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Gao S, Ashikaga H, Suzuki M, Mansi T, Kim YH, Ghesu FC, Kang J, Boctor EM, Halperin HR, Zhang HK. Cardiac-gated spectroscopic photoacoustic imaging for ablation-induced necrotic lesion visualization. JOURNAL OF BIOPHOTONICS 2024; 17:e202400126. [PMID: 39075610 DOI: 10.1002/jbio.202400126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/31/2024]
Abstract
Radiofrequency (RF) ablation is a minimally invasive therapy for atrial fibrillation. Conventional RF procedures lack intraoperative monitoring of ablation-induced necrosis, complicating assessment of completeness. While spectroscopic photoacoustic (sPA) imaging shows promise in distinguishing ablated tissue, multi-spectral imaging is challenging in vivo due to low imaging quality caused by motion. Here, we introduce a cardiac-gated sPA imaging (CG-sPA) framework to enhance image quality using a motion-gated averaging filter, relying on image similarity. Necrotic extent was calculated based on the ratio between spectral unmixed ablated tissue contrast and total tissue contrast, visualizing as a continuous color map to highlight necrotic area. The validation of the concept was conducted in both ex vivo and in vivo swine models. The ablation-induced necrotic lesion was successfully detected throughout the cardiac cycle through CG-sPA imaging. The results suggest the CG-sPA imaging framework has great potential to be incorporated into clinical workflow to guide ablation procedures intraoperatively.
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Affiliation(s)
- Shang Gao
- Department of Robotics Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Hiroshi Ashikaga
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Masahito Suzuki
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tommaso Mansi
- Siemens Healthineers, Digital Technology and Innovation, Princeton, New Jersey, USA
| | - Young-Ho Kim
- Siemens Healthineers, Digital Technology and Innovation, Princeton, New Jersey, USA
| | | | - Jeeun Kang
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Whiting School of Engineering, Baltimore, Maryland, USA
| | - Emad M Boctor
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Whiting School of Engineering, Baltimore, Maryland, USA
| | - Henry R Halperin
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Haichong K Zhang
- Department of Robotics Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
- Department of Computer Science, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
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Gao S, Liu H, Post A, Jaworski L, Bernard D, John M, Cosgriff-Hernandez E, Razavi M, Zhang HK. Enhancing boundary detection of radiofrequency ablation lesions through photoacoustic mapping. Sci Rep 2024; 14:19370. [PMID: 39169048 PMCID: PMC11339419 DOI: 10.1038/s41598-024-68046-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/18/2024] [Indexed: 08/23/2024] Open
Abstract
Atrial fibrillation (A-fib) is the most common type of heart arrhythmia, typically treated with radiofrequency catheter ablation to isolate the heart from abnormal electrical signals. Monitoring the formation of ablation-induced lesions is crucial for preventing recurrences and complications arising from excessive or insufficient ablation. Existing imaging modalities lack real-time feedback, and their intraoperative usage is in its early stages. A critical need exists for an imaging-based lesion indexing (LSI) method that directly reflects tissue necrosis formation. Previous studies have indicated that spectroscopic photoacoustic (sPA) imaging can differentiate ablated tissues from their non-ablated counterparts based on PA spectrum variation. In this paper, we introduce a method for detecting ablation lesion boundaries using sPA imaging. This approach utilizes ablation LSI, which quantifies the ratio between the signal from ablated tissue and the total tissue signal. We enhance boundary detection accuracy by adapting a regression model-based compensation. Additionally, the method was cross-validated with clinically used intraoperative monitoring parameters. The proposed method was validated with ex vivo porcine cardiac tissues with necrotic lesions created by different ablation durations. The PA-measured lesion size was compared with gross pathology. Statistical analysis demonstrates a strong correlation (R > 0.90) between the PA-detected lesion size and gross pathology. The PA-detected lesion size also exhibits a moderate to strong correlation (R > 0.75) with local impedance changes recorded during procedures. These results suggest that the introduced PA imaging-based LSI has great potential to be incorporated into the clinical workflow, guiding ablation procedures intraoperatively.
