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  • Review Article
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The emerging role of photoacoustic imaging in clinical oncology

Nature Reviews Clinical Oncology volume 19, pages 365–384 (2022)Cite this article

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Abstract

Clinical oncology can benefit substantially from imaging technologies that reveal physiological characteristics with multiscale observations. Complementing conventional imaging modalities, photoacoustic imaging (PAI) offers rapid imaging (for example, cross-sectional imaging in real time or whole-breast scanning in 10–15 s), scalably high levels of spatial resolution, safe operation and adaptable configurations. Most importantly, this novel imaging modality provides informative optical contrast that reveals details on anatomical, functional, molecular and histological features. In this Review, we describe the current state of development of PAI and the emerging roles of this technology in cancer screening, diagnosis and therapy. We comment on the performance of cutting-edge photoacoustic platforms, and discuss their clinical applications and utility in various clinical studies. Notably, the clinical translation of PAI is accelerating in the areas of macroscopic and mesoscopic imaging for patients with breast or skin cancers, as well as in microscopic imaging for histopathology. We also highlight the potential of future developments in technological capabilities and their clinical implications, which we anticipate will lead to PAI becoming a desirable and widely used imaging modality in oncological research and practice.

Key points

  • Photoacoustic imaging (PAI) has emerged as an appealing modality that can complement existing imaging techniques for cancer screening, diagnosis and treatment guidance.

  • The elegant fusion of light and sound provides PAI with several distinctive capabilities including scalable spatial resolution and imaging depth while maintaining a high imaging speed.

  • By selecting suitable optical wavelengths, PAI can image a wide variety of endogenous molecules or exogenous agents, revealing the anatomy, histology, function and molecular activity of biological systems in vivo.

  • Taking advantage of the high sensitivity to tumour-associated hypoxia and angiogenesis, PAI has the potential to enable early detection of cancers of the breast, skin and prostate.

  • The role of PAI in clinical oncology has been demonstrated by the first FDA approval of this technology for breast cancer diagnosis; other areas of potential clinical application include cancer detection, biopsy guidance and molecular imaging.

  • In addition to cancer screening and diagnosis, PAI has shown potential benefit for the assessment of responses to neoadjuvant chemotherapy, guiding surgical resection and monitoring drug delivery.

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Fig. 1: Representative configurations and images of photoacoustic imaging.
Fig. 2: Representative photoacoustic contrasts in biological tissues.
Fig. 3: Representative in vivo photoacoustic imaging for cancer detection.
Fig. 4: PAI for cancer diagnosis.
Fig. 5: Photoacoustic imaging for assessment and guidance of cancer treatment.
Fig. 6: Selection of the PAI configurations and contrasts according to clinical applications.

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Acknowledgements

The authors thank R. Cao for useful discussions. The authors are also grateful to J. Ballard, D. Garrett and J. Olick-Gibson for close reading of the paper.

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  1. Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA

    Li Lin & Lihong V. Wang

  2. Department of Electrical Engineering, California Institute of Technology, Pasadena, CA, USA

    Lihong V. Wang

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  1. Li Lin
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Both authors made substantial contributions to all aspects of the preparation of this manuscript.

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Correspondence to Lihong V. Wang.

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L.V.W. has a financial interest in Microphotoacoustics, Inc., CalPACT, LLC and Union Photoacoustic Technologies, Ltd., which, however, did not support this work. L.L. declares no competing interests.

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Lin, L., Wang, L.V. The emerging role of photoacoustic imaging in clinical oncology. Nat Rev Clin Oncol 19, 365–384 (2022). https://doi.org/10.1038/s41571-022-00615-3

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