In vivo photoacoustic monitoring of vasoconstriction induced by acute hyperglycemia

Photoacoustic Imaging of Metabolic Activities across Biological Length Scales

Imaging is ubiquitous with biomedical research and discovery. This article surveys the role of imaging in our understanding of metabolism and introduces photoacoustic imaging as a compelling candidate for providing high-resolution, label-free, and real-time insights into metabolic processes. As a rapidly evolving modality, photoacoustics holds promising preclinical and clinical potential in imaging of metabolism as well as metabolism-related changes.

Simultaneous head-mounted imaging of neural and hemodynamic activities at high spatiotemporal resolution in freely behaving mice

Exploring the relationship between neural activity and cerebral hemoglobin-oxygenation responses in freely behaving mice can advance our understanding of neurovascular coupling. Head-mounted microscopes enable neuroimaging in freely behaving mice; however, investigating neurovascular dynamics remains challenging because of a lack of hemodynamic information, especially blood oxygenation, or insufficient resolution. Here, we report a head-mounted microscope for neurovascular imaging that enables the simultaneous recording of neuronal burst firing and multiparametric hemodynamics such as vascular oxygen saturation at high spatiotemporal resolution. The 1.7-gram lightweight microscope integrates confocal fluorescence and photoacoustic microscopy, allowing recordings at 0.78 hertz with 1.5-micrometer lateral resolution across a field of view of 400 micrometers by 400 micrometers. We identified cell type-specific neurovascular responses to hypoxic challenges, observed active regulation of arterioles during sensory stimuli, and detected abnormal oxygen depletion and vasodilation preceding burst neuronal discharges in epileptic disorders. This technique provides valuable insights into neurovascular coupling and holds potential for studying the pathology of neurological brain diseases.

Stress hyperglycemia ratio as an important predictive indicator for severe disturbance of consciousness and all-cause mortality in critically ill patients with cerebral infarction: a retrospective study using the MIMIC-IV database

BACKGROUND

Stress hyperglycemia ratio (SHR) has been linked to prognosis of cerebrovascular diseases. Nevertheless, the association between SHR and severe disturbance of consciousness (DC) and mortality among patients with cerebral infarction remains explored. This study seeks to assess the predictive potential of SHR for severe DC and mortality among patients with cerebral infarction.

METHODS

We identified individuals diagnosed with cerebral infarction within the MIMIC-IV database. We employed logistic regression to examine the correlation between the SHR index and the severity of patients' consciousness disturbance, as well as in-hospital mortality. Furthermore, we employed restricted cubic spline curves to explore potential non-linear relationships between the SHR index and outcome measures. To assess the predictive performance of the SHR index and admission blood sugar level on outcome indicators, we compared receiver operating characteristic (ROC) curves.

RESULTS

A non-linear relationship existed between SHR and the risk of severe disturbance of consciousness, while there was a linear relationship with all-cause mortality. The AUC value for predicting severe disturbance of consciousness by the SHR index is 0.5419 (95% CI: 0.5188-0.5661). The AUC value for predicting in-hospital mortality based on the SHR index is 0.6264 (95% CI: 0.5881-0.6662). It is superior to single admission blood sugar level. In addition, SHR has an incremental impact on evaluating various diseases in predicting severe disturbance of consciousness and all-cause mortality in critically ill patients with cerebral infarction.

CONCLUSIONS

SHR is an important predictive indicator for severe disturbance of consciousness and all-cause mortality of patients with cerebral infarction.

