. Photoacoustic-based visual servoing was implemented as the fiber was manually displaced by a translation stage, which provided ground truth measurements of the fiber displacement. GPU-SLSC results were compared with a central processing unit (CPU)-SLSC approach and an amplitude-based delay-and-sum (DAS) beamforming approach. Performance was additionally evaluated with in vivo cardiac data. RESULTS The GPU-SLSC implementation achieved frame rates up to 41.2 Hz, representing a factor of 348 speedup when compared with offline CPU-SLSC. In addition, GPU-SLSC successfully recovered low-energy signals (i.e., ≤268 μJ) with mean ± standard deviation of signal-to-noise ratios of 11.2 ± 2.4 (compared with 3.5 ± 0.8 with conventional DAS beamforming). When energies were lower than the safety limit for skin (i.e., 394.6 μJ for 900-nm wavelength laser light), the median and interquartile range (IQR) of visual servoing tracking errors obtained with GPU-SLSC were 0.64 and 0.52 mm, respectively (which were lower than the median and IQR obtained with DAS by 1.39 and 8.45 mm, respectively). GPU-SLSC additionally reduced the percentage of failed segmentations when applied to in vivo cardiac data. CONCLUSIONS Results are promising for the use of low-energy, miniaturized lasers to perform GPU-SLSC photoacoustic-based visual servoing in the operating room with laser pulse repetition frequencies as high as 41.2 Hz.
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Affiliation(s)
- Eduardo A. Gonzalez
- Johns Hopkins University, School of Medicine, Department of Biomedical Engineering, Baltimore, Maryland, United States
| | - Muyinatu A. Lediju Bell
- Johns Hopkins University, School of Medicine, Department of Biomedical Engineering, Baltimore, Maryland, United States
- Johns Hopkins University, Whiting School of Engineering, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
- Johns Hopkins University, Whiting School of Engineering, Department of Computer Science, Baltimore, Maryland, United States
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Towards Clinical Translation of LED-Based Photoacoustic Imaging: A Review. SENSORS 2020; 20:s20092484. [PMID: 32349414 PMCID: PMC7249023 DOI: 10.3390/s20092484] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Abstract
Photoacoustic imaging, with the capability to provide simultaneous structural, functional, and molecular information, is one of the fastest growing biomedical imaging modalities of recent times. As a hybrid modality, it not only provides greater penetration depth than the purely optical imaging techniques, but also provides optical contrast of molecular components in the living tissue. Conventionally, photoacoustic imaging systems utilize bulky and expensive class IV lasers, which is one of the key factors hindering the clinical translation of this promising modality. Use of LEDs which are portable and affordable offers a unique opportunity to accelerate the clinical translation of photoacoustics. In this paper, we first review the development history of LED as an illumination source in biomedical photoacoustic imaging. Key developments in this area, from point-source measurements to development of high-power LED arrays, are briefly discussed. Finally, we thoroughly review multiple phantom, ex-vivo, animal in-vivo, human in-vivo, and clinical pilot studies and demonstrate the unprecedented preclinical and clinical potential of LED-based photoacoustic imaging.
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Abstract
Photoacoustic imaging has demonstrated its potential for diagnosis over the last few decades. In recent years, its unique imaging capabilities, such as detecting structural, functional and molecular information in deep regions with optical contrast and ultrasound resolution, have opened up many opportunities for photoacoustic imaging to be used during image-guided interventions. Numerous studies have investigated the capability of photoacoustic imaging to guide various interventions such as drug delivery, therapies, surgeries, and biopsies. These studies have demonstrated that photoacoustic imaging can guide these interventions effectively and non-invasively in real-time. In this minireview, we will elucidate the potential of photoacoustic imaging in guiding active and passive drug deliveries, photothermal therapy, and other surgeries and therapies using endogenous and exogenous contrast agents including organic, inorganic, and hybrid nanoparticles, as well as needle-based biopsy procedures. The advantages of photoacoustic imaging in guided interventions will be discussed. It will, therefore, show that photoacoustic imaging has great potential in real-time interventions due to its advantages over current imaging modalities like computed tomography, magnetic resonance imaging, and ultrasound imaging.
