Photoacoustic Monitoring Research Articles

Responsive Theranostic Nanoprobe for Ratiometric Photoacoustic Monitoring of Hypochlorous Acid‐Mediated Inflammation in Cancer Photothermal Therapy

AbstractCancer detection and inflammation monitoring during photothermal therapy (PTT) enable timely cancer intervention and precise inflammation control, advancing to address inflammation‐related tumor recurrence and metastasis associated with PTT. This can be achieved through real‐time monitoring biomarker for cancer and inflammation, like hypochlorous acid (HOCl), a highly reactive oxygen species (hROS) in body with elevated levels in inflammation. Here, a HOCl‐responsive theranostic nanoprobe is introduced, AuNRs@SiO2‐CAA for ratiometric photoacoustic (PA) cancer detection and inflammation monitoring during PTT. AuNRs@SiO2‐CAA emits PA signals at 680 and 820 nm, with only PA680 undergoing changes in the presence of HOCl, enabling precise HOCl imaging via recording changes of ratiometric PA signals (PA680/PA820). AuNRs@SiO2‐CAA exhibits high selectivity and sensitivity, with a detection limit of 0.34 µM for ratiometric PA imaging of HOCl. In vivo, it effectively detects tumor, drives PTT, and monitors inflammation during PTT by sensing HOCl. The successful development of AuNRs@SiO2‐CAA offers a novel theranostic nanoprobe system for cancer diagnosis, poised to enhance PTT through precise inflammation control.

Review on Photoacoustic Monitoring after Drug Delivery: From Label-Free Biomarkers to Pharmacokinetics Agents.

Photoacoustic imaging (PAI) is an emerging noninvasive and label-free method for capturing the vasculature, hemodynamics, and physiological responses following drug delivery. PAI combines the advantages of optical and acoustic imaging to provide high-resolution images with multiparametric information. In recent decades, PAI's abilities have been used to determine reactivity after the administration of various drugs. This study investigates photoacoustic imaging as a label-free method of monitoring drug delivery responses by observing changes in the vascular system and oxygen saturation levels across various biological tissues. In addition, we discuss photoacoustic studies that monitor the biodistribution and pharmacokinetics of exogenous contrast agents, offering contrast-enhanced imaging of diseased regions. Finally, we demonstrate the crucial role of photoacoustic imaging in understanding drug delivery mechanisms and treatment processes.

In Vivo Photoacoustic Monitoring of Stem Cell Location and Apoptosis with Caspase-3-Responsive Nanosensors.

Stem cell therapy has immense potential in a variety of regenerative medicine applications. However, clinical stem cell therapy is severely limited by challenges in assessing the location and functional status of implanted cells in vivo. Thus, there is a great need for longitudinal, noninvasive stem cell monitoring. Here we introduce a multidisciplinary approach combining nanosensor-augmented stem cell labeling with ultrasound guided photoacoustic (US/PA) imaging for the spatial tracking and functional assessment of transplanted stem cell fate. Specifically, our nanosensor incorporates a peptide sequence that is selectively cleaved by caspase-3, the primary effector enzyme in mammalian cell apoptosis; this cleavage event causes labeled cells to show enhanced optical absorption in the first near-infrared (NIR) window. Optimization of labeling protocols and spectral characterization of the nanosensor in vitro showed a 2.4-fold increase in PA signal from labeled cells during apoptosis while simultaneously permitting cell localization. We then successfully tracked the location and apoptotic status of mesenchymal stem cells in a mouse hindlimb ischemia model for 2 weeks in vivo, demonstrating a 4.8-fold increase in PA signal and spectral slope changes in the first NIR window under proapoptotic (ischemic) conditions. We conclude that our nanosensor allows longitudinal, noninvasive, and nonionizing monitoring of stem cell location and apoptosis, which is a significant improvement over current end-point monitoring methods such as biopsies and histological staining of excised tissue.

