Indocyanine-green-embedded PEBBLEs as a contrast agent for photoacoustic imaging

Multimodal optoacoustic imaging: methods and contrast materials

Optoacoustic (OA) imaging offers powerful capabilities for interrogating biological tissues with rich optical absorption contrast while maintaining high spatial resolution for deep tissue observations. The spectrally distinct absorption of visible and near-infrared photons by endogenous tissue chromophores facilitates extraction of diverse anatomic, functional, molecular, and metabolic information from living tissues across various scales, from organelles and cells to whole organs and organisms. The primarily blood-related contrast and limited penetration depth of OA imaging have fostered the development of multimodal approaches to fully exploit the unique advantages and complementarity of the method. We review the recent hybridization efforts, including multimodal combinations of OA with ultrasound, fluorescence, optical coherence tomography, Raman scattering microscopy and magnetic resonance imaging as well as ionizing methods, such as X-ray computed tomography, single-photon-emission computed tomography and positron emission tomography. Considering that most molecules absorb light across a broad range of the electromagnetic spectrum, the OA interrogations can be extended to a large number of exogenously administered small molecules, particulate agents, and genetically encoded labels. This unique property further makes contrast moieties used in other imaging modalities amenable for OA sensing.

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

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

Volumetric registration framework for multimodal functional magnetic resonance and optoacoustic tomography of the rodent brain

Optoacoustic tomography (OAT) provides a non-invasive means to characterize cerebral hemodynamics across an entire murine brain while attaining multi-parametric readouts not available with other modalities. This unique capability can massively impact our understanding of brain function. However, OAT largely lacks the soft tissue contrast required for unambiguous identification of brain regions. Hence, its accurate registration to a reference brain atlas is paramount for attaining meaningful functional readings. Herein, we capitalized on the simultaneously acquired bi-modal data from the recently-developed hybrid magnetic resonance optoacoustic tomography (MROT) scanner in order to devise an image coregistration paradigm that facilitates brain parcellation and anatomical referencing. We evaluated the performance of the proposed methodology by coregistering OAT data acquired with a standalone system using different registration methods. The enhanced performance is further demonstrated for functional OAT data analysis and characterization of stimulus-evoked brain responses. The suggested approach enables better consolidation of the research findings thus facilitating wider acceptance of OAT as a powerful neuroimaging tool to study brain functions and diseases.

The application of indocyanine green in guiding prostate cancer treatment

Objective

Indocyanine green (ICG) with near-infrared fluorescence absorption is approved by the United States Food and Drug Administration for clinical applications in angiography, blood flow evaluation, and liver function assessment. It has strong optical absorption in the near-infrared region, where light can penetrate deepest into biological tissue. We sought to review its value in guiding prostate cancer treatment.

Methods

All related literature at PubMed from January 2000 to December 2020 were reviewed.

Results

Multiple preclinical studies have demonstrated the usefulness of ICG in identifying prostate cancer by using different engineering techniques. Clinical studies have demonstrated the usefulness of ICG in guiding sentinel node dissection during radical prostatectomy, and possible better preservation of neurovascular bundle by identifying landmark prostatic arteries. New techniques such as adding fluorescein in additional to ICG were tested in a limited number of patients with encouraging result. In addition, the use of the ICG was shown to be safe. Even though there are encouraging results, it does not carry sufficient sensitivity and specificity in replacing extended pelvic lymph node dissection during radical prostatectomy.

Conclusion

Multiple preclinical and clinical studies have shown the usefulness of ICG in identifying and guiding treatment for prostate cancer. Larger randomized prospective studies are warranted to further test its usefulness and find new modified approaches.

Nanotherapeutic Intervention in Photodynamic Therapy for Cancer

The clinical need for photodynamic therapy (PDT) has been growing for several decades. Notably, PDT is often used in oncology to treat a variety of tumors since it is a low-risk therapy with excellent selectivity, does not conflict with other therapies, and may be repeated as necessary. The mechanism of action of PDT is the photoactivation of a particular photosensitizer (PS) in a tumor microenvironment in the presence of oxygen. During PDT, cancer cells produce singlet oxygen (¹O₂) and reactive oxygen species (ROS) upon activation of PSs by irradiation, which efficiently kills the tumor. However, PDT's effectiveness in curing a deep-seated malignancy is constrained by three key reasons: a tumor's inadequate PS accumulation in tumor tissues, a hypoxic core with low oxygen content in solid tumors, and limited depth of light penetration. PDTs are therefore restricted to the management of thin and superficial cancers. With the development of nanotechnology, PDT's ability to penetrate deep tumor tissues and exert desired therapeutic effects has become a reality. However, further advancement in this field of research is necessary to address the challenges with PDT and ameliorate the therapeutic outcome. This review presents an overview of PSs, the mechanism of loading of PSs, nanomedicine-based solutions for enhancing PDT, and their biological applications including chemodynamic therapy, chemo-photodynamic therapy, PDT-electroporation, photodynamic-photothermal (PDT-PTT) therapy, and PDT-immunotherapy. Furthermore, the review discusses the mechanism of ROS generation in PDT advantages and challenges of PSs in PDT.

Hybrid magnetic resonance and optoacoustic tomography (MROT) for preclinical neuroimaging

Multi-modal imaging is essential for advancing our understanding of brain function and unraveling pathophysiological processes underlying neurological and psychiatric disorders. Magnetic resonance (MR) and optoacoustic (OA) imaging have been shown to provide highly complementary contrasts and capabilities for preclinical neuroimaging. True integration between these modalities can thus offer unprecedented capabilities for studying the rodent brain in action. We report on a hybrid magnetic resonance and optoacoustic tomography (MROT) system for concurrent noninvasive structural and functional imaging of the mouse brain. Volumetric OA tomography was designed as an insert into a high-field MR scanner by integrating a customized MR-compatible spherical transducer array, an illumination module, and a dedicated radiofrequency coil. A tailored data processing pipeline has been developed to mitigate signal crosstalk and accurately register image volumes acquired with T1-weighted, angiography, and blood oxygenation level-dependent (BOLD) sequences onto the corresponding vascular and oxygenation data recorded with the OA modality. We demonstrate the concurrent acquisition of dual-mode anatomical and angiographic brain images with the scanner, as well as real-time functional readings of multiple hemodynamic parameters from animals subjected to oxygenation stress. Our approach combines the functional and molecular imaging advantages of OA with the superb soft-tissue contrast of MR, further providing an excellent platform for cross-validation of functional readings by the two modalities.

Looking deep inside tissue with photoacoustic molecular probes: a review

Significance

Deep tissue noninvasive high-resolution imaging with light is challenging due to the high degree of light absorption and scattering in biological tissue. Photoacoustic imaging (PAI) can overcome some of the challenges of pure optical or ultrasound imaging to provide high-resolution deep tissue imaging. However, label-free PAI signals from light absorbing chromophores within the tissue are nonspecific. The use of exogeneous contrast agents (probes) not only enhances the imaging contrast (and imaging depth) but also increases the specificity of PAI by binding only to targeted molecules and often providing signals distinct from the background.

