Multimodal photoacoustic imaging in analytic vulnerability of atherosclerosis

Atherosclerosis is a major cause of mortality and morbidity, and rupture can lead to myocardial infarction and stroke. The vulnerability assessment of atherosclerosis plaques is important for providing medical treatment. Identifying vulnerable plaques requires noninvasive, high-resolution imaging techniques for capturing and locating high-risk markers. Photoacoustic imaging (PAI) is a hybrid and novel imaging modality that uses nonionizing excitation and has substantial promise for vulnerability assessment of atherosclerosis. The current review examined current applications of multimodal PAI for identification of atherosclerosis plaques. Furthermore, we discuss the challenges and limitations in the implementation this method and future research directions to overcome these difficulties. First, we discuss two aspects of vulnerable plaque characterization: large necrotic cores and thin degraded cap component identification. Then, we then discuss applications of high-risk plaque characterization, including intraplaque hemorrhage and heme degradation markers detection. We hope that this review will shed light on the potential application of optical imaging techniques in atherosclerosis identification and facilitate further studies that will ultimately lead to the broader application of multimodal PAI in clinical practice.