Photoacoustic real-time monitoring of UV laser ablation of aged varnish coatings on heritage objects

A novel, simple and non-invasive diagnostic methodology is presented herein, as an effective approach to monitor in real-time the UV laser-assisted thinning of aged varnished coatings from heritage objects, using the acoustic signals generated upon light interaction with matter. Detection of the photoacoustic (PA) signals is realized by means of a non-contact air-coupled ultrasonic transducer with a frequency response in the MHz regime. This proposed statistical approach utilizes the information the PA signals provide during the laser ablation process, embedded in their temporal delay and amplitude reduction during varnish removal. Based on the cross-correlation of the PA signals, this monitoring technique determines the critical laser pulse, responsible for complete varnish removal. The efficiency of our methodology has been examined on a series of aged varnish mock-ups on different substrates. The laser treated surfaces were further assessed using various techniques, in order to confirm the results of our PA monitoring strategy. Application of this technique is aimed at validating its potential and suitability in addressing different varnish cleaning challenges. Based on previous encouraging results on encrusted stonework, primary objective of this study is to establish the PA monitoring methodology as an essential, real-time monitoring tool for controlled laser ablation of aged varnish coatings from heritage surfaces (paintings, metallic objects, wall paintings etc.), ensuring their efficient removal while preserving the integrity of the objects. Implementation of the PA technique may pave the way for numerous applications as regards the reliable monitoring of removing unwanted layers from various surfaces of interest.

In vivo photoacoustic monitoring of vasoconstriction induced by acute hyperglycemia

Postprandial hyperglycemia, blood glucose spikes, induces endothelial dysfunction, increasing cardiovascular risks. Endothelial dysfunction leads to vasoconstriction, and observation of this phenomenon is important for understanding acute hyperglycemia. However, high-resolution imaging of microvessels during acute hyperglycemia has not been fully developed. Here, we demonstrate that photoacoustic microscopy can noninvasively monitor morphological changes in blood vessels of live animals’ extremities when blood glucose rises rapidly. As blood glucose level rose from 100 to 400 mg/dL following intraperitoneal glucose injection, heart/breath rate, and body temperature remained constant, but arterioles constricted by approximately –5.7 ± 1.1% within 20 min, and gradually recovered for another 40 min. In contrast, venular diameters remained within about 0.6 ± 1.5% during arteriolar constriction. Our results experimentally and statistically demonstrate that acute hyperglycemia produces transitory vasoconstriction in arterioles, with an opposite trend of change in blood glucose. These findings could help understanding vascular glucose homeostasis and the relationship between diabetes and cardiovascular diseases.

In vivo quantitative photoacoustic monitoring of corticosteroid-induced vasoconstriction.

Corticosteroids-commonly prescribed medications for skin diseases-inhibit the secretion of vasodilators, such as prostaglandin, thereby exerting anti-inflammatory action by constricting capillaries in the dermis. The effectiveness of corticosteroids is determined by the degree of vasoconstriction followed by skin whitening, namely, the blanching effect. However, the current method of observing the blanching effect indirectly evaluates the effects of corticosteroids. In this study, we employed optical-resolution photoacoustic (PA) microscopy (OR-PAM) to directly visualize the blood vessels and quantitatively evaluate vasoconstriction. Using OR-PAM, the vascular density in mice skin was monitored for 60min after performing each experimental procedure for four groups, and the vasoconstriction was quantified. Volumetric PA data were segmented into the papillary dermis, reticular dermis, and hypodermis based on the vascular characteristics obtained through OR-PAM. The vasoconstrictive effect of each skin layer was quantified according to the dermatological treatment method. In the case of corticosteroid topical application, vasoconstriction was observed in the papillary ( ) and reticular ( ) dermis. For corticosteroid subcutaneous injection, constriction was observed solely in the reticular ( ) dermis. In contrast, no vasoconstrictions were observed with nonsteroidal topical application. Our results indicate that OR-PAM can quantitatively monitor the vasoconstriction induced by corticosteroids, thereby validating OR-PAMs potential as a practical evaluation tool for predicting the effectiveness of corticosteroids in dermatology.

Recent Advances in Photoacoustic Agents for Theranostic Applications.