Aim

We aim to review the current development and future progression of photoacoustic molecular probes/contrast agents.

Approach

First, PAI and the need for using contrast agents are briefly introduced. Then, the recent development of contrast agents in terms of materials used to construct them is discussed. Then, various probes are discussed based on targeting mechanisms, in vivo molecular imaging applications, multimodal uses, and use in theranostic applications.

Results

Material combinations are being used to develop highly specific contrast agents. In addition to passive accumulation, probes utilizing activation mechanisms show promise for greater controllability. Several probes also enable concurrent multimodal use with fluorescence, ultrasound, Raman, magnetic resonance imaging, and computed tomography. Finally, targeted probes are also shown to aid localized and molecularly specific photo-induced therapy.

Conclusions

The development of contrast agents provides a promising prospect for increased contrast, higher imaging depth, and molecularly specific information. Of note are agents that allow for controlled activation, explore other optical windows, and enable multimodal use to overcome some of the shortcomings of label-free PAI.

Photoacoustic imaging phantoms for assessment of object detectability and boundary buildup artifacts

Standardized phantoms and test methods are needed to accelerate clinical translation of emerging photoacoustic imaging (PAI) devices. Evaluating object detectability in PAI is challenging due to variations in target morphology and artifacts including boundary buildup. Here we introduce breast fat and parenchyma tissue-mimicking materials based on emulsions of silicone oil and ethylene glycol in polyacrylamide hydrogel. 3D-printed molds were used to fabricate solid target inclusions that produced more filled-in appearance than traditional PAI phantoms. Phantoms were used to assess understudied image quality characteristics (IQCs) of three PAI systems. Object detectability was characterized vs. target diameter, absorption coefficient, and depth. Boundary buildup was quantified by target core/boundary ratio, which was higher in transducers with lower center frequency. Target diameter measurement accuracy was also size-dependent and improved with increasing transducer frequency. These phantoms enable evaluation of multiple key IQCs and may support development of comprehensive standardized test methods for PAI devices.

Chemical Design of Activatable Photoacoustic Probes for Precise Biomedical Applications

Photoacoustic (PA) imaging technology, a three-dimensional hybrid imaging modality that integrates the advantage of optical and acoustic imaging, has great application prospects in molecular imaging due to its high imaging depth and resolution. To endow PA imaging with the ability for real-time molecular visualization and precise biomedical diagnosis, numerous activatable molecular PA probes which can specifically alter their PA intensities upon reacting with the targets or biological events of interest have been developed. This review highlights the recent developments of activatable PA probes for precise biomedical applications including molecular detection of the biotargets and imaging of the biological events. First, the generation mechanism of PA signals will be given, followed by a brief introduction to contrast agents used for PA probe design. Then we will particularly summarize the general design principles for the alteration of PA signals and activatable strategies for developing precise PA probes. Furthermore, we will give a detailed discussion of activatable PA probes in molecular detection and biomedical imaging applications in living systems. At last, the current challenges and outlooks of future PA probes will be discussed. We hope that this review will stimulate new ideas to explore the potentials of activatable PA probes for precise biomedical applications in the future.

Photoacoustic nanodroplets for oxygen enhanced photodynamic therapy of cancer

Photodynamic therapy (PDT) is a well-known cancer therapy that utilizes light to excite a photosensitizer and generate cytotoxic reactive oxygen species (ROS). The efficacy of PDT primarily depends on the photosensitizer and oxygen concentration in the tumor. Hypoxia in solid tumors promotes treatment resistance, resulting in poor PDT outcomes. Hence, there is a need to combat hypoxia while delivering sufficient photosensitizer to the tumor for ROS generation. Here we showcase our unique theranostic perfluorocarbon nanodroplets as a triple agent carrier for oxygen, photosensitizer, and indocyanine green that enables light triggered spatiotemporal delivery of oxygen to the tumors. We evaluated the characteristics of the nanodroplets and validated their ability to deliver oxygen via photoacoustic monitoring of blood oxygen saturation and subsequent PDT efficacy in a murine subcutaneous tumor model. The imaging results were validated with an oxygen sensing probe, which showed a 9.1 fold increase in oxygen content inside the tumor, following systemic administration of the nanodroplets. These results were also confirmed with immunofluorescence. In vivo studies showed that nanodroplets held higher rates of treatment efficacy than a clinically available benzoporphyrin derivative formulation. Histological analysis showed higher necrotic area within the tumor with perfluoropentane nanodroplets. Overall, the photoacoustic nanodroplets can significantly enhance image-guided PDT and has demonstrated substantial potential as a valid theranostic option for patient-specific photodynamic therapy-based treatments.

Targeted contrast agents and activatable probes for photoacoustic imaging of cancer

Photoacoustic (PA) imaging has emerged as a powerful technique for the high resolution visualization of biological processes within deep tissue. Through the development and application of exogenous targeted contrast agents and activatable probes that can respond to a given cancer biomarker, researchers can image molecular events in vivo during cancer progression. This information can provide valuable details that can facilitate cancer diagnosis and therapy monitoring. In this tutorial review, we provide a step-by-step guide to select a cancer biomarker and subsequent approaches to design imaging agents for in vivo use. We envision this information will be a useful summary to those in the field, new members to the community, and graduate students taking advanced imaging coursework. We also highlight notable examples from the recent literature, with emphasis on the molecular designs and their in vivo PA imaging performance. To conclude, we provide our outlook and future perspective in this exciting field.

Aspects of high-performance and bio-acceptable magnetic nanoparticles for biomedical application

This review covers extensively the synthesis & surface modification, characterization, and application of magnetic nanoparticles. For biomedical applications, consideration should be given to factors such as design strategies, the synthesis process, coating, and surface passivation. The synthesis method regulates post-synthetic change and specific applications in vitro and in vivo imaging/diagnosis and pharmacotherapy/administration. Special insights have been provided on biodistribution, pharmacokinetics, and toxicity in a living system, which is imperative for their wider application in biology. These nanoparticles can be decorated with multiple contrast agents and thus can also be used as a probe for multi-mode imaging or double/triple imaging, for example, MRI-CT, MRI-PET. Similarly loading with different drug molecules/dye/fluorescent molecules and integration with other carriers have found application not only in locating these particles in vivo but simultaneously target drug delivery/hyperthermia inside the body. Studies are underway to collect the potential of these magnetically driven nanoparticles in various scientific fields such as particle interaction, heat conduction, imaging, and magnetism. Surely, this comprehensive data will help in the further development of advanced techniques for theranostics based on high-performance magnetic nanoparticles and will lead this research area in a new sustainable direction.

