Label-Free Characterization of Atherosclerotic Plaques Via High-Resolution Multispectral Fluorescence Lifetime Imaging Microscopy.

BACKGROUND: Autofluorescence lifetime (AFL) imaging, a robust technique that enables label-free molecular investigation of biological tissues, is being introduced into the field of cardiovascular diagnostics. However, detailed AFL characteristics of coronary arteries remain elusive and there is a lack of methodology enabling such characterization. METHODS: We developed multispectral fluorescence lifetime imaging microscopy (FLIM) based on analog-mean-delay. Freshly sectioned coronary arteries and atheromas, harvested from 5 swine models, were imaged using FLIM and stained to label lipids, macrophages, collagen, and smooth muscle cells. The components were quantitated from digitized histological images and compared with the corresponding FLIM. Multispectral AFL parameters derived from 2 different spectral bands (390 nm and 450 nm) were analyzed. RESULTS: FLIM provided a wide field-of-view, high-resolution AFL imaging of frozen sections. Principal compositions of coronary arteries, such as tunica media, tunica adventitia, elastic laminas, smooth muscle cell-enriched fibrous plaque, lipid-rich core, and foamy macrophages, were well visualized in FLIM images and were found to have each different AFL spectra. In particular, proatherogenic components including lipids and foamy macrophages exhibited significantly different AFL values compared with plaque-stabilizing collagen- or smooth muscle cell-enriched tissues (P<0.0001). Pairwise comparisons showed that each composition was distinguishable from another by the difference in multispectral AFL parameters. Pixel-level analysis based on coregistered FLIM-histology dataset showed that each component of atherosclerosis (lipids, macrophages, collagen, and smooth muscle cells) had distinct correlation pattern with AFL parameters. Random forest regressors trained with the dataset allowed automated, simultaneous visualization of the key atherosclerotic components with high accuracy (r>0.87). CONCLUSIONS: FLIM provided detailed pixel-level AFL investigation of the complex composition of coronary artery and atheroma. Our FLIM strategy enabling an automated, comprehensive visualization of multiple plaque components from unlabeled sections will be highly useful to efficiently evaluate ex vivo samples without the need for histological staining and analysis.

Method for improving the speed and pattern quality of a DMD maskless lithography system using a pulse exposure method.

Maskless lithography based on a digital micromirror device (DMD) has the advantages of high process flexibility and a low production cost. However, due to the trade-off relationship between the pixel size and exposure area, it is challenging to achieve high resolutions and high patterning speeds at the same time, which hinders the wider application of this technology in micro- and nano-fabrication processes. In addition, micromirrors in DMDs create pixelated edges that limit the pattern quality. In this paper, we propose a novel DMD maskless lithography method to improve the pattern quality during high-speed continuous patterning by means of pulse exposure and oblique scanning processes. A unique criterion, the pixel occupancy, was devised to determine the parameters related to the pulse exposure and oblique scanning optimally. We also studied how the duty cycle of the pulse exposure affects the pattern quality. As a result, we were able to increase the scanning speed up to the speed limit considering the damage threshold of the DMD and improve the pattern quality by resolving the pixelation problem. We anticipate that this method can be used in various microfabrication fields with short product life cycles or in those that require custom designs, such as the manufacturing of PCBs, MEMS devices, and micro-optics devices, among others.

Lateral image reconstruction of optical coherence tomography using one-dimensional deep deconvolution network.

