Detecting joint inflammation by an LED-based photoacoustic imaging system: a feasibility study

SwinDAF3D: Pyramid Swin Transformers with Deep Attentive Features for Automated Finger Joint Segmentation in 3D Ultrasound Images for Rheumatoid Arthritis Assessment

Rheumatoid arthritis (RA) is a chronic autoimmune disease that can cause severe joint damage and functional impairment. Ultrasound imaging has shown promise in providing real-time assessment of synovium inflammation associated with the early stages of RA. Accurate segmentation of the synovium region and quantification of inflammation-specific imaging biomarkers are crucial for assessing and grading RA. However, automatic segmentation of the synovium in 3D ultrasound is challenging due to ambiguous boundaries, variability in synovium shape, and inhomogeneous intensity distribution. In this work, we introduce a novel network architecture, Swin Transformers with Deep Attentive Features for 3D segmentation (SwinDAF3D), which integrates Swin Transformers into a Deep Attentive Features framework. The developed architecture leverages the hierarchical structure and shifted windows of Swin Transformers to capture rich, multi-scale and attentive contextual information, improving the modeling of long-range dependencies and spatial hierarchies in 3D ultrasound images. In a six-fold cross-validation study with 3D ultrasound images of RA patients' finger joints (n = 72), our SwinDAF3D model achieved the highest performance with a Dice Score (DSC) of 0.838 ± 0.013, an Intersection over Union (IoU) of 0.719 ± 0.019, and Surface Dice Score (SDSC) of 0.852 ± 0.020, compared to 3D UNet (DSC: 0.742 ± 0.025; IoU: 0.589 ± 0.031; SDSC: 0.661 ± 0.029), DAF3D (DSC: 0.813 ± 0.017; IoU: 0.689 ± 0.022; SDSC: 0.817 ± 0.013), Swin UNETR (DSC: 0.808 ± 0.025; IoU: 0.678 ± 0.032; SDSC: 0.822 ± 0.039), UNETR++ (DSC: 0.810 ± 0.014; IoU: 0.684 ± 0.018; SDSC: 0.829 ± 0.027) and TransUNet (DSC: 0.818 ± 0.013; IoU: 0.692 ± 0.017; SDSC: 0.815 ± 0.016) models. This ablation study demonstrates the effectiveness of combining a Swin Transformers feature pyramid with a deep attention mechanism, improving the segmentation accuracy of the synovium in 3D ultrasound. This advancement shows great promise in enabling more efficient and standardized RA screening using ultrasound imaging.

Automated Deep Learning-Based Finger Joint Segmentation in 3-D Ultrasound Images With Limited Dataset

Ultrasound imaging has shown promise in assessing synovium inflammation associated early stages of rheumatoid arthritis (RA). The precise identification of the synovium and the quantification of inflammation-specific imaging biomarkers is a crucial aspect of accurately quantifying and grading RA. In this study, a deep learning-based approach is presented that automates the segmentation of the synovium in ultrasound images of finger joints affected by RA. Two convolutional neural network architectures for image segmentation were trained and validated in a limited number of 2-D images, extracted from N = 18 3-D ultrasound volumes acquired from N = 9 RA patients, with sparse ground truth annotations of the synovium. Various augmentation strategies were employed to enhance the diversity and size of the training dataset. The utilization of geometric and noise augmentation transforms resulted in the highest dice score (0.768 ± 0 . 031 , N = 6 ) , and intersection over union ( 0 . 624 ± 0.040, N = 6), as determined via six-fold cross-validation. In addition, the segmentation model is used to generate dense 3-D segmentation maps in the ultrasound volumes, based on the available sparse annotations. The developed technique shows promise in facilitating more efficient and standardized workflow for RA screening using ultrasound imaging.

An Automatic 3-D Ultrasound and Photoacoustic Combined Imaging System for Human Inflammatory Arthritis

Aiming at a point-of-care device for rheumatology clinics, we developed an automatic 3-D imaging system combining the emerging photoacoustic (PA) imaging with conventional Doppler ultrasound (US) for detecting human inflammatory arthritis. This system is based on a commercial-grade GE HealthCare (GEHC, Chicago, IL, USA) Vivid E95 US machine and a Universal Robot UR3 robotic arm. This system automatically locates the patient's finger joints from a photograph taken by an overhead camera powered by an automatic hand joint identification method, followed by the robotic arm moving the imaging probe to the targeted joint to scan and obtain 3-D PA and Doppler US images. The GEHC US machine was modified to enable high-speed, high-resolution PA imaging while maintaining the features available on the system. The commercial-grade image quality and the high sensitivity in detecting inflammation in peripheral joints via PA technology hold great potential to significantly benefit clinical care of inflammatory arthritis in a novel way.