Polyacrylamide hydrogel phantoms for performance evaluation of multispectral photoacoustic imaging systems

As photoacoustic imaging (PAI) begins to mature and undergo clinical translation, there is a need for well-validated, standardized performance test methods to support device development, quality control, and regulatory evaluation. Despite recent progress, current PAI phantoms may not adequately replicate tissue light and sound transport over the full range of optical wavelengths and acoustic frequencies employed by reported PAI devices. Here we introduce polyacrylamide (PAA) hydrogel as a candidate material for fabricating stable phantoms with well-characterized optical and acoustic properties that are biologically relevant over a broad range of system design parameters. We evaluated suitability of PAA phantoms for conducting image quality assessment of three PAI systems with substantially different operating parameters including two commercial systems and a custom system. Imaging results indicated that appropriately tuned PAA phantoms are useful tools for assessing and comparing PAI system image quality. These phantoms may also facilitate future standardization of performance test methodology.

Stabilization of indocyanine green dye in polymeric micelles for NIR-II fluorescence imaging and cancer treatment

One of the most commonly used near infrared (NIR) dyes is indocyanine green (ICG), which has been extensively used for NIR bioimaging, photothermal and photodynamic therapy. However, upon excitation this dye can react with molecular oxygen to form singlet oxygen (SO), which can then cleave ICG to form non-fluorescent debris. In order to reduce the reaction between ICG and oxygen, we used energy transfer (ET) between the former and the NIR dye IR-1061. The two dyes were encapsulated in micelles composed of biocompatible poly(ethylene glycol)-block-poly(ε-caprolactone) (PCL-PEG). Micelles were characterized for their size using dynamic light scattering (DLS) and were found to measure about 35 nm in diameter. Fluorescence emission measurements were conducted to show that the stability of ICG against photodecomposition is increased. Moreover, this increased stability allows the encapsulated dye to generate more heat and for a longer time, compared to its free form. Studies with a SO indicator showed that as more IR-1061 is added to the micelles, less SO is produced. These results show how by changing the amount of added IR-1061 it is possible to tune the heat and SO generated by the system. Cell viability studies demonstrated that while particles were nontoxic under physiological conditions, upon 808 nm irradiation they become potent at eradicating MCF7 cancer cells. Moreover, it was demonstrated that both the increase of temperature and the creation of decomposition debris play a role in the cytotoxic efficacy of the micelles. Dye-loaded micelles that were injected to live mice showed bright fluorescence in the over 1000 nm NIR (OTN-NIR) region, allowing for visualization of blood vessels and internal organs. Most importantly, the encapsulated dyes remained stable for over 30 minutes, gradually accumulating in the liver and spleen. The presence of IR-1061 in addition to the heat-generating dye ICG allowed for simultaneous temperature modification and monitoring. We were able to assess the change in temperature by measuring the change in the fluorescence intensity of IR-1061 in the OTN-NIR region, a range with deep penetration of living tissues. These features illustrate the potential use of ICG/IR-1061 in PCL-PEG micelles as promising candidates for cancer treatment and diagnosis.

Near-Infrared Activated Cyanine Dyes As Agents for Photothermal Therapy and Diagnosis of Tumors

Today, it has become apparent that innovative treatment methods, including those involving simultaneous diagnosis and therapy, are particularly in demand in modern cancer medicine. The development of nanomedicine offers new ways of increasing the therapeutic index and minimizing side effects. The development of photoactivatable dyes that are effectively absorbed in the first transparency window of biological tissues (700-900 nm) and are capable of fluorescence and heat generation has led to the emergence of phototheranostics, an approach that combines the bioimaging of deep tumors and metastases and their photothermal treatment. The creation of near-infrared (NIR) light-activated agents for sensitive fluorescence bioimaging and phototherapy is a priority in phototheranostics, because the excitation of drugs and/or diagnostic substances in the near-infrared region exhibits advantages such as deep penetration into tissues and a weak baseline level of autofluorescence. In this review, we focus on NIR-excited dyes and discuss prospects for their application in photothermal therapy and the diagnosis of cancer. Particular attention is focused on the consideration of new multifunctional nanoplatforms for phototheranostics which allow one to achieve a synergistic effect in combinatorial photothermal, photodynamic, and/or chemotherapy, with simultaneous fluorescence, acoustic, and/or magnetic resonance imaging.

Excitation Transfer in Hybrid Nanostructures of Colloidal Ag2S/TGA Quantum Dots and Indocyanine Green J-Aggregates

The regularities of the electron excitations exchange in hybrid associates of colloidal Ag₂S quantum dots, passivated with thioglycolic acid (Ag₂S/TGA QDs) with an average size of 2.2 and 3.7 nm with Indocyanine Green J-aggregates (ICG) were studied in this work by methods of absorption and luminescence spectroscopy. It was shown that IR luminescence sensitization of Ag₂S/TGA QDs with an average size of 3.7 nm in the region of 1040 nm is possible due to non-radiative resonance energy transfer from Ag₂S/TGA QDs with an average size of 2.2 nm and luminescence peak at 900 nm using ICG J-aggregate as an exciton bridge. The sensitization efficiency is 0.33. This technique provides a transition from the first therapeutic window (NIR-I, 700-950 nm) to the second (NIR-II, 1000-1700 nm). It can allow high to increase the imaging in vivo resolution.

Efficient photoacoustic imaging using indocyanine green (ICG) loaded functionalized mesoporous silica nanoparticles

Photoacoustic (PA) imaging is gaining momentum due to its greater depth of field, low background, and 3D imaging capabilities. However, traditional PA imaging agents (e.g. dyes, quantum dots, etc.) are usually unstable in plasma and bind to serum proteins, and thus cleared rapidly. Because of this, the nanoparticle encapsulation of PA imaging agents is becoming increasingly popular. Therefore, the rational design of carrier nanoparticles for this purpose is necessary for strong imaging signal intensity, high biosafety, and precise targeting. Herein, we systematically evaluate the influence of the chemical and physical surface functionalization of mesoporous silica nanoparticles (MSNs) on the photo-stability, loading, release, and photoacoustic (PA) signal strength of the FDA approved small molecule contrast agent, indocyanine green (ICG). Chemical functionalization involved the modification of MSNs with silanes having amine (NH2) or phosphonate (PO3) terminal groups, whereas physical modifications were performed by capping the ICG loaded MSNs with lipid bilayer (LB) or layer-by-layer (LBL) polyelectrolyte coatings. The NH2-MSNs display the highest ICG mass loading capacity (16.5 wt%) with a limited release of ICG (5%) in PBS over 48 h, while PO3-MSNs only loaded ICG around 3.5 wt%. The physically modified MSNs (i.e. LBMSNs and LBLMSNs) were vacuum loaded resulting in approximately 9 wt% loading and less than 10% ICG release in 48 h. Pure ICG was highly photo-unstable and showed 20% reduction in photoluminescence (PL) within 3 h of exposure to 800 nm, while the ICG loaded onto functionalized MSNs did not photo-degrade. Among the tested formulations, NH2-MSNs and LBLMSNs presented 4-fold in vitro PA signal intensity enhancement at a 200 μg mL-1 equivalent ICG dose. Similar to the in vitro PA imaging, NH2-MSNs and LBLMSNs performed the best when subcutaneously injected into mouse cadavers with 1.29- and 1.43-fold PA signal enhancement in comparison to the pure ICG, respectively.