Non-Invasive Photoacoustic Cerebrovascular Monitoring of Early-Stage Ischemic Strokes In Vivo

Early-stage stroke monitoring enables timely intervention that is crucial to minimizing neuronal damage and increasing the extent of recovery. By monitoring collateral circulation and neovascularization after ischemic stroke, the natural recovery process can be better understood, optimize further treatment strategies, and improve the prognosis. Photoacoustic computed tomography (PACT), a non-invasive imaging modality that captures multiparametric high-resolution images of vessel structures, is well suited for evaluating cerebrovascular structures and their function. Here 3D multiparametric transcranial PACT is implemented to monitor the early stage of a photothrombotic (PT)-stroke model in living rats. New vessels in the PT-induced region are successfully observed using PACT, and these observations are confirmed by histology. Then, using multiparametric PACT, it is found that the SO2 in the ischemic area decreases while the SO2 in newly formed vessels increases, and the SO2 in the PT region also recovers. These findings demonstrate PACT's remarkable ability to image and monitor cerebrovascular morphologic and physiological changes. They highlight the usefulness of whole-brain PACT as a potentially powerful tool for early diagnosis and therapeutic decision-making in treating ischemic stroke.

Unsupervised inter-domain transformation for virtually stained high-resolution mid-infrared photoacoustic microscopy using explainable deep learning

Mid-infrared photoacoustic microscopy can capture biochemical information without staining. However, the long mid-infrared optical wavelengths make the spatial resolution of photoacoustic microscopy significantly poorer than that of conventional confocal fluorescence microscopy. Here, we demonstrate an explainable deep learning-based unsupervised inter-domain transformation of low-resolution unlabeled mid-infrared photoacoustic microscopy images into confocal-like virtually fluorescence-stained high-resolution images. The explainable deep learning-based framework is proposed for this transformation, wherein an unsupervised generative adversarial network is primarily employed and then a saliency constraint is added for better explainability. We validate the performance of explainable deep learning-based mid-infrared photoacoustic microscopy by identifying cell nuclei and filamentous actins in cultured human cardiac fibroblasts and matching them with the corresponding CFM images. The XDL ensures similar saliency between the two domains, making the transformation process more stable and more reliable than existing networks. Our XDL-MIR-PAM enables label-free high-resolution duplexed cellular imaging, which can significantly benefit many research avenues in cell biology.

Association between diabetes mellitus and trochanteric bone mineral density in individuals with osteoporotic fractures: a retrospective study

Background

The relationship between diabetes mellitus (DM) and bone mineral density (BMD) in patients with osteoporotic fractures (OPFs) remains complex and heterogeneous, specifically between the genders. This study aimed to explore the association between diabetes status and trochanteric BMD in a cohort of patients with OPFs and elucidate the differences between male and female patients.

Methods

This retrospective analysis was performed on 710 admitted patients aged 50 years or older with OPFs. In this study, the exposure variable was diabetes status. Trochanteric BMD comprised the dependent variable. While controlling for covariance influences, generalized estimating equations (GEE) were applied to examine the independent link between diabetes status and trochanteric BMD in OPFs patients. Moreover, a subgroup analysis was also conducted to validate the result's stability.

Results

A substantial positive association was noted between diabetes status and trochanteric BMD in diabetic patients, as determined by the fully adjusted model (β = 0.017, 95% CI 0.001 to 0.033, p = 0.035). Furthermore, the sex-specific analysis showed a significant positive relationship between diabetes status and trochanteric BMD in male patients (β = 0.040, 95% CI 0.006 to 0.075, p = 0.022), whereas no significant relationship was observed in female patients (β = 0.010, 95% CI -0.008 to 0.028, p = 0.256).

Conclusion

This study highlighted the significant sex differences in the impact of diabetes on trochanteric BMD among patients with OPFs. The male diabetic patients had higher trochanteric BMD than their non-diabetic counterparts; however, this association was not evident in female patients. Further research is necessary to understand the underlying mechanisms that contribute to these sex-specific differences and to evaluate the clinical implications of managing fracture risk in diabetic patients.