BACKGROUND AND OBJECTIVES: Optical coherence tomography (OCT) is a cross-sectional imaging method utilizing a low coherence interferometry. The lateral resolution of the OCT is limited by the numerical aperture (NA) of the imaging lens. Using a high NA lens improves the lateral resolution but reduces the depth of focus (DOF). In this study, we propose a method to improve the lateral resolution of OCT images by end-to-end training of a deep 1-D deconvolution network without use of high-resolution images. MATERIALS AND METHODS: To improve the lateral resolution of the OCT, we trained the 1-D deconvolution network using lateral profiles of OCT images and the beam spot size. We used our image-guided laparoscopic surgical tool (IGLaST) to acquire OCT images of nonbiological and biological samples ex vivo. The OCT images were then blurred by applying Gaussian functions with various full width half maximums ranging from 40 to 160 µm. The network was trained using the blurred OCT images as input and the non-blurred original OCT images as output. We quantitatively evaluated the developed network in terms of similarity and signal-to-ratio (SNR), using in-vivo images of mesenteric tissue from a porcine model that was not used for training. In addition, we performed knife-edge tests and qualitative evaluation of the network to show the lateral resolution improvement of ex-vivo and in-vivo OCT images. RESULTS: The proposed method showed an improvement of image quality on both blurred images and non-blurred images. When the proposed deconvolution network was applied, the similarity to the non-blurred image was improved by 1.29 times, and the SNR was improved by 1.76 dB compared to the artificially blurred images, which was superior to the conventional deconvolution method. The knife-edge tests at distances at 200 to 1000 µm from the imaging probe showed an approximately 1.2 times improvement in lateral resolution. In addition, through qualitative evaluation, it was found that the image quality of both ex-vivo and in-vivo tissue images was improved with clear structure and less noise. CONCLUSIONS: This study showed the ability of the 1-D deconvolution network to improve the image quality of OCT images with variable lateral resolution. We were able to train the network with a small amount of data by constraining the network in 1-D. The quantitative evaluation showed better results than conventional deconvolution methods for various amount of blurring. Qualitative evaluation showed analogous results with quantitative results. This simple yet powerful image restoration method provides improved lateral resolution and suppresses background noise, making it applicable to a variety of OCT imaging applications.

Stress-associated neurobiological activity is linked with acute plaque instability via enhanced macrophage activity: a prospective serial 18F-FDG-PET/CT imaging assessment.

AIMS: Emotional stress is associated with future cardiovascular events. However, the mechanistic linkage of brain emotional neural activity with acute plaque instability is not fully elucidated. We aimed to prospectively estimate the relationship between brain amygdalar activity (AmygA), arterial inflammation (AI), and macrophage haematopoiesis (HEMA) in acute myocardial infarction (AMI) as compared with controls. METHODS AND RESULTS: 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) imaging was performed within 45 days of the index episode in 62 patients (45 with AMI, mean 60.0 years, 84.4% male; 17 controls, mean 59.6 years, 76.4% male). In 10 patients of the AMI group, serial 18F-FDG-PET/CT imaging was performed after 6 months to estimate the temporal changes. The signals were compared using a customized 3D-rendered PET reconstruction. AmygA [target-to-background ratio (TBR), mean ± standard deviation: 0.65 ± 0.05 vs. 0.60 ± 0.05; P = 0.004], carotid AI (TBR: 2.04 ± 0.39 vs. 1.81 ± 0.25; P = 0.026), and HEMA (TBR: 2.60 ± 0.38 vs. 2.22 ± 0.28; P < 0.001) were significantly higher in AMI patients compared with controls. AmygA correlated significantly with those of the carotid artery (r = 0.350; P = 0.005), aorta (r = 0.471; P < 0.001), and bone marrow (r = 0.356; P = 0.005). Psychological stress scales (PHQ-9 and PSS-10) and AmygA assessed by PET/CT imaging correlated well (P < 0.001). Six-month after AMI, AmygA, carotid AI, and HEMA decreased to a level comparable with the controls. CONCLUSION: AmygA, AI, and HEMA were concordantly enhanced in patients with AMI, showing concurrent dynamic changes over time. These results raise the possibility that stress-associated neurobiological activity is linked with acute plaque instability via augmented macrophage activity and could be a potential therapeutic target for plaque inflammation in AMI.

Color three-dimensional imaging based on patterned illumination using a negative pinhole array.