Multifunctional phototheranostic nanomedicine for cancer imaging and treatment

Cancer, as one of the most life-threatening diseases, shows a high fatality rate around the world. When improving the therapeutic efficacy of conventional cancer treatments, researchers also conduct extensive studies into alternative therapeutic approaches, which are safe, valid, and economical. Phototherapies, including photodynamic therapy (PDT) and photothermal therapy (PTT), are tumor-ablative and function-reserving oncologic interventions, showing strong potential in clinical cancer treatment. During phototherapies, the non-toxic phototherapeutic agents can be activated upon light irradiation to induce cell death without causing much damage to normal tissues. Besides, with the rapid development of nanotechnology in the past decades, phototheranostic nanomedicine also has attracted tremendous interests aiming to continuously refine their performance. Herein, we reviewed the recent progress of phototheranostic nanomedicine for improved cancer therapy. After a brief introduction of the therapeutic principles and related phototherapeutic agents for PDT and PTT, the existing works on developing of phototheranostic nanomedicine by mainly focusing on their categories and applications, particularly on phototherapy-synergized cancer immunotherapy, are comprehensively reviewed. More importantly, a brief conclusion and future challenges of phototheranostic nanomedicine from our point of view are delivered in the last part of this article.

W-doped TiO2 nanoparticles with strong absorption in the NIR-II window for photoacoustic/CT dual-modal imaging and synergistic thermoradiotherapy of tumors

Multifunctional nanomaterials that have integrated diagnostic and therapeutic functions and low toxicity, and can enhance treatment efficacy through combination therapy have drawn tremendous amounts of attention. Herein, a newly developed multifunctional theranostic agent is reported, which is PEGylated W-doped TiO2 (WTO) nanoparticles (NPs) synthesized via a facile organic route, and the results demonstrated strong absorbance of these WTO NPs in the second near-infrared (NIR-II) window due to successful doping with W. These PEGylated WTO NPs can absorb both NIR-II laser and ionizing radiation, rendering them well suited for dual-modal computed tomography/NIR-II photoacoustic imaging and synergistic NIR-II photothermal/radiotherapy of tumors. In addition, the long-term in vivo studies indicated that these PEGylated WTO NPs had no obvious toxicity on mice in vivo, and they can be cleared after a 30-day period. In summary, this multifunctional theranostic agent can absorb both NIR-II laser and ionizing radiation with negligible toxicity and rapid clearance, therefore it has great promise for applications in imaging and therapeutics in biomedicine.

Photoacoustic diagnosis of pharmacokinetics and vascular shutdown effects in photodynamic treatment with indocyanine green-lactosome for a subcutaneous tumor in mice

Indocyanine green lactosome (ICG-lactosome) is an attractive new-generation agent for photodynamic therapy (PDT) that is characterized by a near-infrared excitation wavelength and high stability in the bloodstream. Fluorescence imaging has been used to examine its pharmacokinetics in vivo, but no depth-resolved information can be obtained with this method. In this study, we applied photoacoustic (PA) imaging to visualize the depth distribution of ICG-lactosome in a mouse subcutaneous tumor model. With this method, the depth distribution of blood vessels can also be visualized, enabling detection of vascular shutdown effects due to PDT. We performed PA imaging of both the distributions of ICG-lactosome and blood vessels in a tumor before and after PDT, and we found that PA signals originating from ICG-lactosome were greatly increased at 18 h after drug injection but rapidly decreased after PDT. These results indicate efficient accumulation of ICG-lactosome and rapid photobleaching due to the PDT reaction in the tumor, respectively. After PDT, PA amplitudes of hemoglobin were significantly decreased, being attributable to vascular shutdown effects. These results show the usefulness of PA imaging for monitoring not only photosensitizer accumulation and bleaching but also vascular responses in PDT with ICG-lactosome. This method can be applied to the diagnosis of many types of PDT processes.

State-of-the-Art Preclinical Photoacoustic Imaging in Oncology: Recent Advances in Cancer Theranostics

The optical imaging plays an increasing role in preclinical studies, particularly in cancer biology. The combined ultrasound and optical imaging, named photoacoustic imaging (PAI), is an emerging hybrid technique for real-time molecular imaging in preclinical research and recently expanding into clinical setting. PAI can be performed using endogenous contrast, particularly from oxygenated and deoxygenated hemoglobin and melanin, or exogenous contrast agents, sometimes targeted for specific biomarkers, providing comprehensive morphofunctional and molecular information on tumor microenvironment. Overall, PAI has revealed notable opportunities to improve knowledge on tumor pathophysiology and on the biological mechanisms underlying therapy. The aim of this review is to introduce the principles of PAI and to provide a brief overview of current PAI applications in preclinical research, highlighting also on recent advances in clinical translation for cancer diagnosis, staging, and therapy.

Gold-implanted plasmonic quartz plate as a launch pad for laser-driven photoacoustic microfluidic pumps

A revolutionary microfluidic pump is demonstrated; it has no moving parts and no electrical contacts. It consists of a quartz plate implanted by Au particles where every point on the plate can function as a micropump. The pump is driven by a laser beam and is based on the discovered principle of photoacoustic laser streaming. When a pulsed laser hits the plate, it is absorbed by Au nanoparticles that generate an ultrasound wave, which then drives the fluid via acoustic streaming. Because laser beams can be arbitrarily patterned and timed, the fluid can be controlled by laser in a fashion similar to musical water fountains. Such a laser-driven photoacoustic micropump will find wide applications in microfluidics and optofluidics.

Enabled initially by the development of microelectromechanical systems, current microfluidic pumps still require advanced microfabrication techniques to create a variety of fluid-driving mechanisms. Here we report a generation of micropumps that involve no moving parts and microstructures. This micropump is based on a principle of photoacoustic laser streaming and is simply made of an Au-implanted plasmonic quartz plate. Under a pulsed laser excitation, any point on the plate can generate a directional long-lasting ultrasound wave which drives the fluid via acoustic streaming. Manipulating and programming laser beams can easily create a single pump, a moving pump, and multiple pumps. The underlying pumping mechanism of photoacoustic streaming is verified by high-speed imaging of the fluid motion after a single laser pulse. As many light-absorbing materials have been identified for efficient photoacoustic generation, photoacoustic micropumps can have diversity in their implementation. These laser-driven fabrication-free micropumps open up a generation of pumping technology and opportunities for easy integration and versatile microfluidic applications.