Quantitative volumetric photoacoustic assessment of vasoconstriction by topical corticosteroid application in mice skin

Topical corticosteroids manage inflammatory skin conditions via their action on the immune system. An effect of application of corticosteroids to the skin is skin blanching caused by peripheral vasoconstriction. This has been used to characterize, in some cases relative potency and also as a way to compare skin penetration. Chromameters have been used to assess skin blanching-the outcome of vasoconstriction caused by topical corticosteroids-but do not directly measure vasoconstriction. Here, we demonstrate quantitative volumetric photoacoustic microscopy (PAM) as a tool for directly assessing the vasoconstriction followed by topical corticosteroid application, noninvasively visualizing skin vasculature without any exogeneous contrast agent. We photoacoustically differentiated the vasoconstrictive ability of four topical corticosteroids in small animals through multiparametric analyses, offering detailed 3D insights into vasoconstrictive mechanisms across different skin depths. Our findings highlight the potential of PAM as a noninvasive tool for measurement of comparative vasoconstriction with potential for clinical, pharmaceutical, and bioequivalence applications.

Diagnostic and therapeutic optical imaging in cardiovascular diseases

Cardiovascular disease (CVD) is one of the most prevalent health threats globally. Traditional diagnostic methods for CVDs, including electrocardiography, ultrasound, and cardiac magnetic resonance imaging, have inherent limitations in real-time monitoring and high-resolution visualization of cardiovascular pathophysiology. In recent years, optical imaging technology has gained considerable attention as a non-invasive, high-resolution, real-time monitoring solution in the study and diagnosis of CVD. This review discusses the latest advancements, and applications of optical techniques in cardiac imaging. We compare the advantages of optical imaging over traditional modalities and especially scrutinize techniques such as optical coherence tomography, photoacoustic imaging, and fluorescence imaging. We summarize their investigations in atherosclerosis, myocardial infarction, and heart valve disease, etc. Additionally, we discuss challenges like deep-tissue imaging and high spatiotemporal resolution adjustment, and review existing solutions such as multimodal integration, artificial intelligence, and enhanced optical probes. This article aims to drive further development in optical imaging technologies to provide more precise and efficient tools for early diagnosis, pathological mechanism exploration, and treatment of CVD.

Review on Photoacoustic Monitoring after Drug Delivery: From Label-Free Biomarkers to Pharmacokinetics Agents

Photoacoustic imaging (PAI) is an emerging noninvasive and label-free method for capturing the vasculature, hemodynamics, and physiological responses following drug delivery. PAI combines the advantages of optical and acoustic imaging to provide high-resolution images with multiparametric information. In recent decades, PAI's abilities have been used to determine reactivity after the administration of various drugs. This study investigates photoacoustic imaging as a label-free method of monitoring drug delivery responses by observing changes in the vascular system and oxygen saturation levels across various biological tissues. In addition, we discuss photoacoustic studies that monitor the biodistribution and pharmacokinetics of exogenous contrast agents, offering contrast-enhanced imaging of diseased regions. Finally, we demonstrate the crucial role of photoacoustic imaging in understanding drug delivery mechanisms and treatment processes.

Deep learning-based virtual staining, segmentation, and classification in label-free photoacoustic histology of human specimens

In pathological diagnostics, histological images highlight the oncological features of excised specimens, but they require laborious and costly staining procedures. Despite recent innovations in label-free microscopy that simplify complex staining procedures, technical limitations and inadequate histological visualization are still problems in clinical settings. Here, we demonstrate an interconnected deep learning (DL)-based framework for performing automated virtual staining, segmentation, and classification in label-free photoacoustic histology (PAH) of human specimens. The framework comprises three components: (1) an explainable contrastive unpaired translation (E-CUT) method for virtual H&E (VHE) staining, (2) an U-net architecture for feature segmentation, and (3) a DL-based stepwise feature fusion method (StepFF) for classification. The framework demonstrates promising performance at each step of its application to human liver cancers. In virtual staining, the E-CUT preserves the morphological aspects of the cell nucleus and cytoplasm, making VHE images highly similar to real H&E ones. In segmentation, various features (e.g., the cell area, number of cells, and the distance between cell nuclei) have been successfully segmented in VHE images. Finally, by using deep feature vectors from PAH, VHE, and segmented images, StepFF has achieved a 98.00% classification accuracy, compared to the 94.80% accuracy of conventional PAH classification. In particular, StepFF's classification reached a sensitivity of 100% based on the evaluation of three pathologists, demonstrating its applicability in real clinical settings. This series of DL methods for label-free PAH has great potential as a practical clinical strategy for digital pathology.

