Photoacoustics

Fluorescence imaging in the second near-infrared window (NIR-II, 950-1700 nm) offers reduced scattering, lower autofluorescence, and deeper tissue penetration than NIR-I imaging, but its adoption is limited by the need for custom-synthesized fluorophores. Here, we identify commercially available dyes that exhibit usable NIR-II emission. Eleven visible, far-red, and NIR-I fluorophores were screened under twelve acquisition configurations combining 670, 760, and 808 nm excitation with band-pass (950 nm, 1400 nm) or long-pass (1000 nm, 1250 nm) emission filters. Output varied markedly with fluorophore identity and excitation/emission configuration. Among hydrophobic dyes, DiR exhibited strong emission across almost all excitation and emission filters. Among hydrophilic dyes, strong NIR-II fluorescence was observed for IRDye 680RD (excitation at 670 nm), sulfo-cyanine 7 (excitation at 670 nm and 760 nm), and indocyanine green (excitation at 808 nm). DiR showed a linear concentration-response under 760 nm excitation with BP1400 detection. Upon encapsulation in PEGylated liposomes, strong NIR-II fluorescence was retained. In an in vivo study in mice, NIR-II resolved vasculature that NIR-I could not consistently delineate, and enabled pharmacokinetic analysis. Both windows returned similar ex vivo organ distributions. NIR-II imaging is therefore accessible using commercial off-the-shelf fluorophores, provided the dye is matched to the intended excitation/emission configuration.

Photoacoustic (PA) and ultrasound (US) imaging provide complementary molecular, functional, and anatomical contrasts. Here, we present a panoramic PA-US imaging platform that integrates multispectral PA computed tomography (PACT) along with reflection-mode and transmission-mode US imaging through a single shared full-ring ultrasound array. We employ an ultrafast planewave transmission scheme in reflection-mode US for power Doppler (PWD) imaging and ultrasound localization microscopy (ULM). Additionally, we use the transmission-mode US to reconstruct a spatially resolved speed of sound (SoS) map that corrects both PA and US reconstruction. Such correction sharpens the resolution of PACT, suppresses the artifacts of PWD, and improves microbubble localization of ULM. Elevational scanning further enables whole-body volumetric imaging with co-registered PA and US contrasts. The integrated system maps photoswitchable DrBphP1-expressing tumors alongside their blood perfusion and oxygenation environment. Applying the platform to monitor unilateral renal ischemia-reperfusion injury, we report that microvascular perfusion and renal oxygenation recover at different rates. Collectively, we demonstrate that the integrated PA-US imaging platform provides a unified framework for multiparametric study of anatomy, perfusion, microvascular flow, oxygenation, and molecular activities.

Spectral computed tomography (CT) is a burgeoning quantitative imaging technique with applications in oncologic diagnostics, prognostic prediction, tissue perfusion studies, and treatment follow-up. While normalized iodine concentration values have been correlated with microenvironmental biophysical changes, obtaining accurate iodine concentrations, particularly at low concentrations remains difficult due to varying spectral CT instrumentation performance. Hybrid spectral CT systems, combining multiple spectral CT instrumentation techniques, address these quantitation insufficiencies by increasing spectral separation but have not been evaluated on a clinically analogous platform. We validate a hybrid spectral CT system, comprised of clinical-grade components, acquiring four distinct effective spectra and applying efficient noise-reducing weighting schemes to compare iodine noise and bias against conventional kVp-Switching (kVp-S). Two tube current levels (50, 350 mA) and three duty cycle ratios (33/67, 50/50, 75/25) were implemented to elucidate radiation dose exposure and kVp-S parameterization impact. A standard quality assurance (QA) and patient-derived, abdominal IodinePrint phantom were scanned on the system. The average absolute bias in iodine density images of the QA phantom was comparable across acquisition techniques, below 0.5 mg/mL, while quantitative noise improved by 22% using noise-optimized weighting schemes. In the IodinePrint phantom aorta and pancreas structures, the noise-optimized weighting scheme increased signal-to-noise ratio (SNR) by 1.3x compared to kVp-S alone. These results highlight the increased precision of hybrid, multi-channel spectral CT systems and motivate CT designs that enable robust CT biomarker development.