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Affiliation(s)
- Shang Gao
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA, 01609, USA.
| | - Haotian Liu
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA, 01609, USA
| | - Allison Post
- Electrophysiology Clinical Research and Innovations, The Texas Heart Institute, 6770 Bertner Ave, Houston, TX, 77030, USA
| | - Lukas Jaworski
- Electrophysiology Clinical Research and Innovations, The Texas Heart Institute, 6770 Bertner Ave, Houston, TX, 77030, USA
| | - Drew Bernard
- Electrophysiology Clinical Research and Innovations, The Texas Heart Institute, 6770 Bertner Ave, Houston, TX, 77030, USA
| | - Mathews John
- Electrophysiology Clinical Research and Innovations, The Texas Heart Institute, 6770 Bertner Ave, Houston, TX, 77030, USA
| | | | - Mehdi Razavi
- Electrophysiology Clinical Research and Innovations, The Texas Heart Institute, 6770 Bertner Ave, Houston, TX, 77030, USA
| | - Haichong K Zhang
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA, 01609, USA.
- Department of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA, 01609, USA.
- Department of Computer Science, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA, 01609, USA.
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Zhang H, Ren M, Wang Y, Jin Z, Zhang S, Liu J, Fu J, Qin H. In Vivo Microwave-Induced Thermoacoustic Endoscopy for Colorectal Tumor Detection in Deep Tissue. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:1619-1627. [PMID: 38113149 DOI: 10.1109/tmi.2023.3345008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Optical endoscopy, as one of the common clinical diagnostic modalities, provides irreplaceable advantages in the diagnosis and treatment of internal organs. However, the approach is limited to the characterization of superficial tissues due to the strong optical scattering properties of tissue. In this work, a microwave-induced thermoacoustic (TA) endoscope (MTAE) was developed and evaluated. The MTAE system integrated a homemade monopole sleeve antenna (diameter = 7 mm) for providing homogenized pulsed microwave irradiation to induce a TA signal in the colorectal cavity and a side-viewing focus ultrasonic transducer (diameter = 3 mm) for detecting the TA signal in the ultrasonic spectrum to construct the image. Our MTAE, system combined microwave excitation and acoustic detection; produced images with dielectric contrast and high spatial resolution at several centimeters deep in soft tissues, overcome the current limitations of the imaging depth of optical endoscopy and mechanical wave-based imaging contrast of ultrasound endoscopy, and had the ability to extract complete features for deep location tumors that could be infiltrating and invading adjacent structures. The practical feasibility of the MTAE system was evaluated i n vivo with rabbits having colorectal tumors. The results demonstrated that colorectal tumor progression could be visualized from the changes in electromagnetic parameters of the tissue via MTAE, showing its potential clinical application.
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Rahaman A, Tang Y, Gao S, Ma X, Sorokin I, Zhang HK. Needle Aligned Ultrasound Image-Guided Access Through Dual-Segment Array. IEEE Trans Biomed Eng 2023; 70:2645-2654. [PMID: 37030673 PMCID: PMC10590177 DOI: 10.1109/tbme.2023.3260735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Ultrasound (US) guided access for percutaneous nephrolithotomy (PCNL) is gaining popularity in the urology community as it reduces radiation risk. The most popular technique involves manual image-needle alignment. A misaligned needle however needs to be retracted and reinserted, resulting in a lengthened operation time and complications such as bleeding. These limitations can be mitigated through the co-registration between the US array and needle. The through-hole array concept provides the primary solution, including a hole at the center of the array. Because of the central opening, the image-needle alignment is achieved inherently. Previous literature has described applications that are limited to superficial and intravascular procedures, suggesting that developing a through-hole array for deeper target applications would be a new breakthrough. OBJECTIVE Here, we present a dual-segment array with a central opening. As the prototype development, two segments of 32-element arrays are combined with an open space of 10 mm in length in between them. METHOD We conducted phantom and ex-vivo studies considering the target depth of the 80-100 mm range. The image quality and needle visibility are evaluated by comparing the signal-to-noise ratio (SNR), full width at half maximum (FWHM), and contrast-to-noise ratio (CNR) results measured with a no-hole linear array under equivalent conditions. An ex-vivo study is performed using porcine kidneys with ceramic balls embedded to evaluate the needle access accuracy. RESULTS AND CONCLUSION The mean needle access error of 20 trials is found to be 2.94 ±1.09 mm, suggesting its potential impact on realizing a simple and intuitive deep US image-guided access.