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Affiliation(s)
- Madhumithra S Karthikesh
- Bioengineering Program and Institute for Bioengineering Research, University of Kansas, Lawrence, KS 66045, USA
| | - Xinmai Yang
- Bioengineering Program and Institute for Bioengineering Research, University of Kansas, Lawrence, KS 66045, USA
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS 66045, USA
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Zhao T, Desjardins AE, Ourselin S, Vercauteren T, Xia W. Minimally invasive photoacoustic imaging: Current status and future perspectives. PHOTOACOUSTICS 2019; 16:100146. [PMID: 31871889 PMCID: PMC6909166 DOI: 10.1016/j.pacs.2019.100146] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/26/2019] [Accepted: 09/30/2019] [Indexed: 05/09/2023]
Abstract
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.
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Affiliation(s)
- Tianrui Zhao
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, 4th Floor, Lambeth Wing St Thomas’ Hospital London, London SE1 7EH, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
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Vu T, Razansky D, Yao J. Listening to tissues with new light: recent technological advances in photoacoustic imaging. JOURNAL OF OPTICS (2010) 2019; 21:10.1088/2040-8986/ab3b1a. [PMID: 32051756 PMCID: PMC7015182 DOI: 10.1088/2040-8986/ab3b1a] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Photoacoustic tomography (PAT), or optoacoustic tomography, has achieved remarkable progress in the past decade, benefiting from the joint developments in optics, acoustics, chemistry, computing and mathematics. Unlike pure optical or ultrasound imaging, PAT can provide unique optical absorption contrast as well as widely scalable spatial resolution, penetration depth and imaging speed. Moreover, PAT has inherent sensitivity to tissue's functional, molecular, and metabolic state. With these merits, PAT has been applied in a wide range of life science disciplines, and has enabled biomedical research unattainable by other imaging methods. This Review article aims at introducing state-of-the-art PAT technologies and their representative applications. The focus is on recent technological breakthroughs in structural, functional, molecular PAT, including super-resolution imaging, real-time small-animal whole-body imaging, and high-sensitivity functional/molecular imaging. We also discuss the remaining challenges in PAT and envisioned opportunities.
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Affiliation(s)
- Tri Vu
- Photoacoustic Imaging Lab, Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Daniel Razansky
- Faculty of Medicine and Institute of Pharmacology and Toxicology, University of Zurich, Switzerland
- Institute for Biomedical Engineering and Department of Information Technology and Electrical Engineering, ETH Zurich, Switzerland
| | - Junjie Yao
- Photoacoustic Imaging Lab, Department of Biomedical Engineering, Duke University, Durham, NC, USA
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12
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Abstract
Ultrasound image guidance is widely used in minimally invasive procedures, including fetal surgery. In this context, maintaining visibility of medical devices is a significant challenge. Needles and catheters can readily deviate from the ultrasound imaging plane as they are inserted. When the medical device tips are not visible, they can damage critical structures, with potentially profound consequences including loss of pregnancy. In this study, we performed 3D ultrasonic tracking of a needle using a novel probe with a 1.5D array of transducer elements that was driven by a commercial ultrasound system. A fiber-optic hydrophone integrated into the needle received transmissions from the probe, and data from this sensor was processed to estimate the position of the hydrophone tip in the coordinate space of the probe. Golay coding was used to increase the signal-to-noise (SNR). The relative tracking accuracy was better than 0.4 mm in all dimensions, as evaluated using a water phantom. To obtain a preliminary indication of the clinical potential of 3D ultrasonic needle tracking, an intravascular needle insertion was performed in an in vivo pregnant sheep model. The SNR values ranged from 12 to 16 at depths of 20 to 31 mm and at an insertion angle of 49° relative to the probe surface normal. The results of this study demonstrate that 3D ultrasonic needle tracking with a fiber-optic hydrophone sensor and a 1.5D array is feasible in clinically realistic environments.
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13
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Lediju Bell MA, Shubert J. Photoacoustic-based visual servoing of a needle tip. Sci Rep 2018; 8:15519. [PMID: 30341371 PMCID: PMC6195562 DOI: 10.1038/s41598-018-33931-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/08/2018] [Indexed: 12/15/2022] Open
Abstract
In intraoperative settings, the presence of acoustic clutter and reflection artifacts from metallic surgical tools often reduces the effectiveness of ultrasound imaging and complicates the localization of surgical tool tips. We propose an alternative approach for tool tracking and navigation in these challenging acoustic environments by augmenting ultrasound systems with a light source (to perform photoacoustic imaging) and a robot (to autonomously and robustly follow a surgical tool regardless of the tissue medium). The robotically controlled ultrasound probe continuously visualizes the location of the tool tip by segmenting and tracking photoacoustic signals generated from an optical fiber inside the tool. System validation in the presence of fat, muscle, brain, skull, and liver tissue with and without the presence of an additional clutter layer resulted in mean signal tracking errors <2 mm, mean probe centering errors <1 mm, and successful recovery from ultrasound perturbations, representing either patient motion or switching from photoacoustic images to ultrasound images to search for a target of interest. A detailed analysis of channel SNR in controlled experiments with and without significant acoustic clutter revealed that the detection of a needle tip is possible with photoacoustic imaging, particularly in cases where ultrasound imaging traditionally fails. Results show promise for guiding surgeries and procedures in acoustically challenging environments with this novel robotic and photoacoustic system combination.