Advancing insights into in vivo meningeal lymphatic vessels with stereoscopic wide-field photoacoustic microscopy

Meningeal lymphatic vessels (mLVs) play a pivotal role in regulating metabolic waste from cerebrospinal fluid (CSF). However, the current limitations in field of view and resolution of existing imaging techniques impede understanding the stereoscopic morphology and dynamic behavior of mLVs in vivo. Here, we utilized dual-contrast functional photoacoustic microscopy to achieve wide-field intravital imaging of the lymphatic system, including mLVs and glymphatic pathways. The stereoscopic photoacoustic microscopy based on opto-acoustic confocal features has a depth imaging capability of 3.75 mm, facilitating differentiation between mLVs on the meninges and glymphatic pathways within the brain parenchyma. Subsequently, using this imaging technique, we were able to visualize the dynamic drainage of mLVs and identify a peak drainage period occurring around 20-40 min after injection, along with determining the flow direction from CSF to lymph nodes. Inspiringly, in the Alzheimer's disease (AD) mouse model, we observed that AD mice exhibit a ~ 70% reduction in drainage volume of mLVs compared to wild-type mice. With the development of AD, there is be continued decline in mLVs drainage volume. This finding clearly demonstrates that the AD mouse model has impaired CSF drainage. Our study opens up a horizon for understanding the brain's drainage mechanism and dissecting mLVs-associated neurological disorders.

Simultaneous photoacoustic and ultrasound imaging: A review

Photoacoustic imaging (PAI) is an emerging biomedical imaging technique that combines the advantages of optical and ultrasound imaging, enabling the generation of images with both optical resolution and acoustic penetration depth. By leveraging similar signal acquisition and processing methods, the integration of photoacoustic and ultrasound imaging has introduced a novel hybrid imaging modality suitable for clinical applications. Photoacoustic-ultrasound imaging allows for non-invasive, high-resolution, and deep-penetrating imaging, providing a wealth of image information. In recent years, with the deepening research and the expanding biomedical application scenarios of photoacoustic-ultrasound bimodal systems, the immense potential of photoacoustic-ultrasound bimodal imaging in basic research and clinical applications has been demonstrated, with some research achievements already commercialized. In this review, we introduce the principles, technical advantages, and biomedical applications of photoacoustic-ultrasound bimodal imaging techniques, specifically focusing on tomographic, microscopic, and endoscopic imaging modalities. Furthermore, we discuss the future directions of photoacoustic-ultrasound bimodal imaging technology.

Hybrid Photoacoustic Ultrasound Imaging System for Cold-Induced Vasoconstriction and Vasodilation Monitoring

Lewis hunting reaction refers to the alternating cold-induced vasoconstriction and dilation in extremities, whose underlying mechanism is complex. While numerous studies reported this intriguing phenomenon by measuring cutaneous temperature fluctuation under cold exposure, few of them tracked peripheral vascular responses in real-time, lacking a non-invasive and quantitative imaging tool. To better monitor hunting reaction and diagnose relevant diseases, we developed a hybrid photoacoustic ultrasound (PAUS) tomography system to monitor finger vessels' dynamic response to cold, together with simultaneous temperature measurement. We also came out a standard workflow for image analysis with self-defined indices. In the small cohort observational study, vascular changes in the first cycle of hunting reaction were successfully captured by the image series and quantified. Time difference between vasodilation and temperature recovery was noticed and reported for the first time, thanks to the unique capability of the PAUS imaging system in real-time and continuous vascular monitoring. The developed imaging system and indices enabled more objective and quantitative monitoring of peripheral vascular activities, indicating its great potential in numerous clinical applications.