Ultrathin endoscopy is highly attractive for real-time tissue imaging in narrow and hard-to-reach regions of the body. A single multimode fibre (MMF) is an attractive probe because of its small diameter, flexibility, and diffraction-limited spatial resolution enabled by the large number of transverse modes guided within a single core. Because the distal fibre tip is inaccessible during endoscopy, reflection-mode imaging, in which the same fibre delivers illumination and collects backscattered light, is more practical than transmission-mode imaging. However, image recovery from the resulting speckle pattern is challenging because light undergoes double-pass propagation through the MMF, with mode coupling and dispersion; the backscattered signal is weak, and the camera records intensity only, without phase information. Here, we propose a single-shot reflection-mode MMF imaging framework that combines a reflected real-valued intensity transmission matrix (reflected-RVITM) with an image restoration network. The reflected-RVITM is calibrated using intensity-only measurements, without interferometry or phase retrieval, and provides a physics-guided initial reconstruction from a single backscattered speckle frame. A restoration network then refines this initial reconstruction instead of inverting the raw speckle. Four restoration backbones are evaluated: HPM-Attention-UNet, GAM, MambaIRv2, and CICPNet. On matched datasets, hybrid models outperformed corresponding networks trained to map raw speckle directly to images. For example, HPM-Attention-UNet on MNIST improved mean PCC from 0.572 to 0.944 (+65.1%). Under domain shift, with training only on Fashion-MNIST and tested on unseen CIFAR scenes, hybrid models achieved mean PCC of 0.61-0.65, compared with 0.36-0.50 for direct learning. This framework is further demonstrated using physical objects at the distal fibre tip. These results demonstrate that a reflected-RVITM physics prior combined with a restoration network enables single-shot image recovery after intensity-only calibration, offering a phase-retrieval-free and generalisable route towards minimally invasive reflection-mode MMF endoscopy.

Continuous wave diffuse correlation spectroscopy (cw-DCS) is a noninvasive optical technique to monitor the tissues blood flow changes. This technique measures the tissue blood flow index (BFI) by evaluating the decay rate of the autocorrelation function. The derived BFI is proportional to mean squared displacements of the red blood cells considered as the fast-dynamic scatterer component of tissue in time. However, biological tissue contains static scatterer component and slow-dynamic scatterer component which affect the decay rate of autocorrelation function and as a result the derived BFI. In this study, we assessed the fractional contribution of static, slow-dynamic and fast-dynamic scatterer components of a medium in the flow index derived by cw-DCS. The measurements performed on Agar-based phantom with tube showed that presence of static scatterer component and slow-dynamic scatterer component led to substantial underestimation ({approx} 123%) of the flow index derived by Siegert relation, compared to effective diffusion coefficient of fast-dynamic scatterers components derived by modified Siegert relation and bi-exponential model. The less underestimation was observed for the corresponding parameters obtained from the liquid phantom measurements ({approx} 25%) as well as during the forearm occlusion test and respiratory challenges ({approx} 16% - 26%).

Spectroscopic single-molecule localization microscopy (sSMLM) enables multiplexed super-resolution imaging by simultaneously acquiring the spatial position and spectral information of individual fluorophores. Dual-wedge prism (DWP)-based implementations provide a compact, alignment-stable approach to spectral dispersion, but trade-offs between localization precision, spectral precision, and experimental complexity remain. We systematically compare five DWP-based sSMLM configurations, including two-dimensional (2D) and three-dimensional (3D) implementations using single DWP (DWP-sSMLM) and symmetrically-dispersed DWP (SDDWP-sSMLM). We evaluate lateral precision, spectral precision, and ease of use. SDDWP configurations acquire spectral images in both channels and utilize both for spatial localization, yielding the highest lateral and spectral precision. However, for applications that do not require axial information, 2D-DWP provides a simple, plug-and-play solution with robust performance. This work offers a guideline for selecting DWP configurations based on experimental needs.