Photoacoustic agents are widely used in various theranostic applications. By evaluating the biodistribution obtained from photoacoustic images, the effectiveness of theranostic agents in terms of their delivery efficiency and treatment responses can be analyzed. Through this study, we evaluate and summarize the recent advances in photoacoustic-guided phototherapy, particularly in photothermal and photodynamic therapy. This overview can guide the future directions for theranostic development. Because of the recent applications of photoacoustic imaging in clinical trials, theranostic agents with photoacoustic monitoring have the potential to be translated into the clinical world.

Supramolecular Loading of DNA Hydrogels with Dye-Drug Conjugates for Real-Time Photoacoustic Monitoring of Chemotherapy.

A longstanding problem with conventional cancer therapy is the nonspecific distribution of chemotherapeutics. Monitoring drug release in vivo via noninvasive bioimaging can thus have value, but it is difficult to distinguish loaded from released drug in live tissue. Here, this work describes an injectable supramolecular hydrogel that allows slow and trackable release of doxorubicin (Dox) via photoacoustic (PA) tomography. Doxis covalently linked with photoacoustic methylene blue (MB) to monitor Doxbefore, during, and after release from the hydrogel carrier. The conjugate (MB-Dox) possesses an IC50 of 161.4× 10-9 m against human ovarian carcinoma (SKOV3) cells and loads into a DNA-clad hydrogel with 91.3% loading efficiency due to MB-Dox's inherent intramolecular affinity to DNA. The hydrogel is biodegradable by nuclease digestion, which causes gradual release of MB-Dox. This release rate is tunable based on the wt% of the hydrogel. This hydrogel maintains distinct PA contrast on the order of days when injected in vivo and demonstrates activatable PA spectral shifts during hydrogel degradation. The released and loaded payload can be imaged relative to live tissue via PA and ultrasound signal being overlaid in real-time. The hydrogel slowed the rate of the murine intraperitoneal tumor growth 72.2% more than free Dox.

An artificial bone window for long-term photoacoustic monitoring of bone recovery.

Blood vessels that deliver nutrients and oxygen over the entire body is essential for bone homeostasis. Especially, for the bone recovery, long-term in vivo vascular imaging is desirable. Here, we propose an optical and ultrasonic transparent bone window, which allows repeated, chronic monitoring of bone angiogenesis in mouse tibia defect. A metal ring with an outer diameter of 2 mm and an inner diameter of 1 mm is bonded with a silicone-based polydimethylsiloxane (PDMS) film and cover the bone surface, which can effectively eliminate the inflammation caused by repeated wound opening before imaging. We make a bone defect model in mouse tibia, and employ an optical resolution photoacoustic microscopy (ORPAM) to provide a high-resolution, label-free, long-term, in vivo observation of the bone vascularization during the bone defect healing. The results suggest that the artificial bone window can remain stable for inspection and play positive role for bone repair.

Background-suppressed tumor-targeted photoacoustic imaging using bacterial carriers

Photoacoustic (PA) imaging offers promise for biomedical applications due to its ability to image deep within biological tissues while providing detailed molecular information; however, its detection sensitivity is limited by high background signals that arise from endogenous chromophores. Genetic reporter proteins with photoswitchable properties enable the removal of background signals through the subtraction of PA images for each light-absorbing form. Unfortunately, the application of photoswitchable chromoproteins for tumor-targeted imaging has been hampered by the lack of an effective targeted delivery scheme; that is, photoswitchable probes must be delivered invivo with high targeting efficiency and specificity. To overcome this limitation, we have developed a tumor-targeting delivery system in which tumor-homing bacteria (Escherichia coli) are exploited as carriers to affect the point-specific delivery of genetically encoded photochromic probes to the tumor area. To improve the efficiency of the desired background suppression, we engineered a phytochrome-based reporter protein (mDrBphP-PCMm/F469W) that displays higher photoswitching contrast than those in the current state of the art. Photoacoustic computed tomography was applied to achieve good depth and resolution in the context of invivo (mice) imaging. The present system effectively integrates a genetically encoded phytochrome-based reporter protein, PA imaging, and synthetic biology (GPS), to achieve essentially background-suppressed tumor-targeted PA monitoring in deep-seated tissues. The ability to image tumors at substantial depths may enable target-specific cancer diagnoses to be made with greater sensitivity, fidelity, and specificity.