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Affiliation(s)
- Muyinatu A Lediju Bell
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, MD, 21218, USA. .,Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD, 21218, USA. .,Johns Hopkins University, Department of Computer Science, Baltimore, MD, 21218, USA.
| | - Joshua Shubert
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, MD, 21218, USA
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14
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Xia W, West SJ, Finlay MC, Pratt R, Mathews S, Mari JM, Ourselin S, David AL, Desjardins AE. Three-Dimensional Ultrasonic Needle Tip Tracking with a Fiber-Optic Ultrasound Receiver. J Vis Exp 2018. [PMID: 30199033 PMCID: PMC6231697 DOI: 10.3791/57207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Ultrasound is frequently used for guiding minimally invasive procedures, but visualizing medical devices is often challenging with this imaging modality. When visualization is lost, the medical device can cause trauma to critical tissue structures. Here, a method to track the needle tip during ultrasound image-guided procedures is presented. This method involves the use of a fiber-optic ultrasound receiver that is affixed within the cannula of a medical needle to communicate ultrasonically with the external ultrasound probe. This custom probe comprises a central transducer element array and side element arrays. In addition to conventional two-dimensional (2D) B-mode ultrasound imaging provided by the central array, three-dimensional (3D) needle tip tracking is provided by the side arrays. For B-mode ultrasound imaging, a standard transmit-receive sequence with electronic beamforming is performed. For ultrasonic tracking, Golay-coded ultrasound transmissions from the 4 side arrays are received by the hydrophone sensor, and subsequently the received signals are decoded to identify the needle tip's spatial location with respect to the ultrasound imaging probe. As a preliminary validation of this method, insertions of the needle/hydrophone pair were performed in clinically realistic contexts. This novel ultrasound imaging/tracking method is compatible with current clinical workflow, and it provides reliable device tracking during in-plane and out-of-plane needle insertions.
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Affiliation(s)
- Wenfeng Xia
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London;
| | - Simeon J West
- Department of Anaesthesia, University College Hospital
| | - Malcolm C Finlay
- Department of Medical Physics and Biomedical Engineering, University College London; St Bartholomew's Hospital and Queen Mary University of London
| | - Rosalind Pratt
- Institute for Women's Health, University College London; Centre for Medical Imaging Computing, University College London
| | - Sunish Mathews
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
| | | | - Sebastien Ourselin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London; Centre for Medical Imaging Computing, University College London
| | - Anna L David
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Institute for Women's Health, University College London; Department of Development and Regeneration, KU Leuven (Katholieke Universiteit); NIHR University College London Hospitals Biomedical Research Centre
| | - Adrien E Desjardins
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
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15
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Wu C, Bayer CL. Imaging placental function: current technology, clinical needs, and emerging modalities. ACTA ACUST UNITED AC 2018; 63:14TR01. [DOI: 10.1088/1361-6560/aaccd9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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16
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Allman D, Reiter A, Bell MAL. Photoacoustic Source Detection and Reflection Artifact Removal Enabled by Deep Learning. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:1464-1477. [PMID: 29870374 PMCID: PMC6075868 DOI: 10.1109/tmi.2018.2829662] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Interventional applications of photoacoustic imaging typically require visualization of point-like targets, such as the small, circular, cross-sectional tips of needles, catheters, or brachytherapy seeds. When these point-like targets are imaged in the presence of highly echogenic structures, the resulting photoacoustic wave creates a reflection artifact that may appear as a true signal. We propose to use deep learning techniques to identify these types of noise artifacts for removal in experimental photoacoustic data. To achieve this goal, a convolutional neural network (CNN) was first trained to locate and classify sources and artifacts in pre-beamformed data simulated with -Wave. Simulations initially contained one source and one artifact with various medium sound speeds and 2-D target locations. Based on 3,468 test images, we achieved a 100% success rate in classifying both sources and artifacts. After adding noise to assess potential performance in more realistic imaging environments, we achieved at least 98% success rates for channel signal-to-noise ratios (SNRs) of -9dB or greater, with a severe decrease in performance below -21dB channel SNR. We then explored training with multiple sources and two types of acoustic receivers and achieved similar success with detecting point sources. Networks trained with simulated data were then transferred to experimental waterbath and phantom data with 100% and 96.67% source classification accuracy, respectively (particularly when networks were tested at depths that were included during training). The corresponding mean ± one standard deviation of the point source location error was 0.40 ± 0.22 mm and 0.38 ± 0.25 mm for waterbath and phantom experimental data, respectively, which provides some indication of the resolution limits of our new CNN-based imaging system. We finally show that the CNN-based information can be displayed in a novel artifact-free image format, enabling us to effectively remove reflection artifacts from photoacoustic images, which is not possible with traditional geometry-based beamforming.