X-ray free-electron laser induced acoustic microscopy (XFELAM)

The X-ray free-electron laser (XFEL) has remarkably advanced X-ray imaging technology and enabled important scientific achievements. The XFEL's extremely high power, short pulse width, low emittance, and high coherence make possible such diverse imaging techniques as absorption/emission spectroscopy, diffraction imaging, and scattering imaging. Here, we demonstrate a novel XFEL-based imaging modality that uses the X-ray induced acoustic (XA) effect, which we call X-ray free-electron laser induced acoustic microscopy (XFELAM). Initially, we verified the XA effect by detecting XA signals from various materials, then we validated the experimental results with simulation outcomes. Next, in resolution experiments, we successfully imaged a patterned tungsten target with drilled various-sized circles at a spatial resolution of 7.8 ± 5.1 µm, which is the first micron-scale resolution achieved by XA imaging. Our results suggest that the novel XFELAM can expand the usability of XFEL in various areas of fundamental scientific research.

Video-rate endocavity photoacoustic/harmonic ultrasound imaging with miniaturized light delivery

Significance

Endocavity ultrasound (US) imaging is a frequently employed diagnostic technique in gynecology and urology for the assessment of male and female genital diseases that present challenges for conventional transabdominal imaging. The integration of photoacoustic (PA) imaging with clinical US imaging has displayed promising outcomes in clinical research. Nonetheless, its application has been constrained due to size limitations, restricting it to spatially confined locations such as vaginal or rectal canals.

Aim

This study presents the development of a video-rate (20 Hz) endocavity PA/harmonic US imaging (EPAUSI) system.

Approach

The approach incorporates a commercially available endocavity US probe with a miniaturized laser delivery unit, comprised of a single large-core fiber and a line beamshaping engineered diffuser. The system facilitates real-time image display and subsequent processing, including angular energy density correction and spectral unmixing, in offline mode.

Results

The spatial resolutions of the concurrently acquired PA and harmonic US images were measured at 318    μ m and 291    μ m in the radial direction, respectively, and 1.22 deg and 1.50 deg in the angular direction, respectively. Furthermore, the system demonstrated its capability in multispectral PA imaging by successfully distinguishing two clinical dyes in a tissue-mimicking phantom. Its rapid temporal resolution enabled the capture of kinetic dye perfusion into an ex vivo porcine ovary through the depth of porcine uterine tissue. EPAUSI proved its clinical viability by detecting pulsating hemodynamics in the male rat's prostate in vivo and accurately classifying human blood vessels into arteries and veins based on sO 2 measurements.

Conclusions

Our proposed EPAUSI system holds the potential to unveil previously overlooked indicators of vascular alterations in genital cancers or endometriosis, addressing pressing requirements in the fields of gynecology and urology.

Contrast Agent-Free 3D Renal Ultrafast Doppler Imaging Reveals Vascular Dysfunction in Acute and Diabetic Kidney Diseases

To combat the irreversible decline in renal function associated with kidney disease, it is essential to establish non-invasive biomarkers for assessing renal microcirculation. However, the limited resolution and/or vascular sensitivity of existing diagnostic imaging techniques hinders the visualization of complex cortical vessels. Here, a 3D renal ultrafast Doppler (UFD) imaging system that uses a high ultrasound frequency (18 MHz) and ultrahigh frame rate (1 KHz per slice) to scan the entire volume of a rat's kidney in vivo is demonstrated. The system, which can visualize the full 3D renal vascular branching pyramid at a resolution of 167 µm without any contrast agent, is used to chronically and noninvasively monitor kidneys with acute kidney injury (AKI, 3 days) and diabetic kidney disease (DKD, 8 weeks). Multiparametric UFD analyses (e.g., vessel volume occupancy (VVO), fractional moving blood volume (FMBV), vessel number density (VND), and vessel tortuosity (VT)) describe rapid vascular rarefaction from AKI and long-term vascular degeneration from DKD, while the renal pathogeneses are validated by in vitro blood serum testing and stained histopathology. This work demonstrates the potential of 3D renal UFD to offer valuable insights into assessing kidney perfusion levels for future research in diabetes and kidney transplantation.