Reflectance confocal microscopy is widely used for non-destructive optical three-dimensional (3D) imaging. In confocal microscopy, a stack of sequential two-dimensional (2D) images with respect to the axial position is typically needed to reconstruct a 3D image. As a result, in conventional confocal microscopy, acquisition speed is often limited by the rate of mechanical scanning in both the transverse and axial directions. We previously reported a high-speed parallel confocal detection method using a pinhole array for color 3D imaging without any mechanical scanners. Here, we report a high-speed color 3D imaging method based on patterned illumination employing a negative pinhole array, whose optical characteristics are the reverse of the conventional pinhole array for transmitting light. The negative pinhole array solves the inherent limitation of a conventional pinhole array, i.e., low transmittance, meaning brighter color images with abundant color information can be acquired. We also propose a 3D image processing algorithm based on the 2D cross-correlation between the acquired image and filtering masks, to produce an axial response. By using four-different filtering masks, we were able to increase the sampling points in calculation of height and enhance the lateral resolution of the color acquisition by a factor of four. The feasibility of high-speed non-contact color 3D measurement with the improved lateral resolution and brightness provided by the negative pinhole array was demonstrated by imaging various specimens. We anticipate that this high-speed color 3D measurement technology with negative pinhole array will be a useful tool in a variety of fields where rapid and accurate non-contact measurement are required, such as industrial inspection and dental scanning.

Label-free multimodal microscopy using a single light source and detector for biological imaging.

Multimodal nonlinear microscopy has been widely applied in biology and medicine due to its relatively deep penetration into tissue and its label-free manner. However, current multimodal systems require the use of multiple sources and detectors, leading to bulky, complex, and expensive systems. In this Letter, we present a novel method of using a single light source and detector for nonlinear multimodal imaging of biological samples. Using a photonic crystal fiber, a pulse picker, and multimode fibers, our developed system successfully acquired multimodal images of swine coronary arteries, including two-photon excitation fluorescence, second-harmonic generation, coherent anti-Stokes Raman scattering, and backreflection. The developed system could be a valuable tool for various biomedical applications.

Targeted theranostic photoactivation on atherosclerosis.

BACKGROUND: Photoactivation targeting macrophages has emerged as a therapeutic strategy for atherosclerosis, but limited targetable ability of photosensitizers to the lesions hinders its applications. Moreover, the molecular mechanistic insight to its phototherapeutic effects on atheroma is still lacking. Herein, we developed a macrophage targetable near-infrared fluorescence (NIRF) emitting phototheranostic agent by conjugating dextran sulfate (DS) to chlorin e6 (Ce6) and estimated its phototherapeutic feasibility in murine atheroma. Also, the phototherapeutic mechanisms of DS-Ce6 on atherosclerosis were investigated. RESULTS: The phototheranostic agent DS-Ce6 efficiently internalized into the activated macrophages and foam cells via scavenger receptor-A (SR-A) mediated endocytosis. Customized serial optical imaging-guided photoactivation of DS-Ce6 by light illumination reduced both atheroma burden and inflammation in murine models. Immuno-fluorescence and -histochemical analyses revealed that the photoactivation of DS-Ce6 produced a prominent increase in macrophage-associated apoptotic bodies 1 week after laser irradiation and induced autophagy with Mer tyrosine-protein kinase expression as early as day 1, indicative of an enhanced efferocytosis in atheroma. CONCLUSION: Imaging-guided DS-Ce6 photoactivation was able to in vivo detect inflammatory activity in atheroma as well as to simultaneously reduce both plaque burden and inflammation by harmonic contribution of apoptosis, autophagy, and lesional efferocytosis. These results suggest that macrophage targetable phototheranostic nanoagents will be a promising theranostic strategy for high-risk atheroma.

Astigmatism-corrected endoscopic imaging probe for optical coherence tomography using soft lithography.