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17
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Xia W, Kuniyil Ajith Singh M, Maneas E, Sato N, Shigeta Y, Agano T, Ourselin S, J West S, E Desjardins A. Handheld Real-Time LED-Based Photoacoustic and Ultrasound Imaging System for Accurate Visualization of Clinical Metal Needles and Superficial Vasculature to Guide Minimally Invasive Procedures. SENSORS (BASEL, SWITZERLAND) 2018; 18:E1394. [PMID: 29724014 PMCID: PMC5982119 DOI: 10.3390/s18051394] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 01/11/2023]
Abstract
Ultrasound imaging is widely used to guide minimally invasive procedures, but the visualization of the invasive medical device and the procedure’s target is often challenging. Photoacoustic imaging has shown great promise for guiding minimally invasive procedures, but clinical translation of this technology has often been limited by bulky and expensive excitation sources. In this work, we demonstrate the feasibility of guiding minimally invasive procedures using a dual-mode photoacoustic and ultrasound imaging system with excitation from compact arrays of light-emitting diodes (LEDs) at 850 nm. Three validation experiments were performed. First, clinical metal needles inserted into biological tissue were imaged. Second, the imaging depth of the system was characterized using a blood-vessel-mimicking phantom. Third, the superficial vasculature in human volunteers was imaged. It was found that photoacoustic imaging enabled needle visualization with signal-to-noise ratios that were 1.2 to 2.2 times higher than those obtained with ultrasound imaging, over insertion angles of 26 to 51 degrees. With the blood vessel mimicking phantom, the maximum imaging depth was 38 mm. The superficial vasculature of a human middle finger and a human wrist were clearly visualized in real-time. We conclude that the LED-based system is promising for guiding minimally invasive procedures with peripheral tissue targets.
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Affiliation(s)
- Wenfeng Xia
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.
| | - Mithun Kuniyil Ajith Singh
- Research and Business Development Division, PreXion Corporation, Stationsplein 45 A4.004, 3013AK Rotterdam, The Netherlands.
| | - Efthymios Maneas
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.
| | - Naoto Sato
- Research and Development Division, 1-14-1, Kandasudacho, Chiyoda-ku, Tokyo 101-0041, Japan.
| | - Yusuke Shigeta
- Research and Development Division, 1-14-1, Kandasudacho, Chiyoda-ku, Tokyo 101-0041, Japan.
| | - Toshitaka Agano
- Research and Development Division, 1-14-1, Kandasudacho, Chiyoda-ku, Tokyo 101-0041, Japan.
| | - Sebastian Ourselin
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Centre for Medical Imaging Computing, University College London, Gower Street, London WC1E 6BT, UK.
| | - Simeon J West
- Department of Anaesthesia, University College Hospital, Main Theatres, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1 2BU, UK.
| | - Adrien E Desjardins
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.