Photoacoustic imaging on its way toward clinical utility: a tutorial review focusing on practical application in medicine

Significance

Photoacoustic imaging (PAI) enables the visualization of optical contrast with ultrasonic imaging. It is a field of intense research, with great promise for clinical application. Understanding the principles of PAI is important for engineering research and image interpretation.

Aim

In this tutorial review, we lay out the imaging physics, instrumentation requirements, standardization, and some practical examples for (junior) researchers, who have an interest in developing PAI systems and applications for clinical translation or applying PAI in clinical research.

Approach

We discuss PAI principles and implementation in a shared context, emphasizing technical solutions that are amenable to broad clinical deployment, considering factors such as robustness, mobility, and cost in addition to image quality and quantification.

Results

Photoacoustics, capitalizing on endogenous contrast or administered contrast agents that are approved for human use, yields highly informative images in clinical settings, which can support diagnosis and interventions in the future.

Conclusion

PAI offers unique image contrast that has been demonstrated in a broad set of clinical scenarios. The transition of PAI from a "nice-to-have" to a "need-to-have" modality will require dedicated clinical studies that evaluate therapeutic decision-making based on PAI and consideration of the actual value for patients and clinicians, compared with the associated cost.

Niche preclinical and clinical applications of photoacoustic imaging with endogenous contrast

In the past decade, photoacoustic (PA) imaging has attracted a great deal of popularity as an emergent diagnostic technology owing to its successful demonstration in both preclinical and clinical arenas by various academic and industrial research groups. Such steady growth of PA imaging can mainly be attributed to its salient features, including being non-ionizing, cost-effective, easily deployable, and having sufficient axial, lateral, and temporal resolutions for resolving various tissue characteristics and assessing the therapeutic efficacy. In addition, PA imaging can easily be integrated with the ultrasound imaging systems, the combination of which confers the ability to co-register and cross-reference various features in the structural, functional, and molecular imaging regimes. PA imaging relies on either an endogenous source of contrast (e.g., hemoglobin) or those of an exogenous nature such as nano-sized tunable optical absorbers or dyes that may boost imaging contrast beyond that provided by the endogenous sources. In this review, we discuss the applications of PA imaging with endogenous contrast as they pertain to clinically relevant niches, including tissue characterization, cancer diagnostics/therapies (termed as theranostics), cardiovascular applications, and surgical applications. We believe that PA imaging's role as a facile indicator of several disease-relevant states will continue to expand and evolve as it is adopted by an increasing number of research laboratories and clinics worldwide.

Photoacoustic clinical applications: Musculoskeletal and abdominal imaging

Photoacoustic (PA) imaging has been extensively investigated in application in biomedicine over the last decade. This article reviews the motivation, significance, and system configuration of a few ongoing studies of implementing photoacoustic technology in musculoskeletal imaging, abdominal imaging, and interstitial sensing. The review then summarizes the methodologies and latest progress of relevant projects. Finally, we discuss our expectations for the future of translation research in PA imaging.

Photoacoustic Imaging and Characterization of Bone in Medicine: Overview, Applications, and Outlook

Photoacoustic techniques have shown promise in identifying molecular changes in bone tissue and visualizing tissue microstructure. This capability represents significant advantages over gold standards (i.e., dual-energy X-ray absorptiometry) for bone evaluation without requiring ionizing radiation. Instead, photoacoustic imaging uses light to penetrate through bone, followed by acoustic pressure generation, resulting in highly sensitive optical absorption contrast in deep biological tissues. This review covers multiple bone-related photoacoustic imaging contributions to clinical applications, spanning bone cancer, joint pathologies, spinal disorders, osteoporosis, bone-related surgical guidance, consolidation monitoring, and transsphenoidal and transcranial imaging. We also present a summary of photoacoustic-based techniques for characterizing biomechanical properties of bone, including temperature, guided waves, spectral parameters, and spectroscopy. We conclude with a future outlook based on the current state of technological developments, recent achievements, and possible new directions.