In endoscopic optical coherence tomography, a transparent protective sheath is used to protect the optics and tissue. However, the sheath causes astigmatism, which degrades transverse resolution and signal-to-noise ratio due to the cylindrical lens effect. Generally used methods for correcting this astigmatism are complex, difficult to control precisely, high-cost, and increase the dimensions of the imaging probe. To overcome these problems, we have developed an astigmatism-corrected imaging probe with an epoxy window. The astigmatism is precisely and cost-effectively adjusted controlling the curvature radius of the epoxy window, which is produced by soft lithography. Using the fiber optic fusion splicing, the fabrication process is simple. The fabricated imaging probe is almost monolithic, so its diameter is similar to that of a standard single-mode fiber. We demonstrate its astigmatism-correcting performance using focal spot analysis, imaging micro-beads and a biological sample.

High-speed color three-dimensional measurement based on parallel confocal detection with a focus tunable lens.

Reflectance confocal microscopy is a widely used optical imaging technique for non-destructive three-dimensional (3D) surface measurement. In confocal microscopy, a stack of two-dimensional (2D) images along the axial position is used for 3D reconstruction. This means the speed of 3D volumetric acquisition is limited by the beam scanning and the mechanical axial scanning. To achieve fast volumetric imaging, simultaneous multiple point scanning by parallelizing the beam instead of transverse point scanning can be considered, using a pinhole array. Previously, we developed a direct-view confocal microscope with a focus tunable lens (FTL) to produce a monochrome 3D surface profile of a sample without any mechanical scanning. Here, we report a high-speed color 3D measurement method based on parallel confocal detection. The proposed method produces a color 3D image of an object by acquiring 180 2D color images with an acquisition time of 1 second. We also visualized the color information of the object by overlaying the color obtained with a color area detector and a white LED illumination on top of the 3D surface profile. In addition, we designed an improved optical system to reduce artifacts caused by internal reflections and developed a new algorithm for noise-resistant 3D measurements. The feasibility of the proposed non-contact high-speed color 3D measurement for use in industrial or biomedical fields was demonstrated by imaging the color 3D shapes of various specimens. We anticipate that this technology can be utilized in various fields, where rapid 3D surface profiles with color information are required.

Endoscopic micro-optical coherence tomography with extended depth of focus using a binary phase spatial filter.

Micro-optical coherence tomography (µOCT) is an advanced imaging technique that acquires a three-dimensional microstructure of biological samples with a high spatial resolution, up to 1 µm, by using a broadband light source and a high numerical aperture (NA) lens. As high NA produces a short depth of focus (DOF), extending the DOF is necessary to obtain a reasonable imaging depth. However, due to the complexity of optics and the limited space, it has been challenging to fabricate endoscopic µOCT, which is essential for clinical translation. Here, we report an endoscopic µOCT probe with an extended DOF by using a binary phase spatial filter. The imaging results from latex beads demonstrated that the µOCT probe achieved an axial resolution of 2.49 µm and a lateral resolution of 2.59 µm with a DOF extended by a factor of 2. The feasibility of clinical use was demonstrated by ex vivo imaging of the rabbit iliac artery.

Intracoronary dual-modal optical coherence tomography-near-infrared fluorescence structural-molecular imaging with a clinical dose of indocyanine green for the assessment of high-risk plaques and stent-associated inflammation in a beating coronary artery.