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18
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Allard M, Shubert J, Bell MAL. Feasibility of photoacoustic-guided teleoperated hysterectomies. J Med Imaging (Bellingham) 2018; 5:021213. [PMID: 29487885 PMCID: PMC5803551 DOI: 10.1117/1.jmi.5.2.021213] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 01/11/2018] [Indexed: 02/01/2023] Open
Abstract
Hysterectomies (i.e., surgical removal of the uterus) are the prevailing solution to treat medical conditions such as uterine cancer, endometriosis, and uterine prolapse. One complication of hysterectomies is accidental injury to the ureters located within millimeters of the uterine arteries that are severed and cauterized to hinder blood flow and enable full uterus removal. This work explores the feasibility of using photoacoustic imaging to visualize the uterine arteries (and potentially the ureter) when this imaging method is uniquely combined with a da Vinci® surgical robot that enables teleoperated hysterectomies. We developed a specialized light delivery system to surround a da Vinci® curved scissor tool, and an ultrasound probe was placed externally, representing a transvaginal approach, to receive the acoustic signals. Photoacoustic images were acquired while sweeping the tool across our custom 3-D uterine vessel model covered in ex vivo bovine tissue that was placed between the 3-D model and the fiber, as well as between the ultrasound probe and the 3-D model. Four tool orientations were explored, and the robot kinematics were used to provide tool position and orientation information simultaneously with each photoacoustic image acquisition. The optimal tool orientation produced images with contrast >10 dB and background signal-to-noise ratios (SNRs) >1.7, indicating minimal acoustic clutter from the tool tip. We achieved similar contrast and SNR measurements with four unique wrist orientations explored with the scissor tool in open and closed configurations. Results indicate that photoacoustic imaging is a promising approach to enable visualization of the uterine arteries to guide hysterectomies (and other gynecological surgeries). These results are additionally applicable to other da Vinci® surgeries and other surgical instruments with similar tip geometry.
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Affiliation(s)
- Margaret Allard
- Smith College, Department of Physics, Northampton, Massachusetts, United States
| | - Joshua Shubert
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States
| | - Muyinatu A Lediju Bell
- Johns Hopkins University, Department of Electrical and Computer Engineering, Baltimore, Maryland, United States.,Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Maryland, United States
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19
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Yamaleyeva LM, Sun Y, Bledsoe T, Hoke A, Gurley SB, Brosnihan KB. Photoacoustic imaging for in vivo quantification of placental oxygenation in mice. FASEB J 2017; 31:5520-5529. [PMID: 28842425 PMCID: PMC5690392 DOI: 10.1096/fj.201700047rr] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 08/07/2017] [Indexed: 11/11/2022]
Abstract
Accurate analysis of placental and fetal oxygenation is critical during pregnancy. Photoacoustic imaging (PAI) combines laser technology with ultrasound in real time. We tested the sensitivity and accuracy of PAI for analysis of placental and fetal oxygen saturation (sO2) in mice. The placental labyrinth (L) had a higher sO2 than the junctional zone plus decidua region (JZ+D) in C57Bl/6 mice. Changing maternal O2 from 100 to 20% in C57Bl/6 mice lowered sO2 in these regions. C57Bl/6 mice were treated with the NO synthase inhibitor L-NG-nitroarginine methyl ester (L-NAME) from gestational day (GD) 11 to GD18 to induce hypertension. L-NAME decreased sO2 in L and JZ+D at GD14 and GD18 in association with fetal growth restriction and higher blood pressure. Hypoxia-inducible factor 1α immunostaining was higher in L-NAME vs control mice at GD14. Fetal sO2 levels were similar between l-NAME and control mice at GD14 and GD18. In contrast to untreated C57Bl/6, L-NAME decreased placental sO2 at GD14 and GD18 vs GD10 or GD12. Placental sO2 was lower in fetal growth restriction in an angiotensin-converting enzyme 2 knockout mouse model characterized by placental hypoxia. On phantom studies, patterns of sO2 measured directly correlated with those measured by PAI. In summary, PAI enables the detection of placental and fetal oxygenation during normal and pathologic pregnancies in mice.-Yamaleyeva, L. M., Sun, Y., Bledsoe, T., Hoke, A., Gurley, S. B., Brosnihan, K. B. Photoacoustic imaging for in vivo quantification of placental oxygenation in mice.