While light-sheet microscopy is emerging as a robust method for volumetric imaging with improved axial resolution, its capability regarding two-dimensional, surface-level mapping is often hindered by limitations in data redundancy and reconstruction efficiency stemming from volumetric registration methods. We demonstrate that a multiview imaging approach in an axially-swept, dithered light-sheet microscope paired with computational image reconstruction of view projections is able to address these trade-offs to enable large-scale mapping of surface structural features, leveraging the advantages of multiview light-sheet in scalable field of view, working distance, and near isotropic resolution across the entire imaging depth. To aid in the acquisition and analysis of two-dimensional surface structures, we present a tailored surface mapping workflow and a Fiji plugin for computational reconstruction, promoting robust and comprehensive visualization of surface features of uncleared volumetric samples. Our strategy, termed projection reconstruction for imaging surface morphology (PRISM), integrates axially swept dithered light-sheet microscopy and post-processing software for multiview imaging. The imaging hardware enables near-isotropic resolution across its entire field of view, while the software implementation leverages rigid and affine transformations to align two-dimensional projections of multiview samples. It is designed to work with the BigStitcher pipeline, leveraging its robust algorithm to provide support for two-dimensional image alignment and stitching. We demonstrate the capability of PRISM in studies of lymphatic network mapping in the epicardial layer of intact mouse hearts, as well as surface profiles of FaDu spheroids labeled with antibody-nanodiamond conjugates. This method allows us to quantify cardiac lymphatic branch numbers, diameters, and lengths of a Prox1-tdTomato mouse cardiac model, as well as cluster number and diameters of epidermal growth factor receptor within a FaDu spheroid labeled with a nanodiamond-antibody conjugate, with a significant reduction of post-processing data size. PRISM leverages multiview image projections to promote studies of cardiac lymphatics in mouse models and surface receptor distributions within spheroid models, enabling efficient surface mapping of large, intact, and uncleared biological samples across a variety of scales.

Diffusion models achieve high reconstruction quality in low-dose computed tomography (LDCT), but their iterative sampling trajectories impose substantial computational costs. Unlike unconditional generation, paired LDCT reconstruction starts from an image that already contains the anatomy and spatial structure of the standard-dose CT (SDCT) target; reconstruction primarily requires correcting dose-related noise and artifacts. We therefore introduce Residual Endpoint Flow Matching (REFM), an LDCT reconstruction method that learns to transport an LDCT image directly toward its paired SDCT endpoint rather than defining a noise-to-image trajectory. REFM predicts the residual velocity along linear interpolations between both images and supports single-step and multi-step reconstruction using the same trained network. We evaluate five model capacities using 1 to 50 Euler steps against deterministic U-Net and diffusion-based baselines. Across all REFM variants, one-step inference consistently provides the highest reconstruction quality. On the TCIA validation set, REFM Base achieves 50.98 dB PSNR and 0.9865 SSIM at 94.54 fps, compared with 50.92 dB, 0.9847, and 9.26 fps for DDPM-10. REFM Small retains 50.71 dB while increasing throughput to 198.56 fps. Without fine-tuning, REFM Base also matches the 25-step DDPM baseline on the external Mayo Clinic dataset, although DDPM remains stronger on synthetically degraded CRLM images. Thus, our results show that exploiting paired anatomical correspondence enables diffusion-level LDCT reconstruction with a single step reconstruction.