Photoacoustic monitoring of angiogenesis predicts response to therapy in healing wounds.

Chronic wounds are a major health problem that cause the medical infrastructure billions of dollars every year. Chronic wounds are often difficult to heal and cause significant discomfort. Although wound specialists have numerous therapeutic modalities at their disposal, tools that could three dimensional-map wound bed physiology and guide therapy do not exist. Visual cues are the current standard but are limited to surface assessment; clinicians rely on experience to predict response to therapy. Photoacoustic (PA) ultrasound (US) is a non-invasive, hybrid imaging modality that can solve these major limitations. PA relies on the contrast generated by haemoglobin in blood which allows it to map local angiogenesis, tissue perfusion and oxygen saturation-all critical parameters for wound healing. This work evaluates the use of PA-US to monitor angiogenesis and stratify patients responding versus not-responding to therapy. We imaged 19 patients with 22 wounds once a week for at least 3 weeks. Our findings suggest that PA imaging directly visualises angiogenesis. Patients responding to therapy showed clear signs of angiogenesis and an increased rate of PA increase (p=0.002). These responders had a significant and negative correlation between PA intensity and wound size. Hypertension was correlated to impaired angiogenesis in non-responsive patients. The rate of PA increase and hence the rate of angiogenesis was able to predict healing times within 30 days from the start of monitoring (power=88%, alpha=0.05). This early response detection system could help inform management and treatment strategies while improving outcomes and reducing costs.

A Model-Based Approach To Detection Of The Circulating Melanoma Cells From The Photoacoustic Cytometry Data

Background ― Effective treatment of melanoma is only possible during the early stages of the disease. However, current techniques of cancer diagnostics are not sensitive enough to be reliable during the early stages. Photoacoustic cytometry provides a very perspective method for early diagnostics, which, in principle, can detect even a single melanoma circulating melanoma cell. However, the photoacoustic monitoring system needs to be paired with an effective automated algorithm, which will detect acoustic responses from melanoma cells among normal blood cells. Objective ― The study aims to compare the currently adopted algorithm for the detection of circulating melanoma cells based on a calculation of the standard deviation of the acoustic responses with the new model-based algorithm. Methods ― We tested and compared two different methods of automated detection of melanoma acoustic responses. The first approach was based on a calculation of the deviation of the acoustic responses. The second approach was based on the subtraction of the ensemble average normal acoustic response from melanoma acoustic responses. The resulting differential signals contained positive spikes, which were detected. Results ― The model-based approach demonstrated better sensitivity and specificity when detecting circulating melanoma cells in comparison to the approach based on the calculation of standard deviation of the acoustic responses. Conclusions ― Obtained results suggest that the model-based approach is a more reliable basis for an automated algorithm for the detection of circulating melanoma cells. The model-based approach has an additional advantage of being simpler to calculate and requires less computational power to run in real-time.

Predicting intestinal viability by consecutive photoacoustic monitoring of oxygenation recovery after reperfusion in acute mesenteric ischemia in rats

The purpose was to assess whether consecutive monitoring of oxygenation by photoacoustic imaging (PAI) can objectively predict intestinal viability during surgery for acute mesenteric ischemia (AMI). PAI uses laser light to detect relative amounts of oxygenated and deoxygenated hemoglobin in intestinal tissue. In 30 rats, AMI was induced by clamping the mesenteric and marginal vessels of the ileum for 0 min in the control group, 30 min in the mild group, and 180 min in the severe group (10 rats per group). After 60 min of reperfusion, intestinal damage was evaluated pathologically. Oxygenation of the intestine was monitored throughout the procedure in real time by a commercially available PAI system and compared among the groups. All rats showed irreversible (i.e. transmucosal or transmural infarction) damage in the severe group. After reperfusion, the oxygenation in the mild group recovered immediately and was significantly higher than in the severe group at 1, 5, 10, 30, and 60 min (P = .011, 002, < .001, 001, and 001, respectively). Oxygenation showed a significant strong negative correlation with pathological severity (rs = − 0.7783, − 0.7806, − 0.7422, − 0.7728, and − 0.7704, respectively). In conclusion, PAI could objectively predict irreversible ischemic damage immediately after reperfusion, which potentially prevents inadequate surgery.