Longitudinal volumetric assessment of inflammatory arthritis via photoacoustic imaging and Doppler ultrasound imaging

Aiming at clinical translation, we developed an automatic 3D imaging system combining the emerging photoacoustic imaging with conventional Doppler ultrasound for detecting inflammatory arthritis. This system was built with a GE HealthCare (GEHC) Vivid™ E95 ultrasound system and a Universal Robot UR3 robotic arm. In this work, the performance of this system was examined with a longitudinal study utilizing a clinically relevant adjuvant induced arthritis (AIA) murine model. After adjuvant injection, daily imaging of the rat ankle joints was conducted until joint inflammation was obvious based on visual inspection. Processed imaging results and statistical analyses indicated that both the hyperemia (enhanced blood volume) detected by photoacoustic imaging and the enhanced blood flow detected by Doppler ultrasound reflected the progress of joint inflammation. However, photoacoustic imaging, by leveraging the highly sensitive optical contrast, detected inflammation earlier than Doppler ultrasound, and also showed changes that are more statistically significant. This side-by-side comparison between photoacoustic imaging and Doppler ultrasound using the same commercial grade GEHC ultrasound machine demonstrates the advantage and potential value of the emerging photoacoustic imaging for rheumatology clinical care of arthritis.

Photoacoustic Imaging of COVID-19 Vaccine Site Inflammation of Autoimmune Disease Patients

Based on the observations made in rheumatology clinics, autoimmune disease (AD) patients on immunosuppressive (IS) medications have variable vaccine site inflammation responses, whose study may help predict the long-term efficacy of the vaccine in this at-risk population. However, the quantitative assessment of the inflammation of the vaccine site is technically challenging. In this study analyzing AD patients on IS medications and normal control subjects, we imaged the inflammation of the vaccine site 24 h after mRNA COVID-19 vaccinations were administered using both the emerging photoacoustic imaging (PAI) method and the established Doppler ultrasound (US) method. A total of 15 subjects were involved, including 6 AD patients on IS and 9 normal control subjects, and the results from the two groups were compared. Compared to the results obtained from the control subjects, the AD patients on IS medications showed statistically significant reductions in vaccine site inflammation, indicating that immunosuppressed AD patients also experience local inflammation after mRNA vaccination but not in as clinically apparent of a manner when compared to non-immunosuppressed non-AD individuals. Both PAI and Doppler US were able to detect mRNA COVID-19 vaccine-induced local inflammation. PAI, based on the optical absorption contrast, shows better sensitivity in assessing and quantifying the spatially distributed inflammation in soft tissues at the vaccine site.

LED-based photoacoustic imaging for preoperative visualization of lymphatic vessels in patients with secondary limb lymphedema

Lymphedema is the accumulation of protein-rich fluid in the interstitium (i.e., dermal backflow (DBF)). Preoperative imaging of the lymphatic vessels is a prerequisite for lymphovenous bypass surgical planning. We investigated the visualization of lymphatic vessels and veins using light-emitting diode (LED)-based photoacoustic imaging (PAI). Indocyanine-green mediated near-infrared fluorescence lymphography (NIRF-L) was done in fifteen patients with secondary limb lymphedema. Photoacoustic images were acquired in locations where lymphatic vessels and DBF were observed with NIRF-L. We demonstrated that LED-based PAI can visualize and differentiate lymphatic vessels and veins even in the presence of DBF. We observed lymphatic and blood vessels up to depths of 8.3 and 8.6 mm, respectively. Superficial lymphatic vessels and veins can be visualized using LED-based PAI even in the presence of DBF showing the potential for pre-operative assessment. Further development of the technique is needed to improve its usability in clinical settings.

Synovial Oxygenation at Photoacoustic Imaging to Assess Rheumatoid Arthritis Disease Activity