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Affiliation(s)
- Liliya M Yamaleyeva
- Department of Surgery/Hypertension and Vascular Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA;
| | - Yao Sun
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Tiffaney Bledsoe
- Department of Surgery/Hypertension and Vascular Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Asia Hoke
- Department of Surgery/Hypertension and Vascular Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Susan B Gurley
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers, Durham, North Carolina, USA
| | - K Bridget Brosnihan
- Department of Surgery/Hypertension and Vascular Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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20
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Xia W, Noimark S, Ourselin S, West SJ, Finlay MC, David AL, Desjardins AE. Ultrasonic Needle Tracking with a Fibre-Optic Ultrasound Transmitter for Guidance of Minimally Invasive Fetal Surgery. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2017; 10434:637-645. [PMID: 28948240 DOI: 10.1007/978-3-319-66185-8_72] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ultrasound imaging is widely used for guiding minimally invasive procedures, including fetal surgery. Visualisation of medical devices such as medical needles is critically important and it remains challenging in many clinical contexts. During in-plane insertions, a needle can have poor visibility at steep insertion angles and at large insertion depths. During out-of-plane insertions, the needle tip can have a similar ultrasonic appearance to the needle shaft when it intersects with the ultrasound imaging plane. When the needle tip is not accurately identified, it can damage critical structures, with potentially severe consequences, including loss of pregnancy. In this paper, we present a tracking system to directly visualise the needle tip with an ultrasonic beacon. The waves transmitted by the beacon were received by an external ultrasound imaging probe. Pairs of co-registered images were acquired in rapid succession with this probe: a photoacoustic image obtained with the system in receive-only mode, and a conventional B-mode ultrasound image. The beacon comprised a custom elastomeric nanocomposite coating at the distal end of an optical fibre, which was positioned within the lumen of a commercial 22 gauge needle. Delivery of pulsed light to the coating resulted in the photoacoustic generation of ultrasonic waves. The measured tracking accuracies in water in the axial and lateral dimensions were 0.39±0.19 mm and 1.85±0.29 mm, respectively. To obtain a preliminary indication of the clinical potential of this ultrasonic needle tracking system, needle insertions were performed in an in vivo fetal sheep model. The results demonstrate that ultrasonic needle tracking with a fibre-optic transmitter is feasible in a clinically realistic fetal surgery environment, and that it could be useful to guide minimally invasive procedures by providing accurate visualisation of the medical device tip.
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Affiliation(s)
- Wenfeng Xia
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
| | - Sacha Noimark
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.,Materials Chemistry Research Centre, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - Sebastien Ourselin
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
| | - Simeon J West
- Department of Anaesthesia, University College Hospital, 235 Euston Road, London NW1 2BU, UK
| | - Malcolm C Finlay
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK.,St Bartholomew's Hospital and Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Anna L David
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - Adrien E Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, UK
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21
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Arthuis CJ, Novell A, Raes F, Escoffre JM, Lerondel S, Le Pape A, Bouakaz A, Perrotin F. Real-Time Monitoring of Placental Oxygenation during Maternal Hypoxia and Hyperoxygenation Using Photoacoustic Imaging. PLoS One 2017; 12:e0169850. [PMID: 28081216 PMCID: PMC5232166 DOI: 10.1371/journal.pone.0169850] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 12/22/2016] [Indexed: 12/15/2022] Open
Abstract
Purpose This preclinical study aimed to evaluate placental oxygenation in pregnant rats by real-time photoacoustic (PA) imaging on different days of gestation and to specify variations in placental oxygen saturation under conditions of maternal hypoxia and hyperoxygenation. Material and methods Placentas of fifteen Sprague-Dawley rats were examined on days 14, 17, and 20 of pregnancy with a PA imaging system coupled to high-resolution ultrasound imaging. Pregnant rats were successively exposed to hyperoxygenated and hypoxic conditions by changing the oxygen concentration in inhaled gas. Tissue oxygen saturation was quantitatively analyzed by real-time PA imaging in the skin and 3 regions of the placenta. All procedures were performed in accordance with applicable ethical guidelines and approved by the animal care committee. Results Maternal hypoxia was associated with significantly greater decrease in blood oxygen saturation (ΔO2 Saturation) in the skin (70.74% ±7.65) than in the mesometrial triangle (32.66% ±5.75) or other placental areas (labyrinth: 18.58% ± 6.61; basal zone: 13.13% ±5.72) on different days of pregnancy (P<0.001). ΔO2 Saturation did not differ significantly between the labyrinth, the basal zone, and the decidua. After the period of hypoxia, maternal hyperoxygenation led to a significant rise in oxygen saturation, which returned to its initial values in the different placental regions (P<0.001). Conclusions PA imaging enables the variation of blood oxygen saturation to be monitored in the placenta during maternal hypoxia or hyperoxygenation. This first preclinical study suggests that the placenta plays an important role in protecting the fetus against maternal hypoxia.