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Gao S, Wang Y, Ma X, Zhou H, Jiang Y, Yang K, Lu L, Wang S, Nephew BC, Fichera L, Fischer GS, Zhang HK. Intraoperative laparoscopic photoacoustic image guidance system in the da Vinci surgical system. BIOMEDICAL OPTICS EXPRESS 2023; 14:4914-4928. [PMID: 37791285 PMCID: PMC10545189 DOI: 10.1364/boe.498052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 10/05/2023]
Abstract
This paper describes a framework allowing intraoperative photoacoustic (PA) imaging integrated into minimally invasive surgical systems. PA is an emerging imaging modality that combines the high penetration of ultrasound (US) imaging with high optical contrast. With PA imaging, a surgical robot can provide intraoperative neurovascular guidance to the operating physician, alerting them of the presence of vital substrate anatomy invisible to the naked eye, preventing complications such as hemorrhage and paralysis. Our proposed framework is designed to work with the da Vinci surgical system: real-time PA images produced by the framework are superimposed on the endoscopic video feed with an augmented reality overlay, thus enabling intuitive three-dimensional localization of critical anatomy. To evaluate the accuracy of the proposed framework, we first conducted experimental studies in a phantom with known geometry, which revealed a volumetric reconstruction error of 1.20 ± 0.71 mm. We also conducted an ex vivo study by embedding blood-filled tubes into chicken breast, demonstrating the successful real-time PA-augmented vessel visualization onto the endoscopic view. These results suggest that the proposed framework could provide anatomical and functional feedback to surgeons and it has the potential to be incorporated into robot-assisted minimally invasive surgical procedures.
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Affiliation(s)
- Shang Gao
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Yang Wang
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Xihan Ma
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Haoying Zhou
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Yiwei Jiang
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Kehan Yang
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Liang Lu
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Department of Computer Science, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Shiyue Wang
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Department of Computer Science, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Benjamin C. Nephew
- Department of Biology & Biotechnology, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Neuroscience Program, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Loris Fichera
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Gregory S. Fischer
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Department of Mechanical & Materials Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Department of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Department of Electrical & Computer Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
| | - Haichong K. Zhang
- Department of Robotics Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Department of Computer Science, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
- Department of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, USA
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Tsumura R, Gao S, Tang Y, Zhang HK. Concentric-ring arrays for forward-viewing ultrasound imaging. J Med Imaging (Bellingham) 2022; 9:065002. [PMID: 36444284 PMCID: PMC9683378 DOI: 10.1117/1.jmi.9.6.065002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2023] Open
Abstract
Purpose Current ultrasound (US)-image-guided needle insertions often require an expertized technique for clinicians because the performance of tasks in a three-dimensional space using two-dimensional images requires operators to cognitively maintain the spatial relationships between the US probe, the needle, and the lesion. This work presents forward-viewing US imaging with a ring array configuration to enable needle interventions without requiring the registration between tools and targets. Approach The center-open ring array configuration allows the needle to be inserted from the center of the visualized US image, providing simple and intuitive guidance. To establish the feasibility of the ring array configuration, the design parameters causing the image quality, including the radius of the center hole and the number of ring layers and transducer elements, were investigated. Results Experimental results showed successful visualization, even with a hole in the transducer elements, and the target visibility was improved by increasing the number of ring layers and the number of transducer elements in each ring layer. Reducing the hole radius improved the region's image quality at a shallow depth. Conclusions Forward-viewing US imaging with a ring array configuration has the potential to be a viable alternative to conventional US image-guided needle insertion methods.