AIMS: Inflammation plays essential role in development of plaque disruption and coronary stent-associated complications. This study aimed to examine whether intracoronary dual-modal optical coherence tomography (OCT)-near-infrared fluorescence (NIRF) structural-molecular imaging with indocyanine green (ICG) can estimate inflammation in swine coronary artery. METHODS AND RESULTS: After administration of clinically approved NIRF-enhancing ICG (2.0 mg/kg) or saline, rapid coronary imaging (20 mm/s pullback speed) using a fully integrated OCT-NIRF catheter was safely performed in 12 atheromatous Yucatan minipigs and in 7 drug-eluting stent (DES)-implanted Yorkshire pigs. Stronger NIRF activity was identified in OCT-proven high-risk plaque compared to normal or saline-injected controls (P = 0.0016), which was validated on ex vivo fluorescence reflectance imaging. In vivo plaque target-to-background ratio (pTBR) was much higher in inflamed lipid-rich plaque compared to fibrous plaque (P < 0.0001). In vivo and ex vivo peak pTBRs correlated significantly (P < 0.0022). In vitro cellular ICG uptake and histological validations corroborated the OCT-NIRF findings in vivo. Indocyanine green colocalization with macrophages and lipids of human plaques was confirmed with autopsy atheroma specimens. Two weeks after DES deployment, OCT-NIRF imaging detected strong NIRF signals along stent struts, which was significantly higher than baseline (P = 0.0156). Histologically, NIRF signals in peri-strut tissue co-localized well with macrophages. CONCLUSION: The OCT-NIRF imaging with a clinical dose of ICG was feasible to accurately assess plaque inflammation and DES-related inflammation in a beating coronary artery. This highly translatable dual-modal molecular-structural imaging strategy could be relevant for clinical intracoronary estimation of high-risk plaques and DES biology.

Design and fabrication of an optical probe with a phase filter for extended depth of focus.

The trade-off between spot size and depth of focus (DOF) often limits the performance of optical systems, such as optical coherence tomography and optical tweezers. Although researchers have proposed various methods to extend the DOF in free-space optics, many are difficult to implement in miniaturized optical probes due to space limitations. In this study, we present an optical probe with an extended DOF using a binary phase spatial filter (BPSF). The BPSF pattern was fabricated on the distal tip of an optical probe with a diameter of 1 mm by replica molding soft lithography, which can be easily implemented in a miniaturized optical probe due to its simple configuration. We optimized the BPSF pattern to enhance DOF, spot diameter, and light efficiency. To evaluate the fabricated endoscopic optical probe, we measured the three-dimensional point spread function of the BPSF probe and compared it with a probe without BPSF. The BPSF probe has a spot diameter of 3.56 µm and a DOF of 199.7 µm, while the probe without BPSF has a spot diameter of 3.69 µm and a DOF of 73.9 µm, representing a DOF gain of 2.7. We anticipate that this optical probe can be used in biomedical applications, including optical imaging and optical trapping techniques.

High-speed 3-D measurement with a large field of view based on direct-view confocal microscope with an electrically tunable lens.

We propose a new structure of confocal imaging system based on a direct-view confocal microscope (DVCM) with an electrically tunable lens (ETL). Since it has no mechanical moving parts to scan both the lateral (x-y) and axial (z) directions, the DVCM with an ETL allows for high-speed 3-dimensional (3-D) imaging. Axial response and signal intensity of the DVCM were analyzed theoretically according to the pinhole characteristics. The system was designed to have an isotropic spatial resolution of 20 µm in both lateral and axial direction with a large field of view (FOV) of 10 × 10 mm. The FOV was maintained according to the various focal shifts as a result of an integrated design of an objective lens with the ETL. The developed system was calibrated to have linear focal shift over a range of 9 mm with an applied current to the ETL. The system performance of 3-D volume imaging was demonstrated using standard height specimens and a dental plaster.

Compact fiber optic dual-detection confocal displacement sensor.

We propose a dual-detection confocal displacement sensor (DDCDS) with a compact fiber-based optical probe. This all-fiber-optic sensor probe is simple and robust, since it only requires simple alignment of a gradient refractive index lens and a double-clad fiber (DCF). The DDCDS is composed of two point detectors, one coupled to a single mode fiber and the other coupled to a multimode fiber, which are used to measure the light intensity from a core and an inner clad of a DCF, respectively. The ratio of the axial response curves, measured by the two detectors, can be used to obtain a linear relationship between the axial position of the object plane and the ratio of the intensity signals. We demonstrate the performance of the proposed method by measuring micromovement and fast vibration.

High-speed time-resolved laser-scanning microscopy using the line-to-pixel referencing method.