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Affiliation(s)
- Chloé J. Arthuis
- Inserm U930, François Rabelais University, Tours, France
- University Hospital Center of Tours, Department of Obstetrics, Gynecology and Fetal Medicine, Tours, France
- * E-mail:
| | - Anthony Novell
- Inserm U930, François Rabelais University, Tours, France
| | - Florian Raes
- PHENOMIN-TAAM-UPS44, Center for Small Animal Imaging (CIPA), CNRS Orléans, France
| | | | - Stéphanie Lerondel
- PHENOMIN-TAAM-UPS44, Center for Small Animal Imaging (CIPA), CNRS Orléans, France
| | - Alain Le Pape
- PHENOMIN-TAAM-UPS44, Center for Small Animal Imaging (CIPA), CNRS Orléans, France
| | - Ayache Bouakaz
- Inserm U930, François Rabelais University, Tours, France
| | - Franck Perrotin
- Inserm U930, François Rabelais University, Tours, France
- University Hospital Center of Tours, Department of Obstetrics, Gynecology and Fetal Medicine, Tours, France
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22
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Hill ER, Xia W, Clarkson MJ, Desjardins AE. Identification and removal of laser-induced noise in photoacoustic imaging using singular value decomposition. BIOMEDICAL OPTICS EXPRESS 2017; 8:68-77. [PMID: 28101402 PMCID: PMC5231316 DOI: 10.1364/boe.8.000068] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/28/2016] [Accepted: 11/11/2016] [Indexed: 05/20/2023]
Abstract
Singular value decomposition (SVD) was used to identify and remove laser-induced noise in photoacoustic images acquired with a clinical ultrasound scanner. This noise, which was prominent in the radiofrequency data acquired in parallel from multiple transducer elements, was induced by the excitation light source. It was modelled by truncating the SVD matrices so that only the first few largest singular value components were retained, and subtracted prior to image reconstruction. The dependency of the signal amplitude and the number of the largest singular value components used for noise modeling was investigated for different photoacoustic source geometries. Validation was performed with simulated data and measured noise, and with photoacoustic images acquired from the human forearm and finger in vivo using L14-5/38 and L40-8/12 linear array clinical imaging probes. The use of only one singular value component was found to be sufficient to achieve near-complete removal of laser-induced noise from reconstructed images. This method has strong potential to increase image quality for a wide range of photoacoustic imaging systems with parallel data acquisition.
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Affiliation(s)
- Emma R. Hill
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, UK
- Equal contribution
| | - Wenfeng Xia
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, UK
- Equal contribution
| | - Matthew J. Clarkson
- Translational Imaging Group (TIG), Centre for Medical Image Computing (CMIC), Dept. of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, UK
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23
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Xia W, Ginsberg Y, West SJ, Nikitichev DI, Ourselin S, David AL, Desjardins AE. Coded excitation ultrasonic needle tracking: An in vivo study. Med Phys 2016; 43:4065. [PMID: 27370125 PMCID: PMC5207306 DOI: 10.1118/1.4953205] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 04/25/2016] [Accepted: 05/21/2016] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Accurate and efficient guidance of medical devices to procedural targets lies at the heart of interventional procedures. Ultrasound imaging is commonly used for device guidance, but determining the location of the device tip can be challenging. Various methods have been proposed to track medical devices during ultrasound-guided procedures, but widespread clinical adoption has remained elusive. With ultrasonic tracking, the location of a medical device is determined by ultrasonic communication between the ultrasound imaging probe and a transducer integrated into the medical device. The signal-to-noise ratio (SNR) of the transducer data is an important determinant of the depth in tissue at which tracking can be performed. In this paper, the authors present a new generation of ultrasonic tracking in which coded excitation is used to improve the SNR without spatial averaging. METHODS A fiber optic hydrophone was integrated into the cannula of a 20 gauge insertion needle. This transducer received transmissions from the ultrasound imaging probe, and the data were processed to obtain a tracking image of the needle tip. Excitation using Barker or Golay codes was performed to improve the SNR, and conventional bipolar excitation was performed for comparison. The performance of the coded excitation ultrasonic tracking system was evaluated in an in vivo ovine model with insertions to the brachial plexus and the uterine cavity. RESULTS Coded excitation significantly increased the SNRs of the tracking images, as compared with bipolar excitation. During an insertion to the brachial plexus, the SNR was increased by factors of 3.5 for Barker coding and 7.1 for Golay coding. During insertions into the uterine cavity, these factors ranged from 2.9 to 4.2 for Barker coding and 5.4 to 8.5 for Golay coding. The maximum SNR was 670, which was obtained with Golay coding during needle withdrawal from the brachial plexus. Range sidelobe artifacts were observed in tracking images obtained with Barker coded excitation, and they were visually absent with Golay coded excitation. The spatial tracking accuracy was unaffected by coded excitation. CONCLUSIONS Coded excitation is a viable method for improving the SNR in ultrasonic tracking without compromising spatial accuracy. This method provided SNR increases that are consistent with theoretical expectations, even in the presence of physiological motion. With the ultrasonic tracking system in this study, the SNR increases will have direct clinical implications in a broad range of interventional procedures by improving visibility of medical devices at large depths.
