Towards in vivo characterization of thyroid nodules suspicious for malignancy using multispectral optoacoustic tomography.

PURPOSE: Patient-tailored management of thyroid nodules requires improved risk of malignancy stratification by accurate preoperative nodule assessment, aiming to personalize decisions concerning diagnostics and treatment. Here, we perform an exploratory pilot study to identify possible patterns on multispectral optoacoustic tomography (MSOT) for thyroid malignancy stratification. For the first time, we directly correlate MSOT images with histopathology data on a detailed level. METHODS: We use recently enhanced data processing and image reconstruction methods for MSOT to provide next-level image quality by means of improved spatial resolution and spectral contrast. We examine optoacoustic features in thyroid nodules associated with vascular patterns and correlate these directly with reference histopathology. RESULTS: Our methods show the ability to resolve blood vessels with diameters of 250 µm at depths of up to 2 cm. The vessel diameters derived on MSOT showed an excellent correlation (R2-score of 0.9426) with the vessel diameters on histopathology. Subsequently, we identify features of malignancy observable in MSOT, such as intranodular microvascularity and extrathyroidal extension verified by histopathology. Despite these promising features in selected patients, we could not determine statistically relevant differences between benign and malignant thyroid nodules based on mean oxygen saturation in thyroid nodules. Thus, we illustrate general imaging artifacts of the whole field of optoacoustic imaging that reduce image fidelity and distort spectral contrast, which impedes quantification of chromophore presence based on mean concentrations. CONCLUSION: We recommend examining optoacoustic features in addition to chromophore quantification to rank malignancy risk. We present optoacoustic images of thyroid nodules with the highest spatial resolution and spectral contrast to date, directly correlated to histopathology, pushing the clinical translation of MSOT.

Individual transducer impulse response characterization method to improve image quality of array-based handheld optoacoustic tomography.

The physical properties of each transducer element play a vital role in the quality of images generated in optoacoustic (photoacoustic) tomography using transducer arrays. Thorough experimental characterization of such systems is often laborious and impractical. A shortcoming of the existing impulse response correction methods, however, is the assumption that all transducers in the array are identical and therefore share one electrical impulse response (EIR). In practice, the EIRs of the transducer elements in the array vary, and the effect of this element-to-element variability on image quality has not been investigated so far, to the best of our knowledge. We hereby propose a robust EIR derivation for individual transducer elements in an array using sparse measurements of the total impulse response (TIR) and by solving the linear system for temporal convolution. Thereafter, we combine a simulated spatial impulse response with the derived individual EIRs to obtain a full characterization of the TIR, which we call individual synthetic TIR. Correcting for individual transducer responses, we demonstrate significant improvement in isotropic resolution, which further enhances the clinical potential of array-based handheld transducers.