Fluorescence lifetime imaging microscopy (FLIM) is a powerful technique to visualize photophysical characteristics of biological targets. However, conventional FLIM methods have some limitations that restrict obtaining high-precision images in real time. Here, we propose a high-speed time-resolved laser-scanning microscopy by incorporating a novel line-to-pixel referencing method into the previously suggested analog mean-delay (AMD) method. The AMD method dramatically enhances the photon accumulation speed for achieving the certain precision compared to the time-correlated single-photon counting (TCSPC) method while maintaining high photon efficiency. However, its imaging pixel rate can still be restricted by the rearm time of the digitizer when it is triggered by laser pulses. With our line-to-pixel referencing method, the pulse train repeats faster than the trigger rearm time can be utilized by generating a line trigger, which is phase-locked with only the first pulse in each horizontal line composing an image. Our proposed method has been tested with a pulsed laser with 40 MHz repetition rate and a commercial digitizer with a 500 ns trigger rearm time, and a frame rate of 3.73 fps with a pixel rate of 3.91 MHz was accomplished while maintaining the measurement precision under 20 ps.

Concurrent Carotid Inflammation in Acute Coronary Syndrome as Assessed by (18)F-FDG PET/CT: A Possible Mechanistic Link for Ischemic Stroke.

BACKGROUND: Patients with acute coronary syndrome (ACS) are prone to ischemic stroke (IS) especially during the early phase. ACS patients are more likely to have concurrent complex carotid plaques which, when destabilized, may serve as a source of distal embolism. This study investigated whether inflammatory activity in carotid artery was increased in ACS survivors compared to chronic stable angina (CSA) patients. METHODS: We prospectively enrolled 74 patients with ACS or CSA (39 ACS patients versus 35 CSA patients), and fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) was performed within 1 week after diagnosis. Carotid PET signal was quantified as standardized uptake value (SUV) and target-to-background ratio (TBR, carotid SUV/jugular venous SUV). RESULTS: Baseline characteristics were similar between groups. TBRs and SUVs were significantly higher in the carotid arteries of ACS patients than those of CSA patients (P < .001). Systemic inflammatory biomarker correlated significantly with carotid FDG uptake (high-sensitivity C-reactive protein versus average SUV: r = .361, P = .002), and the presence of cardiovascular risk factors was also related to inflammation activity. During follow-up, 3 cerebrovascular events occurred in ACS patients (including 1 early IS in a patient with severe baseline carotid inflammation), whereas none in CSA patients (P = .057). CONCLUSIONS: This study provided in vivo evidence that ACS survivors might experience concurrent carotid arterial inflammation. Our findings supported the role of systemic immune activation contributing to multiarterial instability in symptomatic atherosclerosis as a possible mechanistic link between ACS and IS.

Swept-source Raman spectroscopy of chemical and biological materials.

Significance: Raman spectroscopy has been used as a powerful tool for chemical analysis, enabling the noninvasive acquisition of molecular fingerprints from various samples. Raman spectroscopy has proven to be valuable in numerous fields, including pharmaceutical, materials science, and biomedicine. Active research and development efforts are currently underway to bring this analytical instrument into the field, enabling in situ Raman measurements for a wider range of applications. Dispersive Raman spectroscopy using a fixed, narrowband source is a common method for acquiring Raman spectra. However, dispersive Raman spectroscopy requires a bulky spectrometer, which limits its field applicability. Therefore, there has been a tremendous need to develop a portable and sensitive Raman system. Aim: We developed a compact swept-source Raman (SS-Raman) spectroscopy system and proposed a signal processing method to mitigate hardware limitations. We demonstrated the capabilities of the SS-Raman spectroscopy by acquiring Raman spectra from both chemical and biological samples. These spectra were then compared with Raman spectra obtained using a conventional dispersive Raman spectroscopy system. Approach: The SS-Raman spectroscopy system used a wavelength-swept source laser (822 to 842 nm), a bandpass filter with a bandwidth of 1.5 nm, and a low-noise silicon photoreceiver. Raman spectra were acquired from various chemical samples, including phenylalanine, hydroxyapatite, glucose, and acetaminophen. A comparative analysis with the conventional dispersive Raman spectroscopy was conducted by calculating the correlation coefficients between the spectra from the SS-Raman spectroscopy and those from the conventional system. Furthermore, Raman mapping was obtained from cross-sections of swine tissue, demonstrating the applicability of the SS-Raman spectroscopy in biological samples. Results: We developed a compact SS-Raman system and validated its performance by acquiring Raman spectra from both chemical and biological materials. Our straightforward signal processing method enhanced the quality of the Raman spectra without incurring high costs. Raman spectra in the range of 900 to 1200 cm-1 were observed for phenylalanine, hydroxyapatite, glucose, and acetaminophen. The results were validated with correlation coefficients of 0.88, 0.84, 0.87, and 0.73, respectively, compared with those obtained from dispersive Raman spectroscopy. Furthermore, we performed scans across the cross-section of swine tissue to generate a biological tissue mapping plot, providing information about the composition of swine tissue. Conclusions: We demonstrate the capabilities of the proposed compact SS-Raman spectroscopy system by obtaining Raman spectra of chemical and biological materials, utilizing straightforward signal processing. We anticipate that the SS-Raman spectroscopy will be utilized in various fields, including biomedical and chemical applications.