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Affiliation(s)
- Ryosuke Tsumura
- Worcester Polytechnic Institute, Department of Biomedical Engineering, Worcester, Massachusetts, United States
- National Institute of Advanced Industrial Science and Technology, Health and Medical Research Institute, Tsukuba, Japan
| | - Shang Gao
- Worcester Polytechnic Institute, Department of Robotics Engineering, Worcester, Massachusetts, United States
| | - Yichuan Tang
- Worcester Polytechnic Institute, Department of Robotics Engineering, Worcester, Massachusetts, United States
| | - Haichong K. Zhang
- Worcester Polytechnic Institute, Department of Biomedical Engineering, Worcester, Massachusetts, United States
- Worcester Polytechnic Institute, Department of Robotics Engineering, Worcester, Massachusetts, United States
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Xiao M, Tian F, Liu X, Zhou Q, Pan J, Luo Z, Yang M, Yi C. Virus Detection: From State-of-the-Art Laboratories to Smartphone-Based Point-of-Care Testing. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2105904. [PMID: 35393791 PMCID: PMC9110880 DOI: 10.1002/advs.202105904] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/27/2022] [Indexed: 05/07/2023]
Abstract
Infectious virus outbreaks pose a significant challenge to public healthcare systems. Early and accurate virus diagnosis is critical to prevent the spread of the virus, especially when no specific vaccine or effective medicine is available. In clinics, the most commonly used viral detection methods are molecular techniques that involve the measurement of nucleic acids or proteins biomarkers. However, most clinic-based methods require complex infrastructure and expensive equipment, which are not suitable for low-resource settings. Over the past years, smartphone-based point-of-care testing (POCT) has rapidly emerged as a potential alternative to laboratory-based clinical diagnosis. This review summarizes the latest development of virus detection. First, laboratory-based and POCT-based viral diagnostic techniques are compared, both of which rely on immunosensing and nucleic acid detection. Then, various smartphone-based POCT diagnostic techniques, including optical biosensors, electrochemical biosensors, and other types of biosensors are discussed. Moreover, this review covers the development of smartphone-based POCT diagnostics for various viruses including COVID-19, Ebola, influenza, Zika, HIV, et al. Finally, the prospects and challenges of smartphone-based POCT diagnostics are discussed. It is believed that this review will aid researchers better understand the current challenges and prospects for achieving the ultimate goal of containing disease-causing viruses worldwide.
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Affiliation(s)
- Meng Xiao
- Guangdong Provincial Key Laboratory of Sensing Technology and Biomedical Instrument, School of Biomedical EngineeringShenzhen Campus of Sun Yat‐Sen UniversityShenzhen518107P. R. China
| | - Feng Tian
- Department of Biomedical EngineeringThe Hong Kong Polytechnic UniversityHunghomHong Kong999077P. R. China
| | - Xin Liu
- Guangdong Provincial Key Laboratory of Sensing Technology and Biomedical Instrument, School of Biomedical EngineeringShenzhen Campus of Sun Yat‐Sen UniversityShenzhen518107P. R. China
| | - Qiaoqiao Zhou
- Guangdong Provincial Key Laboratory of Sensing Technology and Biomedical Instrument, School of Biomedical EngineeringShenzhen Campus of Sun Yat‐Sen UniversityShenzhen518107P. R. China
| | - Jiangfei Pan
- Guangdong Provincial Key Laboratory of Sensing Technology and Biomedical Instrument, School of Biomedical EngineeringShenzhen Campus of Sun Yat‐Sen UniversityShenzhen518107P. R. China
| | - Zhaofan Luo
- Department of Clinical LaboratoryThe Seventh Affiliated Hospital of Sun Yat‐Sen UniversityShenzhen518107P. R. China
| | - Mo Yang
- Department of Biomedical EngineeringThe Hong Kong Polytechnic UniversityHunghomHong Kong999077P. R. China
| | - Changqing Yi
- Guangdong Provincial Key Laboratory of Sensing Technology and Biomedical Instrument, School of Biomedical EngineeringShenzhen Campus of Sun Yat‐Sen UniversityShenzhen518107P. R. China
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