Background Synovial hypoxia is a hallmark of rheumatoid arthritis (RA). Photoacoustic (PA) imaging, based on the use of laser-generated US, can detect the oxygenation status of tissue in individuals with RA. However, large studies are lacking, with few investigating the correlation between oxygenation status and disease activity. Purpose To measure synovial oxygenation status in participants with RA by using a multimodal PA US imaging system and to determine the correlation between PA imaging-measured oxygen saturation (SO₂) and disease activity. Materials and Methods In this prospective observational cohort study, multimodal PA US imaging examinations were performed on small joints of consecutive participants with RA, who were treated at two outpatient rheumatology clinics from 2019 to 2021, and healthy controls. The SO₂ values of the synovium were measured with dual-wavelength PA imaging and classified into three categories-hyperoxia, intermediate oxygenation status, or hypoxia-based on the signal coloration and clustering analysis of the SO₂ values. The correlations of oxygenation status with power Doppler US (PDUS) scoring and clinical disease activity index were evaluated with one-way analysis of variance and the Kruskal-Wallis test with Bonferroni correction. Results A total of 118 participants with RA (median age, 55 years [IQR, 41-62 years]; 92 women) and 15 healthy control participants (median age, 37 years [IQR, 33-41 years]; 11 women) were included. The wrist synovium was categorized as hyperoxic in 36 participants with RA, of intermediate oxygenation status in 48 participants, and hypoxic in 34 participants. All control participants had hyperoxic synovial tissues. For participants with RA, hyperoxic synovium had more affluent Doppler US-depicted vasculature than those with hypoxia and intermediate oxygenation status (mean PDUS grade: hyperoxia, 2.7 ± 0.6 [SD]; intermediate, 1.3 ± 0.7; hypoxia, 1.1 ± 0.8; P < .001). Participants with intermediate status synovium had a lower clinical disease activity index than those with hypoxia (intermediate, 11.0 [IQR, 5.0-21.5] vs hypoxia, 26.0 [IQR, 18.0-39.0]; P = .001). Conclusion Photoacoustic imaging-detected hypoxia in thickened synovium correlated with less vascularization and higher disease activity in participants with rheumatoid arthritis. Clinical trial registration no. NCT04297475 © RSNA, 2022 Online supplemental material is available for this article.

Spatiotemporal singular value decomposition for denoising in photoacoustic imaging with a low-energy excitation light source

Photoacoustic (PA) imaging is an emerging hybrid imaging modality that combines rich optical spectroscopic contrast and high ultrasonic resolution, and thus holds tremendous promise for a wide range of pre-clinical and clinical applications. Compact and affordable light sources such as light-emitting diodes (LEDs) and laser diodes (LDs) are promising alternatives to bulky and expensive solid-state laser systems that are commonly used as PA light sources. These could accelerate the clinical translation of PA technology. However, PA signals generated with these light sources are readily degraded by noise due to the low optical fluence, leading to decreased signal-to-noise ratio (SNR) in PA images. In this work, a spatiotemporal singular value decomposition (SVD) based PA denoising method was investigated for these light sources that usually have low fluence and high repetition rates. The proposed method leverages both spatial and temporal correlations between radiofrequency (RF) data frames. Validation was performed on simulations and in vivo PA data acquired from human fingers (2D) and forearm (3D) using a LED-based system. Spatiotemporal SVD greatly enhanced the PA signals of blood vessels corrupted by noise while preserving a high temporal resolution to slow motions, improving the SNR of in vivo PA images by 90.3%, 56.0%, and 187.4% compared to single frame-based wavelet denoising, averaging across 200 frames, and single frame without denoising, respectively. With a fast processing time of SVD (∼50 µs per frame), the proposed method is well suited to PA imaging systems with low-energy excitation light sources for real-time in vivo applications.

Biomedical Application of Photoacoustics: A Plethora of Opportunities

The photoacoustic (PA) technique is a non-invasive, non-ionizing hybrid technique that exploits laser irradiation for sample excitation and acquires an ultrasound signal generated due to thermoelastic expansion of the sample. Being a hybrid technique, PA possesses the inherent advantages of conventional optical (high resolution) and ultrasonic (high depth of penetration in biological tissue) techniques and eliminates some of the major limitations of these conventional techniques. Hence, PA has been employed for different biomedical applications. In this review, we first discuss the basic physics of PA. Then, we discuss different aspects of PA techniques, which includes PA imaging and also PA frequency spectral analysis. The theory of PA signal generation, detection and analysis is also detailed in this work. Later, we also discuss the major biomedical application area of PA technique.

A Novel Matching Layer Design for Improving the Performance of Transparent Ultrasound Transducers

Transparent ultrasound transducer (TUT) technology allows easy co-alignment of optical and acoustic beams in the development of compact photoacoustic imaging (PAI) devices with minimum acoustic coupling. However, TUTs suffer from narrow bandwidth and low pulse-echo sensitivity due to the lack of suitable transparent acoustic matching and backing layers. Here, we studied translucent glass beads (GB) in transparent epoxy as an acoustic matching layer for the transparent lithium niobate piezoelectric material-based TUTs (LN-TUTs). The acoustic and optical properties of various volume fractions of GB matching layers were studied using theoretical calculations, simulations, and experiments. These results demonstrated that the GB matching layer has significantly enhanced the pulse-echo sensitivity and bandwidth of the TUTs. Moreover, the GB matching layer served as a light diffuser to help achieve uniform optical fluence on the tissue surface and also improved the photoacoustic (PA) signal bandwidth. The proposed GB matching layer fabrication is low cost, easy to manufacture using conventional ultrasound transducer fabrication tools, acoustically compatible with soft tissue, and minimizes the use of the acoustic coupling medium.

Deep learning for biomedical photoacoustic imaging: A review

Photoacoustic imaging (PAI) is a promising emerging imaging modality that enables spatially resolved imaging of optical tissue properties up to several centimeters deep in tissue, creating the potential for numerous exciting clinical applications. However, extraction of relevant tissue parameters from the raw data requires the solving of inverse image reconstruction problems, which have proven extremely difficult to solve. The application of deep learning methods has recently exploded in popularity, leading to impressive successes in the context of medical imaging and also finding first use in the field of PAI. Deep learning methods possess unique advantages that can facilitate the clinical translation of PAI, such as extremely fast computation times and the fact that they can be adapted to any given problem. In this review, we examine the current state of the art regarding deep learning in PAI and identify potential directions of research that will help to reach the goal of clinical applicability.

Photoacoustic Imaging of Human Vasculature Using LED versus Laser Illumination: A Comparison Study on Tissue Phantoms and In Vivo Humans

Vascular diseases are becoming an epidemic with an increasing aging population and increases in obesity and type II diabetes. Point-of-care (POC) diagnosis and monitoring of vascular diseases is an unmet medical need. Photoacoustic imaging (PAI) provides label-free multiparametric information of deep vasculature based on strong absorption of light photons by hemoglobin molecules. However, conventional PAI systems use bulky nanosecond lasers which hinders POC applications. Recently, light-emitting diodes (LEDs) have emerged as cost-effective and portable optical sources for the PAI of living subjects. However, state-of-art LED arrays carry significantly lower optical energy (<0.5 mJ/pulse) and high pulse repetition frequencies (PRFs) (4 KHz) compared to the high-power laser sources (100 mJ/pulse) with low PRFs of 10 Hz. Given these tradeoffs between portability, cost, optical energy and frame rate, this work systematically studies the deep tissue PAI performance of LED and laser illuminations to help select a suitable source for a given biomedical application. To draw a fair comparison, we developed a fiberoptic array that delivers laser illumination similar to the LED array and uses the same ultrasound transducer and data acquisition platform for PAI with these two illuminations. Several controlled studies on tissue phantoms demonstrated that portable LED arrays with high frame averaging show higher signal-to-noise ratios (SNRs) of up to 30 mm depth, and the high-energy laser source was found to be more effective for imaging depths greater than 30 mm at similar frame rates. Label-free in vivo imaging of human hand vasculature studies further confirmed that the vascular contrast from LED-PAI is similar to laser-PAI for up to 2 cm depths. Therefore, LED-PAI systems have strong potential to be a mobile health care technology for diagnosing vascular diseases such as peripheral arterial disease and stroke in POC and resource poor settings.

Imaging of enthesitis by an LED-based photoacoustic system

SIGNIFICANCE

One key pathological characteristic of seronegative spondyloarthropathy (SpA) is inflammation at the insertion of tendons and ligaments into the bone (enthesitis).

AIM

We explore the potential of the emerging photoacoustic (PA) imaging in diagnosis of SpA and review its feasibility in detecting SpA-associated Achilles tendon enthesitis.

APPROACH

A light-emitting diode (LED)-based PA and ultrasound combined system was employed. The PA images, both along the long and the short axes of each Achilles tendon insertion region, were acquired at 850-nm wavelength, which is sensitive in depicting increased blood volume (i.e., hyperemia). To assess the hyperemia indicating enthesis inflammation, two parameters were quantified in the imaged tendons, including the average intensity and the density of the color pixels in the pseudo-color PA images. Ten SpA patients, all of which met Assessment of SpA International Society (ASAS) criteria for SpA and were found to have Achilles enthesitis by clinical exam according to a board-certified rheumatologist, were included in the study.

RESULTS

The PA and Doppler ultrasound imaging of Achilles enthesitis resulting from these 10 SpA patients were compared to those from 10 healthy volunteers, leading to statistically significant differences (p  <  0.05) in the applied t-tests.

CONCLUSIONS

This preliminary clinical study suggests that the LED-based PA imaging holds a promise for sensitive and objective assessment of SpA enthesitis in an outpatient setting of the rheumatology clinic.

Portable and Affordable Light Source-Based Photoacoustic Tomography

Photoacoustic imaging is a hybrid imaging modality that offers the advantages of optical (spectroscopic contrast) and ultrasound imaging (scalable spatial resolution and imaging depth). This promising modality has shown excellent potential in a wide range of preclinical and clinical imaging and sensing applications. Even though photoacoustic imaging technology has matured in research settings, its clinical translation is not happening at the expected pace. One of the main reasons for this is the requirement of bulky and expensive pulsed lasers for excitation. To accelerate the clinical translation of photoacoustic imaging and explore its potential in resource-limited settings, it is of paramount importance to develop portable and affordable light sources that can be used as the excitation light source. In this review, we focus on the following aspects: (1) the basic theory of photoacoustic imaging; (2) inexpensive light sources and different implementations; and (3) important preclinical and clinical applications, demonstrated using affordable light source-based photoacoustics. The main focus will be on laser diodes and light-emitting diodes as they have demonstrated promise in photoacoustic tomography-the key technological developments in these areas will be thoroughly reviewed. We believe that this review will be a useful opus for both the beginners and experts in the field of biomedical photoacoustic imaging.

In Vivo Tumor Vascular Imaging with Light Emitting Diode-Based Photoacoustic Imaging System

Photoacoustic (PA) imaging has shown tremendous promise for imaging tumor vasculature and its function at deeper penetration depths without the use of exogenous contrast agents. Traditional PA imaging systems employ expensive and bulky class IV lasers with low pulse repetition rate, due to which its availability for preclinical cancer research is hampered. In this study, we evaluated the capability of a Light-Emitting Diode (LED)-based PA and ultrasound (US) imaging system for monitoring heterogeneous microvasculature in tumors (up to 10 mm in depth) and quantitatively compared the PA images with gold standard histology images. We used a combination of a 7 MHz linear array US transducer and 850 nm excitation wavelength LED arrays to image blood vessels in a subcutaneous tumor model. After imaging, the tumors were sectioned and stained for endothelial cells to correlate with PA images across similar cross-sections. Analysis of 30 regions of interest in tumors from different mice showed a statistically significant R-value of 0.84 where the areas with high blood vessel density had high PA response while low blood vessel density regions had low PA response. Our results confirm that LED-based PA and US imaging can provide 2D and 3D images of tumor vasculature and the potential it has as a valuable tool for preclinical cancer research.

Optimizing Irradiation Geometry in LED-Based Photoacoustic Imaging with 3D Printed Flexible and Modular Light Delivery System

Photoacoustic (PA) imaging–a technique combining the ability of optical imaging to probe functional properties of the tissue and deep structural imaging ability of ultrasound–has gained significant popularity in the past two decades for its utility in several biomedical applications. More recently, light-emitting diodes (LED) are being explored as an alternative to bulky and expensive laser systems used in PA imaging for their portability and low-cost. Due to the large beam divergence of LEDs compared to traditional laser beams, it is imperative to quantify the angular dependence of LED-based illumination and optimize its performance for imaging superficial or deep-seated lesions. A custom-built modular 3-D printed hinge system and tissue-mimicking phantoms with various absorption and scattering properties were used in this study to quantify the angular dependence of LED-based illumination. We also experimentally calculated the source divergence of the pulsed-LED arrays to be 58° ± 8°. Our results from point sources (pencil lead phantom) in non-scattering medium obey the cotangential relationship between the angle of irradiation and maximum PA intensity obtained at various imaging depths, as expected. Strong dependence on the angle of illumination at superficial depths (−5°/mm at 10 mm) was observed that becomes weaker at intermediate depths (−2.5°/mm at 20 mm) and negligible at deeper locations (−1.1°/mm at 30 mm). The results from the tissue-mimicking phantom in scattering media indicate that angles between 30–75° could be used for imaging lesions at various depths (12 mm–28 mm) where lower LED illumination angles (closer to being parallel to the imaging plane) are preferable for deep tissue imaging and superficial lesion imaging is possible with higher LED illumination angles (closer to being perpendicular to the imaging plane). Our results can serve as a priori knowledge for the future LED-based PA system designs employed for both preclinical and clinical applications.