Imaging peritoneal blood vessels through optical coherence tomography angiography for laparoscopic surgery.

Laparoscopic surgery presents challenges in identifying blood vessels due to lack of tactile feedback. The image-guided laparoscopic surgical tool (IGLaST) integrated with optical coherence tomography (OCT) has potential for in vivo blood vessel imaging; however, distinguishing vessels from surrounding tissue remains a challenge. In this study, we propose utilizing an inter-A-line intensity differentiation-based OCT angiography (OCTA) to improve visualization of blood vessels. By evaluating a tissue phantom with varying flow speeds, we optimized the system's blood flow imaging capabilities in terms of minimum detectable flow and contrast-to-noise ratio. In vivo experiments on rat and porcine models, successfully visualized previously unidentified blood vessels and concealed blood flows beneath the 1 mm depth peritoneum. Qualitative comparison of various OCTA algorithms indicated that the intensity differentiation-based algorithm performed best for our application. We believe that implementing IGLaST with OCTA can enhance surgical outcomes and reduce procedure time in laparoscopic surgeries.

Macrophage-mannose-receptor-targeted photoactivatable agent for in vivo imaging and treatment of atherosclerosis.

Previous studies have demonstrated the effects of theranostic agents on atherosclerotic plaques. However, there is limited information on targeted theranostics for photodynamic treatment of atherosclerosis. This study aimed to develop a macrophage-mannose-receptor-targeted photoactivatable nanoagent that regulates atherosclerosis and to evaluate its efficacy as well as safety in atherosclerotic mice. We synthesised and characterised D-mannosamine (MAN)-polyethylene glycol (PEG)-chlorin e6 (Ce6) for phototheranostic treatment of atherosclerosis. The diagnostic and therapeutic effects of MAN-PEG-Ce6 were investigated using the atherosclerotic mouse model. The hydrophobic Ce6 photosensitiser was surrounded by the hydrophilic MAN-PEG outer shell of the self-assembled nanostructure under aqueous conditions. The MAN-PEG-Ce6 was specifically internalised in macrophage-derived foam cells through receptor-mediated endocytosis. After laser irradiation, the MAN-PEG-Ce6 markedly increased singlet oxygen generation. Intravital imaging and immunohistochemistry analyses verified MAN-PEG-Ce6's specificity to plaque macrophages and its notable anti-inflammatory impact by effectively reducing mannose-receptor-positive macrophages. The toxicity assay showed that MAN-PEG-Ce6 had negligible effects on the biochemical profile and structural damage in the skin and organs. Targeted photoactivation with MAN-PEG-Ce6 thus has the potential to rapidly reduce macrophage-derived inflammatory responses in atheroma and present favourable toxicity profiles, making it a promising approach for both imaging and treatment of atherosclerosis.