Optoacoustic classification of diabetes mellitus with the synthetic impacts via optimized neural networks

A highly accurate classification of diabetes mellitus (DM) with the synthetic impacts of several variables is first studied via optoacoustic technology in this work. For this purpose, an optoacoustic measurement apparatus of blood glucose is built, and the optoacoustic signals and peak-peak values for 625 cases of in vitro rabbit blood are obtained. The results show that although the single impact of five variables are obtained, the precise classification of DM is limited because of the synthetic impacts. Based on clinical standards, different levels of blood glucose corresponding to hypoglycaemia, normal, slight diabetes, moderate diabetes and severe diabetes are employed. Then, a wavelet neural network (WNN) is utilized to establish a classification model of DM severity. The classification accuracy is 94.4 % for the testing blood samples. To enhance the classification accuracy, particle swarm optimization (PSO) and quantum-behaved particle swarm optimization (QPSO) are successively utilized to optimize WNN, and accuracy is enhanced to 98.4 % and 100 %, respectively. It is demonstrated from comparison between several algorithms that optoacoustic technology united with the QPSO-optimized WNN algorithm can achieve precise classification of DM with synthetic impacts.

Dual-wavelength UV-visible metalens for multispectral photoacoustic microscopy: A simulation study

Photoacoustic microscopy is advancing with research on utilizing ultraviolet and visible light. Dual-wavelength approaches are sought for observing DNA/RNA- and vascular-related disorders. However, the availability of high numerical aperture lenses covering both ultraviolet and visible wavelengths is severely limited due to challenges such as chromatic aberration in the optics. Herein, we present a groundbreaking proposal as a pioneering simulation study for incorporating multilayer metalenses into ultraviolet-visible photoacoustic microscopy. The proposed metalens has a thickness of 1.4 µm and high numerical aperture of 0.8. By arranging cylindrical hafnium oxide nanopillars, we design an achromatic transmissive lens for 266 and 532 nm wavelengths. The metalens achieves a diffraction-limited focal spot, surpassing commercially available objective lenses. Through three-dimensional photoacoustic simulation, we demonstrate high-resolution imaging with superior endogenous contrast of targets with ultraviolet and visible optical absorption bands. This metalens will open new possibilities for downsized multispectral photoacoustic microscopy in clinical and preclinical applications.

Automated Laser-Fiber Coupling Module for Optical-Resolution Photoacoustic Microscopy

Photoacoustic imaging has emerged as a promising biomedical imaging technique that enables visualization of the optical absorption characteristics of biological tissues in vivo. Among the different photoacoustic imaging system configurations, optical-resolution photoacoustic microscopy stands out by providing high spatial resolution using a tightly focused laser beam, which is typically transmitted through optical fibers. Achieving high-quality images depends significantly on optical fluence, which is directly proportional to the signal-to-noise ratio. Hence, optimizing the laser-fiber coupling is critical. Conventional coupling systems require manual adjustment of the optical path to direct the laser beam into the fiber, which is a repetitive and time-consuming process. In this study, we propose an automated laser-fiber coupling module that optimizes laser delivery and minimizes the need for manual intervention. By incorporating a motor-mounted mirror holder and proportional derivative control, we successfully achieved efficient and robust laser delivery. The performance of the proposed system was evaluated using a leaf-skeleton phantom in vitro and a human finger in vivo, resulting in high-quality photoacoustic images. This innovation has the potential to significantly enhance the quality and efficiency of optical-resolution photoacoustic microscopy.

Review on ultrasound-guided photoacoustic imaging for complementary analyses of biological systems in vivo

Photoacoustic imaging has been developed as a new biomedical molecular imaging modality. Due to its similarity to conventional ultrasound imaging in terms of signal detection and image generation, dual-modal photoacoustic and ultrasound imaging has been applied to visualize physiological and morphological information in biological systems in vivo. By complementing each other, dual-modal photoacoustic and ultrasound imaging showed synergistic advances in photoacoustic imaging with the guidance of ultrasound images. In this review, we introduce our recent progresses in dual-modal photoacoustic and ultrasound imaging systems at various scales of study, from preclinical small animals to clinical humans. A summary of the works reveals various strategies for combining the structural information of ultrasound images with the molecular information of photoacoustic images.