Laser-activated microparticles for multimodal imaging: ultrasound and photoacoustics

The increasing personalization of medical treatment demands refined imaging and increased monitoring capabilities, as well as an improved efficacy through targeted drug delivery. Such a transition in health care can be facilitated by the use of multimodal contrast agents. In this paper, we present a novel type of multimodal contrast agents, that enhances contrast both in ultrasound and in photoacoustic imaging, while at the same time being capable of triggered drug delivery. Upon pulsed laser irradiation, polymeric microparticles-containing a dye and an oil core-can create a cavitation bubble that subsequently emits a strong acoustic wave. We investigated different formulations of these particles, by changing the oil content, dye concentration and probing conditions using a combination of pulsed laser excitation and an ultrasound chirp. We demonstrated that capsules with a core containing a low boiling point oil give the highest photoacoustic and acoustic response. The laser activation threshold for this system is high in the visible range, but within the near infrared medical limits. The same system also produces a stable bubble. US scattering by these stable bubbles results in medically relevant frequencies, making the particles of interest for biomedical and pre-clinical imaging. Finally, the system has potential to carry a functional drug-load, and a route to these applications is discussed.

Highly-Soluble Cyanine J-aggregates Entrapped by Liposomes for In Vivo Optical Imaging around 930 nm

Near infrared (NIR) dyes are useful for in vivo optical imaging. Liposomes have been used extensively for delivery of diverse cargos, including hydrophilic cargos which are passively loaded in the aqueous core. However, most currently available NIR dyes are only slightly soluble in water, making passive entrapment in liposomes challenging for achieving high optical contrast.

Methods: We modified a commercially-available NIR dye (IR-820) via one-step Suzuki coupling with dicarboxyphenylboronic acid, generating a disulfonated heptamethine; dicarboxyphenyl cyanine (DCP-Cy). DCP-Cy was loaded in liposomes and used for optical imaging.

Results: Owing to increased charge in mildly basic aqueous solution, DCP-Cy had substantially higher water solubility than indocyanine green (by an order of magnitude), resulting in higher NIR absorption. Unexpectedly, DCP-Cy tended to form J-aggregates with pronounced spectral red-shifting to 934 nm (from 789 nm in monomeric form). J-aggregate formation was dependent on salt and DCP-Cy concentration. Dissolved at 20 mg/mL, DCP-Cy J-aggregates could be entrapped in liposomes. Full width at half maximum absorption of the liposome-entrapped dye was just 25 nm. The entrapped DCP-Cy was readily detectable by fluorescence and photoacoustic NIR imaging. Upon intravenous administration to mice, liposomal DCP-Cy circulated substantially longer than the free dye. Accumulation was largely in the spleen, which was visualized with fluorescence and photoacoustic imaging.

Conclusions: DCP-Cy is simple to synthesize and exhibits high aqueous solubility and red-shifted absorption from J-aggregate formation. Liposomal dye entrapment is possible, which facilitates in vivo photoacoustic and fluorescence imaging around 930 nm.

Current concepts in nanostructured contrast media development for in vivo photoacoustic imaging

To overcome the endogenous photoacoustic contrast arising from endogenous species, specific contrast agents need to be developed, allowing PAI to successfully identify targeted contrast in the range of wavelength in which the interference from the biomatrix is minimized.

The effect of nanoencapsulation of ICG on two-photon bioimaging

Multiphoton imaging, a highly effective diagnostic technique, has recently gained widespread attention for early-stage cancer detection. Tremendous efforts have been dedicated to explore various types of exogenous contrast agents for improved signal-to-noise ratio of multiphoton imaging. Indocyanine green (ICG), the only U. S. FDA approved near-infrared chromophore, has been recently used as an exogenous contrast agent for two-photon bioimaging. Despite its great potential applications in clinical settings, the conventional delivery method of ICG has limited applications due to its poor cellular uptake and optical stability in its free form. Herein, we report the effect of nanoencapsulation of ICG on two-photon bioimaging. For this study, ICG was encapsulated within poly-l-arginine (PLA) based nanoparticles for the first time. These nanoparticles were found to be biocompatible and biodegradable as the major constituents were salts and PLA. These nanoparticles were spherical with a mean diameter of ∼61 nm and exhibit higher photostability than free ICG. Additionally, nanoencapsulated ICG treated cells show enhanced contrast for two-photon bioimaging in comparison with its free form. In summary, nanoencapsulated ICG could serve as an exogenous chromophore for multiphoton imaging, which shows excellent delivery efficacy.

ICG-PLA NPs were synthesized for multiphoton bioimaging. The ICG-PLA NPs were more efficiently taken up by the cells and improved the photostability of the ICG. The ICG-PLA NPs incubated cells display superior contrast in multiphoton imaging.

Photothermal treatment of port-wine stains using erythrocyte-derived particles doped with indocyanine green: a theoretical study

Pulsed dye laser irradiation in the wavelength range of 585 to 600 nm is currently the gold standard for treatment of port-wine stains (PWSs). However, this treatment method is often ineffective for deeply seated blood vessels and in individuals with moderate to heavy pigmentation. Use of optical particles doped with the FDA-approved near-infrared (NIR) absorber, indocyanine green (ICG), can potentially provide an effective method to overcome these limitations. Herein, we theoretically investigate the effectiveness of particles derived from erythrocytes, which contain ICG, in mediating photothermal destruction of PWS blood vessels. We refer to these particles as NIR erythrocyte-derived transducers (NETs). Our theoretical model consists of a Monte Carlo algorithm to estimate the volumetric energy deposition, a finite elements approach to solve the heat diffusion equation, and a damage integral based on an Arrhenius relationship to quantify tissue damage. The model geometries include simulated PWS blood vessels as well as actual human PWS blood vessels plexus obtained by the optical coherence tomography. Our simulation results indicate that blood vessels containing micron- or nano-sized NETs and irradiated at 755 nm have higher levels of photothermal damage as compared to blood vessels without NETs irradiated at 585 nm. Blood vessels containing micron-sized NETs also showed higher photothermal damage than blood vessels containing nano-sized NETs. The theoretical model presented can be used in guiding the fabrication of NETs with patient-specific optical properties to allow for personalized treatment based on the depth and size of blood vessels as well as the pigmentation of the individual's skin.

Molecular Photoacoustic Contrast Agents: Design Principles & Applications

Photoacoustic imaging (PAI) is a rapidly growing field which offers high spatial resolution and high contrast for deep-tissue imaging in vivo. PAI is nonionizing and noninvasive and combines the optical resolution of fluorescence imaging with the spatial resolution of ultrasound imaging. In particular, the development of exogenous PA contrast agents has gained significant momentum of late with a vastly expanding complexity of dye materials under investigation ranging from small molecules to macromolecular proteins, polymeric and inorganic nanoparticles. The goal of this review is to survey the current state of the art in molecular photoacoustic contrast agents (MPACs) for applications in biomedical imaging. The fundamental design principles of MPACs are presented and a review of prior reports spanning from early-to-current literature is put forth.