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.

High-resolution functional photoacoustic monitoring of vascular dynamics in human fingers

Functional imaging of microvascular dynamics in extremities delivers intuitive information for early detection, diagnosis, and prognosis of vascular diseases. High-resolution and high-speed photoacoustic microscopy (PAM) visualizes and measures multiparametric information of microvessel networks in vivo such as morphology, flow, oxygen saturation, and metabolic rate. Here, we demonstrate high-resolution photoacoustic monitoring of vascular dynamics in human fingers. We photoacoustically monitored the position displacement of blood vessels associated with arterial pulsation in human fingers. Then, during and after arterial occlusion, we photoacoustically quantified oxygen consumption and blood perfusion in the fingertips. The results demonstrate that high-resolution functional PAM could be a vital tool in peripheral vascular examination for measuring heart rate, oxygen consumption, and/or blood perfusion.

Photoacoustic-guided photothermal therapy by mapping of tumor microvasculature and nanoparticle

Abstract Although photothermal therapy (PTT) has demonstrated its clinical value and adaptability, it still requires imaging guidance to motivate the development of precise and effective treatment. For PTT, high-resolution visualization of tumor microvasculature and accurate location of nanoparticles distribution are crucial for the therapeutic outcome. Here, a wavelength-switchable photoacoustic microscopy (PAM) was developed to noninvasively investigate the tumor microvasculature and the accumulation of nanoparticles for accurately guiding PTT and evaluating the therapeutic effect. In a tumor model, PAM was used to continuously monitor the tumor microenvironment in vivo, and the proportion of microvessels in tumor site was found increased by 10%, and the diameters of the draining veins were doubled on day 7. In addition, quantitative parameters such as tumor volume and vascular density can also be demonstrated by the PAM. Meanwhile, the concentration of Den-RGD/Cy7 at the tumor site reached its maximum at 8 h by PA mapping after intravenous injection, which was used to determine the optimal irradiation timing. After treatment, photoacoustic monitoring showed that PTT can precisely kill the tumors and minimize damage to surrounding normal tissues, which was consistent with the pathological slides. The experimental results proved that PAM can provide an auxiliary means for precision PTT.

Emerging photoacoustic and thermoacoustic imaging technologies for detecting primary and metastatic cancer and guiding therapy.

In recent years, there has been a progressive trend towards less invasive technologies for detecting metastatic cancer and guiding therapy with the goal of lower morbidity, better outcomes, and superior cosmetic appearance than traditional methods. This mini-review examines three emerging noninvasive hybrid technologies for detecting primary cancer, metastasis and guiding thermal therapy. Real-time thermoacoustic imaging and thermometry potentially provides valuable and critical feedback for guiding focused microwave ablation therapy. Label-free photoacoustic monitoring of cancer cells is a promising clinical diagnostic and theranostic tool for detecting metastatic disease and monitoring the response to therapy. Finally, immunologically targeted gold nanoparticles combined with photoacoustic imaging is able to detect lymph node micrometastasis in mouse models of breast cancer. These emerging techniques have the potential to improve the decision to biopsy, provide more accurate prognosis, and enhance the efficacy of therapy for early and late stage cancers.

