Abstract
High-frequency ultrasound imaging can provide exquisite visualizations of tissue to guide minimally invasive procedures. Here, we demonstrate that an all-optical ultrasound transducer, through which light guided by optical fibers is used to generate and receive ultrasound, is suitable for real-time invasive medical imaging in vivo. Broad-bandwidth ultrasound generation was achieved through the photoacoustic excitation of a multiwalled carbon nanotube-polydimethylsiloxane composite coating on the distal end of a 300-μm multi-mode optical fiber by a pulsed laser. The interrogation of a high-finesse Fabry–Pérot cavity on a single-mode optical fiber by a wavelength-tunable continuous-wave laser was applied for ultrasound reception. This transducer was integrated within a custom inner transseptal needle (diameter 1.08 mm; length 78 cm) that included a metallic septum to acoustically isolate the two optical fibers. The use of this needle within the beating heart of a pig provided unprecedented real-time views (50 Hz scan rate) of cardiac tissue (depth: 2.5 cm; axial resolution: 64 μm) and revealed the critical anatomical structures required to safely perform a transseptal crossing: the right and left atrial walls, the right atrial appendage, and the limbus fossae ovalis. This new paradigm will allow ultrasound imaging to be integrated into a broad range of minimally invasive devices in different clinical contexts.
Highlights
High-frequency ultrasound imaging can provide an exquisite visualization of tissue to guide minimally invasive procedures, but it remains severely underutilized in clinical practice
The fiber-optic ultrasound generator with a multiwalled carbon nanotube (MWCNT)-PDMS coating developed by Colchester et al.[13] used for benchtop all-optical ultrasound imaging with synthetic aperture reconstruction generated a peak-to-peak pressure level of 1.96 MPa at 1.5 mm, a − 6 dB bandwidth of 15 MHz, and an angular divergence (FWHM) of 29°
In summary, we present a novel platform for performing pulse-echo ultrasound imaging using fiber optics integrated within a clinical needle through the photoacoustic excitation of a nanocomposite coating for generation and a high-finesse Fabry–Pérot cavity for reception
Summary
High-frequency ultrasound imaging can provide an exquisite visualization of tissue to guide minimally invasive procedures, but it remains severely underutilized in clinical practice. Higher levels of spatial resolution are achieved at the expense of imaging depth, so the integration of ultrasound transducers into medical devices is often required to visualize tissue microstructures from within the body. We demonstrate that all-optical ultrasound transducers can provide real-time interventional imaging to guide minimally invasive procedures. To bring all-optical ultrasound imaging to a point of clinical utility, three advances were required: sufficient sensitivity to reflected ultrasound to provide soft-tissue contrast at centimeter-scale depths in the presence of tissue and device motion; the integration of sensing elements into devices in a manner that preserves current clinical workflows; and an in vivo demonstration through which clinically relevant information can be acquired. We are the first to report the successful attainment of these requirements
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