A Pd corolla-human serum albumin-indocyanine green nanocomposite for photothermal/photodynamic combination therapy of cancer

In this work, a novel nanoplatform based on Pd corolla-human serum albumin-indocyanine green (PdCs-HSA-ICG) was developed for cancer photothermal/photodynamic combination therapy. Pd corollas (denoted as PdCs) with good near-infrared photothermal conversion efficiency (η≈ 37%) were first prepared and modified with human serum albumin (HSA) and indocyanine green (ICG) to get the PdCs-HSA-ICG nanocomposite. The prepared PdCs-HSA-ICG not only improves the colloid and thermal stability of ICG, but also shows a higher temperature increase than that of PdCs and free ICG as well as a comparable singlet oxygen (¹O₂) generation capability to that of free ICG. Upon single 808 nm laser irradiation, the photothermal (PTT)/photodynamic (PDT) combined therapeutic efficacy of PdCs-HSA-ICG at both cellular and animal levels was superior to PdCs-HSA (PTT) or free ICG (PTT and PDT), respectively. Thus, the designed PdCs-HSA-ICG nanocomposite holds great potential as a new class of photosensitive agent for cancer phototherapy.

Advances in Diagnostic and Intraoperative Molecular Imaging of Pancreatic Cancer

Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis. To improve outcomes, there is a critical need for improved tools for detection, accurate staging, and resectability assessment. This could improve patient stratification for the most optimal primary treatment modality. Molecular imaging, used in combination with tumor-specific imaging agents, can improve established imaging methods for PDAC. These novel, tumor-specific imaging agents developed to target specific biomarkers have the potential to specifically differentiate between malignant and benign diseases, such as pancreatitis. When these agents are coupled to various types of labels, this type of molecular imaging can provide integrated diagnostic, noninvasive imaging of PDAC as well as image-guided pancreatic surgery. This review provides a detailed overview of the current clinical imaging applications, upcoming molecular imaging strategies for PDAC, and potential targets for imaging, with an emphasis on intraoperative imaging applications.

Synthesis, Functionalization, and Design of Magnetic Nanoparticles for Theranostic Applications

In order to translate nanotechnology into medical practice, magnetic nanoparticles (MNPs) have been presented as a class of non-invasive nanomaterials for numerous biomedical applications. In particular, MNPs have opened a door for simultaneous diagnosis and brisk treatment of diseases in the form of theranostic agents. This review highlights the recent advances in preparation and utilization of MNPs from the synthesis and functionalization steps to the final design consideration in evading the body immune system for therapeutic and diagnostic applications with addressing the most recent examples of the literature in each section. This study provides a conceptual framework of a wide range of synthetic routes classified mainly as wet chemistry, state-of-the-art microfluidic reactors, and biogenic routes, along with the most popular coating materials to stabilize resultant MNPs. Additionally, key aspects of prolonging the half-life of MNPs via overcoming the sequential biological barriers are covered through unraveling the biophysical interactions at the bio-nano interface and giving a set of criteria to efficiently modulate MNPs' physicochemical properties. Furthermore, concepts of passive and active targeting for successful cell internalization, by respectively exploiting the unique properties of cancers and novel targeting ligands are described in detail. Finally, this study extensively covers the recent developments in magnetic drug targeting and hyperthermia as therapeutic applications of MNPs. In addition, multi-modal imaging via fusion of magnetic resonance imaging, and also innovative magnetic particle imaging with other imaging techniques for early diagnosis of diseases are extensively provided.

Bio-templated silica composites for next-generation biomedical applications

Silica-based materials have extensive biomedical applications owing to their unique physical, chemical, and biological properties. Recently, increasing studies have examined the mechanisms involved in biosilicification to develop novel, fine-tunable, eco-friendly materials and/or technologies. In this review, we focus on recent developments in bio-templated silica synthesis and relevant applications in drug delivery systems, tissue engineering, and biosensing.

Melanin-Based Contrast Agents for Biomedical Optoacoustic Imaging and Theranostic Applications

Optoacoustic imaging emerged in early 1990s as a new biomedical imaging technology that generates images by illuminating tissues with short laser pulses and detecting resulting ultrasound waves. This technique takes advantage of the spectroscopic approach to molecular imaging, and delivers high-resolution images in the depth of tissue. Resolution of the optoacoustic imaging is scalable, so that biomedical systems from cellular organelles to large organs can be visualized and, more importantly, characterized based on their optical absorption coefficient, which is proportional to the concentration of absorbing chromophores. Optoacoustic imaging was shown to be useful in both preclinical research using small animal models and in clinical applications. Applications in the field of molecular imaging offer abundant opportunities for the development of highly specific and effective contrast agents for quantitative optoacoustic imaging. Recent efforts are being made in the direction of nontoxic biodegradable contrast agents (such as nanoparticles made of melanin) that are potentially applicable in clinical optoacoustic imaging. In order to increase the efficiency and specificity of contrast agents and probes, they need to be made smart and capable of controlled accumulation in the target cells. This review was written in recognition of the potential breakthroughs in medical optoacoustic imaging that can be enabled by efficient and nontoxic melanin-based optoacoustic contrast agents.

Gold Nanoclusters-Indocyanine Green Nanoprobes for Synchronous Cancer Imaging, Treatment, and Real-Time Monitoring Based on Fluorescence Resonance Energy Transfer

Well-designed gold nanoclusters-indocyanine green nanoprobes (Au NCs-INPs) have been developed by the conjugation of Au NC assemblies with indocyanine green (ICG) for the therapeutic real-time monitoring based on fluorescence resonance energy transfer (FRET). The synthesized Au NCs-INPs demonstrated the improved cellular uptake and effective tumor targeting because of the enhanced permeability and retention effect and the gp60-mediated secreted protein acidic and rich in cysteine combined transport pathway, suggesting excellent dual-modal near-infrared fluorescence and photoacoustic imaging. Moreover, the simultaneous photodynamic therapy (PDT) and photothermal therapy (PTT) of Au NCs-INPs exhibited higher cancer cell killing and tumor removal efficiency than those of PDT or PTT alone. More importantly, a promising therapeutic monitoring strategy was performed based on FRET between Au NCs and ICG, suggesting that Au NCs-INPs could be utilized to evaluate the therapeutic response by real-time monitoring the change in Au NCs in fluorescence intensity together with ICG supersession. Therefore, Au NCs-INPs as a novel photosensitizer have great potentials for combined tumor imaging, therapy, and therapeutic monitoring in real time.

Advanced Photoacoustic Imaging Applications of Near-Infrared Absorbing Organic Nanoparticles

Progress of nanotechnology in recent years has stimulated fast development of nanoparticles in biomedical research. Photoacoustic (PA) imaging as an emerging non-invasive technique in molecular imaging has improved imaging depth relative to conventional optical imaging, demonstrating great potential in clinical applications. The convergence of nanotechnology and PA imaging has enabled a broad spectrum of new opportunities in fundamental biology and translation medicine. This review focuses on the recent advances of organic nanoparticles in PA imaging applications. Near-infrared absorbing organic nanoparticles are classified and discussed according to their different imaging applications, which include tumor imaging, gastrointestinal imaging, sentinel lymph node imaging, disease microenvironment imaging and real-time drug imaging. The chemistry and PA properties of organic nanoparticles are discussed in details to highlight their own merits, and their challenges and perspectives in PA imaging are also discussed.