Background. Extracellular volume fraction (ECV) derived from contrast-enhanced CT is a validated marker of hepatic fibrosis and has been reported to differ between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma. In published work it is obtained from a small number of hand-placed two-dimensional regions of interest, and the software that computes it is either tied to one manufacturer's workstation or based on spectral or dual-energy acquisition. We are not aware of an accessible tool that produces voxelwise liver ECV maps from conventional single-energy multiphase CT. Methods. We developed CT ECV Mapper, a scripted 3D Slicer extension with a three-layer architecture whose numerical core imports neither slicer nor vtk and is unit-tested outside 3D Slicer. The interactive application provides two-stage registration that the operator inspects and accepts before any ECV is computed, operator-placed three-dimensional regions of interest, user-adjustable calculation parameters, a voxelwise ECV color map and ROI statistics; the same logic layer can be driven unattended across a cohort. The tool was applied to the 164 patients of the public WAW-TACE multiphase HCC/TACE dataset that have both unenhanced and delayed-phase series. Results. 156 of 164 cases (95.1%) completed unattended. Whole-liver ECV had a median of 36.2% (interquartile range 31.9-41.5), consistent with published CT-ECV values for fibrotic and cirrhotic liver. Registering the arterial and portal phases on demand extended tumor ECV from the 38 lesions a conventional two-phase pipeline can reach to 248 lesions in 156 patients. Every failure was attributable to an identifiable mechanism: craniocaudal field-of-view mismatch between phases in six cases, aortic calcification within the blood-pool region in one, and in one case a labeling error in the source dataset, in which the series declared as unenhanced proved to be a second reconstruction of the portal venous phase; this was detected by the blood-pool validity check rather than by visual review. Conclusions. Voxelwise CT ECV mapping of the liver and of hepatic tumors is feasible from conventional multiphase CT on an open platform, both interactively and as an unattended batch, with quality-control instrumentation that fails explicitly and diagnosably. This is a technical development and feasibility report; the application has not been evaluated against a reference standard and no claim of clinical validity is made.

Purpose: Respiratory motion remains a major source of quantitative bias in PET and becomes increasingly relevant for high-sensitivity long axial field-of-view (LAFOV) PET/CT. Although numerous respiratory motion correction (MoCo) methods have been proposed, their quantitative accuracy cannot be established clinically because a patient-specific motion-free reference is fundamentally unavailable in vivo. This study combined clinical PET imaging with a digital twin, a realistic representation of both the PET/CT system and the patient, to objectively validate respiratory MoCo against a corresponding motion-free reference. Methods: Twenty patients (10 [18F]FDG with predominantly pulmonary lesions and 10 [18F]SiFAlin-TATE with predominantly hepatic lesions; total 135 lesions) were analyzed. The digital twin combined a validated LAFOV PET/CT simulation model with an anatomically realistic phantom containing 14 lung and liver lesions, two patient-derived respiratory patterns, and respiratory motion amplitudes of 2 and 3 cm, generating patient-like datasets with corresponding motion-free references. Data-driven and image-based MoCo were evaluated using lesion morphology, SUVmean, SUVmax, and metabolic tumor volume (MTV). Results: In patients, data-driven MoCo produced larger SUVmean increases than image-based MoCo for liver (48.1{+/-}18.9% vs. 17.0 {+/-} 12.0%; p<0.01), lower-lung (32.5{+/-}21.2% vs. 16.3{+/-}15.6%, p=0.06), and upper-lung lesions (28.4{+/-}32.0% vs. 10.4 {+/-} 17.2%; p<0.01), with similar findings for SUVmax and larger MTV reductions. Simulation revealed marked motion-induced SUVmean underestimation before correction, particularly in liver (-31.2{+/-}6.8%) and lower lung (-15.5{+/-}13.9%). Relative to the motion-free reference, data-driven MoCo most accurately recovered hepatic uptake (4.3{+/-}11.7% vs. -10.0 {+/-} 9.2%; p=0.01) but overestimated pulmonary uptake (lower lung: 19.8{+/-}16.3% vs. -1.6 {+/-} 10.2%; p=0.02). SUVmax showed the same regional behavior, whereas image-based MoCo yielded MTV estimates closer to the reference. Quantitative recovery was largely independent of respiratory pattern, while larger motion amplitudes mainly affected image-based MoCo. