Characterization of interventional photoacoustic imaging (iPAI) capabilities in biological tissues

Background Interventional photoacoustic imaging (iPAI) could improve ultrasound-guided minimally invasive procedures by enabling high precision needle steering, target detection, and molecular and physiologic tissue assessment. However, iPAI capabilities including visualization field, imaging depth, and spatial resolution are not well understood in biological tissues commonly encountered in clinical practice. Therefore, the potential clinical utility of iPAI remains unclear. We aim to experimentally determine iPAI capabilities in a variety of biological tissues, to assess its potential for clinical translation. Methods We constructed an iPAI system capable of simultaneous real-time ultrasound (US) and photoacoustic imaging. This system delivers light directly into tissues using optical fiber integrated into a 16-gauge needle and detects photoacoustic signals with an external linear array ultrasound probe. iPAI's geometric visualization field, maximum imaging depth, and spatial resolution were experimentally determined in fat, muscle, kidney, and liver tissues by processing photoacoustic signal intensities of reference targets placed circumferentially around the fiber tip. The maximum detection depths of blood and indocyanine green (ICG), important common endogenous and exogenous contrast agents, respectively, were estimated in each tissue type by comparing their signal intensities with the reference target signal. Results iPAI could be performed in real-time concurrently with US and achieved a nearly spherical visualization field centering around the optical fiber tip in all tissues. Maximum imaging depths from the fiber tip were 54.1 +/- 1.3, 50.0 +/- 1.5, 32.7 +/- 1.1, and 16.9 +/- 1.3 mm in fat, muscle, kidney, and liver tissues, respectively. Calculated maximum detection depths for blood were 41.5 +/- 3.0, 39.5 +/- 2.1, 24.4 +/- 4.0, and 8.6 +/- 2.0 mm and detection depths for ICG at 0.05 mg/mL concentration were 46.6 +/- 2.5, 42.6 +/- 1.4, 28.2 +/- 3.9, and 12.1 +/- 1.5 mm in fat, muscle, kidney, and liver, respectively. Sub-100 mu m axial resolution and submillimeter lateral resolution were achieved in all tissues, and resolution did not significantly vary with distance from the fiber tip. Conclusions Interventional photoacoustic imaging (iPAI) allows real-time visualization of a circumferential volume of tissue around an optical fiber tip, with submillimeter spatial resolution and tissue-dependent imaging depth. Our data strongly support further development of clinical iPAI systems as they could improve needle steering, target detection, and molecular and physiologic tissue assessment during minimally invasive procedures.

Automated summary

Interventional photoacoustic imaging (iPAI) has the potential to improve needle steering, target detection, and tissue assessment during minimally invasive procedures by enabling high precision imaging depth, spatial resolution, and visualization field in various biological tissues encountered in clinical practice. The experimental results strongly support further development of clinical iPAI systems for potential translation into clinical settings.