Optical Characteristics and Tumor Imaging Capabilities of Near Infrared Dyes in Free and Nano-Encapsulated Formulations Comprised of Viral Capsids

Near infrared (NIR) fluorescent molecules and nanosized structures can serve as potential optical probes for image-guided removal of small tumor nodules (≲ 1 mm diameter). Although indocyanine green (ICG) remains as the only FDA-approved NIR dye, other organic dyes are under extensive development for enhanced imaging capabilities. One such dye is BrCy106-NHS where bromine is substituted for aromatic structures in cyanine dyes. Herein, we investigate the absorption and fluorescence characteristics of ICG and BrCy106-NHS, and quantitatively assess their tumor imaging capabilities in free (non-encapsulated) and a nano-encapsulated form that utilizes the capsid protein (CP) from genome-depleted plant-infecting brome mosaic virus as the encapsulating shell. We refer to these nanoconstructs as optical viral ghosts (OVGs). For example, when fabricated at CP to dye concentration ratio of 200, value of the spectrally integrated fluorescence emission for BrCy106-NHS-doped OVGs is ∼60 times higher than that of ICG-doped OVGs. Our analysis of homogenized mice intraperitoneal tumors indicate that the averaged total fluorescence emission associated with the use of BrCy106-NHS-doped can be at least about 44 times greater than that of ICG-doped OVGs. Our results suggest that OVGs containing BrCy106-NHS may potentially serve as effective optical probes for tumor imaging.

Nanoparticles as Theranostic Vehicles in Experimental and Clinical Applications-Focus on Prostate and Breast Cancer

Prostate and breast cancer are the second most and most commonly diagnosed cancer in men and women worldwide, respectively. The American Cancer Society estimates that during 2016 in the USA around 430,000 individuals were diagnosed with one of these two types of cancers, and approximately 15% of them will die from the disease. In Europe, the rate of incidences and deaths are similar to those in the USA. Several different more or less successful diagnostic and therapeutic approaches have been developed and evaluated in order to tackle this issue and thereby decrease the death rates. By using nanoparticles as vehicles carrying both diagnostic and therapeutic molecular entities, individualized targeted theranostic nanomedicine has emerged as a promising option to increase the sensitivity and the specificity during diagnosis, as well as the likelihood of survival or prolonged survival after therapy. This article presents and discusses important and promising different kinds of nanoparticles, as well as imaging and therapy options, suitable for theranostic applications. The presentation of different nanoparticles and theranostic applications is quite general, but there is a special focus on prostate cancer. Some references and aspects regarding breast cancer are however also presented and discussed. Finally, the prostate cancer case is presented in more detail regarding diagnosis, staging, recurrence, metastases, and treatment options available today, followed by possible ways to move forward applying theranostics for both prostate and breast cancer based on promising experiments performed until today.

Biomedical photoacoustics: fundamentals, instrumentation and perspectives on nanomedicine

Photoacoustic imaging (PAI) is an integrated biomedical imaging modality which combines the advantages of acoustic deep penetration and optical high sensitivity. It can provide functional and structural images with satisfactory resolution and contrast which could provide abundant pathological information for disease-oriented diagnosis. Therefore, it has found vast applications so far and become a powerful tool of precision nanomedicine. However, the investigation of PAI-based imaging nanomaterials is still in its infancy. This perspective article aims to summarize the developments in photoacoustic technologies and instrumentations in the past years, and more importantly, present a bright outlook for advanced PAI-based imaging nanomaterials as well as their emerging biomedical applications in nanomedicine. Current challenges and bottleneck issues have also been discussed and elucidated in this article to bring them to the attention of the readership.

Organosilica hybrid nanomaterials with a high organic content: syntheses and applications of silsesquioxanes

Organic-inorganic hybrid materials garner properties from their organic and inorganic matrices as well as synergistic features, and therefore have recently attracted much attention at the nanoscale. Non-porous organosilica hybrid nanomaterials with a high organic content such as silsesquioxanes (R-SiO_1.5, with R organic groups) and bridged silsesquioxanes (O_1.5Si-R-SiO_1.5) are especially attractive hybrids since they provide 20 to 80 weight percent of organic functional groups in addition to the known chemistry and stability of silica. In the organosilica family, silsesquioxanes (R-SiO_1.5) stand between silicas (SiO₂) and silicones (R₂SiO), and are variously called organosilicas, ormosil (organically-modified silica), polysilsesquioxanes and silica hybrids. Herein, we comprehensively review non-porous silsesquioxane and bridged silsesquioxane nanomaterials and their applications in nanomedicine, electro-optics, and catalysis.

Nanocomposites of Molybdenum Disulfide/Methoxy Polyethylene Glycol-co-Polypyrrole for Amplified Photoacoustic Signal

Photoacoustic activity is the generation of an ultrasonic signal via thermal expansion or bubble formation, stimulated by laser irradiation. Photoacoustic nanoplatforms have recently gained focus for application in bioelectric interfaces. Various photoacoustic material types have been evaluated, including gold nanoparticles, semiconductive π-conjugating polymers (SP), etc. In this study, surfactant-free methoxy-polyethylene glycol-co-polypyrrole copolymer (mPEG-co-PPyr) nanoparticles (NPs) and mPEG-co-PPyr NP/molybdenum disulfide (mPEG-co-PPyr/MoS₂) nanocomposites (NCs) were prepared and their photoacoustic activity was demonstrated. The mPEG-co-PPyr NPs and mPEG-co-PPyr/MoS₂ NCs both showed photoacoustic signal activity. The mPEG-co-PPyr/MoS₂ NCs presented a higher photoacoustic signal amplitude at 700 nm than the mPEG-co-PPyr NPs. The enhanced photoacoustic activity of the mPEG-co-PPyr/MoS₂ NCs might be attributed to heterogeneous interfacial contact between mPEG-co-PPyr and the MoS₂ nanosheets due to complex formation. Laser ablation of MoS₂ might elevate the local temperature and facilitate the thermal conductive transfer in the mPEG-co-PPyr/MoS₂ NCs, amplifying PA signal. Our study, for the first time, demonstrates enhanced PA activity in SP/transition metal disulfide (TMD) composites as photoacoustic nanoplatforms.

Clinical photoacoustic imaging of cancer

Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

Encapsulated Conjugated Oligomer Nanoparticles for Real-Time Photoacoustic Sentinel Lymph Node Imaging and Targeted Photothermal Therapy

Noninvasive and nonionizing imaging of sentinel lymph nodes (SLN) is highly desirable for the detection of breast cancer metastasis through sentinel lymph node biopsy. Photoacoustic (PA) imaging is an emerging imaging technique that can serve as a suitable approach for SLN imaging. Herein, novel conjugated oligomer based nanoparticles (NPs) with strong NIR absorption, good biocompatibility, excellent PA contrast, and good photothermal conversion efficiency are reported. Real-time PA imaging of SLN reveals high resolution of the NPs via injection from the left forepaw pad. In addition, the surface functionalized NPs can target breast cancer cells and kill them efficiently and specifically through photothermal therapy upon 808 nm laser irradiation. This work shows great potential of the nanoparticle PA contrast agent to serve as a multifunctional probe for photothermal therapy at SLNs to achieve the inhibition of cancer cell metastasis in the near future.

Photoacoustic imaging of the eye: A mini review

The eye relies on the synergistic cooperation of many different ocular components, including the cornea, crystalline lens, photoreceptors, and retinal neurons, to precisely sense visual information. Complications with a single ocular component can degrade vision and sometimes cause blindness. Immediate treatment and long-term monitoring are paramount to alleviate symptoms, restore vision, and cure ocular diseases. However, successful treatment requires understanding ocular pathological mechanisms, precisely detecting and monitoring the diseases. The investigation and diagnosis of ocular diseases require advanced medical tools. In this mini review, we discuss non-invasive photoacoustic (PA) imaging as a potential research tool and medical screening device. In the research setting, PA imaging can provide valuable information on the disease progression. In the clinical setting, PA imaging can potentially aid in disease detection and treatment monitoring.

[Optoacoustic imaging]

CLINICAL/METHODICAL ISSUE

Imaging modalities play an increasing role in today's medical diagnostics. Among them, ultrasound (US) is one the most widespread techniques although it has relatively poor soft tissue contrast. Furthermore, US is poorly suited as a modality for molecular imaging (MI).

STANDARD RADIOLOGICAL METHODS

Methods such as Doppler and contrast-enhanced US (CEUS) allow functional imaging of the vasculature; however, ultrasound-based MI remains limited to the vascular network due to the size of available contrast agents.

METHODICAL INNOVATIONS

Optoacoustic imaging combines the benefits of optics (high contrast) with those of acoustics (low scattering and high resolution). In this technique, signals are generated in tissue with high contrast depending on the local optical absorption coefficient and detected with an acoustic procedure.

PERFORMANCE

Optoacoustic imaging can intrinsically be scaled in terms of resolution and is therefore usable in various applications from in vitro microscopy, to preclinical small animal imaging up to clinical imaging. With a resolution in the range of clinical ultrasound systems (100-400 µm), highly scattering tissue can be imaged up to several centimeters in depth.

ACHIEVEMENTS

In contrast to conventional ultrasound imaging, optoacoustic techniques are highly suitable for MI. Various contrast agents as well as different technical implementations of the approach have already been preclinically evaluated. The technique is currently close to being transferred to clinical implementation and the first studies have already been started.

PRACTICAL RECOMMENDATIONS

Clinical studies are ongoing with respect to early diagnosis of breast cancer and arthritis. Furthermore, the suitability of the technique for skin imaging is currently being investigated.

Photoacoustic Imaging in Oncology: Translational Preclinical and Early Clinical Experience

Photoacoustic imaging has evolved into a clinically translatable platform with the potential to complement existing imaging techniques for the management of cancer, including detection, characterization, prognosis, and treatment monitoring. In photoacoustic imaging, tissue is optically excited to produce ultrasonographic images that represent a spatial map of optical absorption of endogenous constituents such as hemoglobin, fat, melanin, and water or exogenous contrast agents such as dyes and nanoparticles. It can therefore provide functional and molecular information that allows noninvasive soft-tissue characterization. Photoacoustic imaging has matured over the years and is currently being translated into the clinic with various clinical studies underway. In this review, the current state of photoacoustic imaging is presented, including techniques and instrumentation, followed by a discussion of potential clinical applications of this technique for the detection and management of cancer. (©) RSNA, 2016.

Indocyanine green delivery systems for tumour detection and treatments

Indocyanine green (ICG) is a cyanine compound that displays fluorescent properties in the near infrared region. This dye is employed for numerous indications but nowadays its major application field regards tumour diagnosis and treatments. Optical imaging by near infrared fluorescence provides news opportunities for oncologic surgery. The imaging of ICG can be useful for intraoperative identification of several solid tumours and metastases, and sentinel lymph node detection. In addition, ICG can be used as an agent for the destruction of malignant tissue, by virtue of the production of reactive oxygen species and/or induction of a hyperthermia effect under irradiation. Nevertheless, ICG shows several drawbacks, which limit its clinical application. Several formulative strategies have been studied to overcome these problems. The rationale of the development of ICG containing drug delivery systems is to enhance the in vivo stability and biodistribution profile of this dye, allowing tumour accumulation and resulting in better efficacy. In this review, ICG containing nano-sized carriers are classified based on their chemical composition and structure. In addition to nanosystems, different formulations including hydrogel, microsystems and others loaded with ICG will be illustrated. In particular, this report describes the preparation, in vitro characterization and in vivo application of ICG platforms for cancer imaging and treatment. The promising results of all systems confirm their clinical utility but further studies are required prior to evaluating the formulations in human trials.

Erythrocyte-derived nano-probes functionalized with antibodies for targeted near infrared fluorescence imaging of cancer cells

Constructs derived from mammalian cells are emerging as a new generation of nano-scale platforms for clinical imaging applications. Herein, we report successful engineering of hybrid nano-structures composed of erythrocyte-derived membranes doped with FDA-approved near infrared (NIR) chromophore, indocyanine green (ICG), and surface-functionalized with antibodies to achieve molecular targeting. We demonstrate that these constructs can be used for targeted imaging of cancer cells in vitro. These erythrocyte-derived optical nano-probes may provide a potential platform for clinical translation, and enable molecular imaging of cancer biomarkers.

Prostate cancer characterization by optical contrast enhanced photoacoustics

During the past decades, prostate cancer (PCa), with an annual incident rate much higher than any other cancer, is the most commonly diagnosed cancer in American men. PCa has a relatively low progression rate yet the survival percentage decreases dramatically once the cancer has metastasized. Identifying aggressive from indolent PCa to prevent metastasis and death is critical to improve outcomes for patients with PCa. Standard procedure for assessing the aggressiveness of PCa involves the removal of tumor tissues by transrectal (TR) ultrasound (US) guided needle biopsy. The microscopic architecture of the biopsied tissue is visualized by histological or immunohistochemical staining procedures. The heterogeneity of the microscopic architecture is characterized by a Gleason score, a quantitative description of the aggressiveness of PCa. Due to the inability to identify the cancer cells, most noninvasive imaging modalities can only provide diagnosis of PCa at limited accuracy. This study investigates the feasibility of identifying PCa tumors and characterizing the aggressiveness of PCa by photoacoustic imaging assisted by cancer targeting polyacrylamide (PAA) nanoparticles (NPs). PAA is a biocompatible material used in clinics for the past 20 years. PAA NPs can protect capsulated optical contrast agents from interference by enzymes and enable prolonged systematic circulation in the living biological environment. The cancer targeting mechanism is achieved by conjugating the NPs to F3 peptides, which trace nucleolin overexpressed on the surface of cancer cells. Preliminary studies have shown that the NPs are capable of staining the PCa cells in vivo.