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Affiliation(s)
- Wenfeng Xia
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Yuval Ginsberg
- Institute for Women’s Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, United Kingdom
| | - Simeon J. West
- Department of Anaesthesia, University College Hospital, Main Theaters, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1 2BU, United Kingdom
| | - Daniil I. Nikitichev
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Sebastien Ourselin
- Center for Medical Imaging Computing, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Anna L. David
- Institute for Women’s Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, United Kingdom
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
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24
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Nikitichev DI, Xia W, Hill E, Mosse CA, Perkins T, Konyn K, Ourselin S, Desjardins AE, Vercauteren T. Music-of-light stethoscope: a demonstration of the photoacoustic effect. ACTA ACUST UNITED AC 2016; 51:045015. [PMID: 29249838 PMCID: PMC5717520 DOI: 10.1088/0031-9120/51/4/045015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/11/2016] [Accepted: 04/25/2016] [Indexed: 11/17/2022]
Abstract
In this paper we present a system aimed at demonstrating the photoacoustic (PA) effect for educational purposes. PA imaging is a hybrid imaging modality that requires no contrast agent and has a great potential for spine and brain lesion characterisation, breast cancer and blood flow monitoring notably in the context of fetal surgery. It relies on combining light excitation with ultrasound reception. Our brief was to present and explain PA imaging in a public-friendly way suitable for a variety of ages and backgrounds. We developed a simple, accessible demonstration unit using readily available materials. We used a modulated light emitting diode (LED) torch and an electronic stethoscope. The output of a music player was used for light modulation and the chest piece of the stethoscope covered by a black tape was used as an absorbing target and an enclosed chamber. This demonstration unit was presented to the public at the Bloomsbury Festival On Light in October 2015. Our stall was visited by over 100 people of varying ages. Twenty families returned in-depth evaluation questionnaires, which show that our explanations of the photoacoustic effect were well understood. Their interest in biomedical engineering was increased.
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Affiliation(s)
- D I Nikitichev
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK.,Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, WC1E 6BT, London, UK.,
| | - W Xia
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK
| | - E Hill
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK
| | - C A Mosse
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK
| | - T Perkins
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, WC1E 6BT, London, UK
| | - K Konyn
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK.,Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, WC1E 6BT, London, UK
| | - S Ourselin
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK.,Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, WC1E 6BT, London, UK
| | - A E Desjardins
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK
| | - T Vercauteren
- Translational Imaging group, Centre for Medical Image Computing, University College London, London, UK.,Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, WC1E 6BT, London, UK
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25
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Mari JM, Xia W, West SJ, Desjardins AE. Interventional multispectral photoacoustic imaging with a clinical ultrasound probe for discriminating nerves and tendons: an ex vivo pilot study. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:110503. [PMID: 26580699 PMCID: PMC5217182 DOI: 10.1117/1.jbo.20.11.110503] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/23/2015] [Indexed: 05/19/2023]
Abstract
Accurate and efficient identification of nerves is an essential component of peripheral nerve blocks. While ultrasound (US) imaging is increasingly used as a guidance modality, it often provides insufficient contrast for identifying nerves from surrounding tissues such as tendons. Electrical nerve stimulators can be used in conjunction with US imaging for discriminating nerves from surrounding tissues, but they are insufficient to reliably prevent neural punctures, so that alternative methods are highly desirable. In this study, an interventional multispectral photoacoustic (PA) imaging system was used to directly compare the signal amplitudes and spectra acquired from nerves and tendons ex vivo, for the first time. The results indicate that the system can provide significantly higher image contrast for discriminating nerves and tendons than that provided by US imaging. As such, photoacoustic imaging could be valuable as an adjunct to US for guiding peripheral nerve blocks.
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Affiliation(s)
- Jean Martial Mari
- University College London, Department of Medical Physics
and Biomedical Engineering, Gower Street, London WC1E 6BT, United Kingdom
- University of French Polynesia, GePaSud, Faa’a
98702, French, Polynesia, France
| | - Wenfeng Xia
- University College London, Department of Medical Physics
and Biomedical Engineering, Gower Street, London WC1E 6BT, United Kingdom
| | - Simeon J. West
- University College Hospital, Department of Anaesthesia,
Main Theatres, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1
2BU, United Kingdom
| | - Adrien E. Desjardins
- University College London, Department of Medical Physics
and Biomedical Engineering, Gower Street, London WC1E 6BT, United Kingdom
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