Abstract PO-056: Sonographic and photoacoustic monitoring of radiation-induced parenchymal and vascular injury to salivary glands

Abstract Salivary gland dysfunction is a common side effect of radiation therapy (RT) in patients with head and neck cancer and is a consequence of direct damage to glandular parenchyma along with inflammatory changes and vascular injury following radiation. However, dynamic functional imaging of changes in salivary gland vascularity and oxygenation following RT has not been previously reported. Here, we employed bimodal photoacoustic imaging (PAI) with co-registered ultrasound (US) to non-invasively monitor radiation-induced parenchymal and vascular injury to salivary glands in vivo. Experimental imaging studies revealed parenchymal damage on B-mode US and early increase in vascular resistance on contrast-enhanced US (within 24h following radiation). Notably, this was accompanied by a reduction in oxygen consumption of salivary glands on dynamic PAI following parasympathetic stimulation with pilocarpine. Temporal kinetics of radiation-induced vascular injury was dependent on the host immune status and correlates with stimulated salivary secretion. These findings demonstrate the ability of US-PAI to monitor the dynamic changes in neurovascular coupling of salivary glands following radiation injury and highlight its potential utility to identify drugs or therapeutic approaches that could protect or mitigate radiation-induced vascular damage. Citation Format: Eftekhar Rajab Bolookat, Vui King Vincent-Chong, Anurag K. Singh, Mukund Seshadri. Sonographic and photoacoustic monitoring of radiation-induced parenchymal and vascular injury to salivary glands [abstract]. In: Proceedings of the AACR Virtual Special Conference on Radiation Science and Medicine; 2021 Mar 2-3. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(8_Suppl):Abstract nr PO-056.

Photoacoustic monitoring of oxygenation changes induced by therapeutic ultrasound in murine hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a highly vascular solid tumor. We have previously shown that ultrasound (US) therapy significantly reduces tumor vascularity. This study monitors US-induced changes in tumor oxygenation on murine HCC by photoacoustic imaging (PAI). Oxygen saturation and total hemoglobin were assessed by PAI before and after US treatments performed at different intensities of continuous wave (CW) bursts and pulsed wave (PW) bursts US. PAI revealed significant reduction both in HCC oxygen saturation and in total hemoglobin, proportional to the US intensity. Both CW bursts US (1.6 W/cm2) and the PW bursts US (0.8 W/cm2) significantly reduced HCC oxygen saturation and total hemoglobin which continued to diminish with time following the US treatment. The effects of US therapy were confirmed by power Doppler and histological examination of the hemorrhage in tumors. By each measure, the changes observed in US-treated HCC were more prevalent than those in sham-treated tumors and were statistically significant. In conclusion, the results show that US is an effective vascular-targeting therapy for HCC. The changes in oxygenation induced by the US treatment can be noninvasively monitored longitudinally by PAI without the use of exogenous image-enhancing agents. The combined use of PAI and the therapeutic US has potential for image-guided vascular therapy for HCC.

Tocilizumab-Conjugated Polymer Nanoparticles for NIR-II Photoacoustic-Imaging-Guided Therapy of Rheumatoid Arthritis.

The progressive debilitating nature of rheumatoid arthritis (RA) combined with its unknown etiology and initial similarity to other inflammatory diseases makes early diagnosis a significant challenge. Early recognition and treatment of RA is essential for achieving effective therapeutic outcome. NIR-II photoacoustic (PA) molecular imaging (PMI) is emerging as a promising new strategy for effective diagnosis and treatment guidance of RA, owing to its high sensitivity and specificity at large penetration depth. Herein, an antirheumatic targeted drug tocilizumab (TCZ) is conjugated to polymer nanoparticles (PNPs) to develop the first NIR-II theranostic nanoplatform, named TCZ-PNPs, for PA-imaging-guided therapy of RA. The TCZ-PNPs are demonstrated to have strong NIR-II extinction coefficient, high photostability and excellent biocompatibility. NIR-II PMI results reveal the excellent targeting abilities of TCZ-PNPs for the effective noninvasive diagnosis of RA joint tissue with a high signal-to noise ratio (SNR) of 35.8 dB in 3D PA tomography images. Remarkably, one-month treatment and PA monitoring using TCZ-PNPs shows RA is significantly suppressed. In addition, the therapeutic evaluation of RA mice by NIR-II PMI is shown to be consistent with clinical micro-CT and histological analysis. The TCZ-PNPs-assisted NIR-II PMI provides a new strategy for RA theranostics, therapeutic monitoring and the beyond.