An Automatic Unmixing Approach to Detect Tissue Chromophores from Multispectral Photoacoustic Imaging

Multispectral photoacoustic imaging has been widely explored as an emerging tool to visualize and quantify tissue chromophores noninvasively. This modality can capture the spectral absorption signature of prominent tissue chromophores, such as oxygenated, deoxygenated hemoglobin, and other biomarkers in the tissue by using spectral unmixing methods. Currently, most of the reported image processing algorithms use standard unmixing procedures, which include user interaction in the form of providing the expected spectral signatures. For translational research with patients, these types of supervised spectral unmixing can be challenging, as the spectral signature of the tissues can differ with respect to the disease condition. Imaging exogenous contrast agents and accessing their biodistribution can also be problematic, as some of the contrast agents are susceptible to change in spectral properties after the tissue interaction. In this work, we investigated the feasibility of an unsupervised spectral unmixing algorithm to detect and extract the tissue chromophores without any a-priori knowledge and user interaction. The algorithm has been optimized for multispectral photoacoustic imaging in the spectral range of 680-900 nm. The performance of the algorithm has been tested on simulated data, tissue-mimicking phantom, and also on the detection of exogenous contrast agents after the intravenous injection in mice. Our finding shows that the proposed automatic, unsupervised spectral unmixing method has great potential to extract and quantify the tissue chromophores, and this can be used in any wavelength range of the multispectral photoacoustic images.

Towards Clinical Translation of LED-Based Photoacoustic Imaging: A Review

Photoacoustic imaging, with the capability to provide simultaneous structural, functional, and molecular information, is one of the fastest growing biomedical imaging modalities of recent times. As a hybrid modality, it not only provides greater penetration depth than the purely optical imaging techniques, but also provides optical contrast of molecular components in the living tissue. Conventionally, photoacoustic imaging systems utilize bulky and expensive class IV lasers, which is one of the key factors hindering the clinical translation of this promising modality. Use of LEDs which are portable and affordable offers a unique opportunity to accelerate the clinical translation of photoacoustics. In this paper, we first review the development history of LED as an illumination source in biomedical photoacoustic imaging. Key developments in this area, from point-source measurements to development of high-power LED arrays, are briefly discussed. Finally, we thoroughly review multiple phantom, ex-vivo, animal in-vivo, human in-vivo, and clinical pilot studies and demonstrate the unprecedented preclinical and clinical potential of LED-based photoacoustic imaging.

Light-Emitting-Diode-Based Multispectral Photoacoustic Computed Tomography System

Photoacoustic computed tomography (PACT) has been widely explored for non-ionizing functional and molecular imaging of humans and small animals. In order for light to penetrate deep inside tissue, a bulky and high-cost tunable laser is typically used. Light-emitting diodes (LEDs) have recently emerged as cost-effective and portable alternative illumination sources for photoacoustic imaging. In this study, we have developed a portable, low-cost, five-dimensional (x, y, z, t, λ ) PACT system using multi-wavelength LED excitation to enable similar functional and molecular imaging capabilities as standard tunable lasers. Four LED arrays and a linear ultrasound transducer detector array are housed in a hollow cylindrical geometry that rotates 360 degrees to allow multiple projections through the subject of interest placed inside the cylinder. The structural, functional, and molecular imaging capabilities of the LED-PACT system are validated using various tissue-mimicking phantom studies. The axial, lateral, and elevational resolutions of the system at 2.3 cm depth are estimated as 0.12 mm, 0.3 mm, and 2.1 mm, respectively. Spectrally unmixed photoacoustic contrasts from tubes filled with oxy- and deoxy-hemoglobin, indocyanine green, methylene blue, and melanin molecules demonstrate the multispectral molecular imaging capabilities of the system. Human-finger-mimicking phantoms made of a bone and blood tubes show structural and functional oxygen saturation imaging capabilities. Together, these results demonstrate the potential of the proposed LED-based, low-cost, portable PACT system for pre-clinical and clinical applications.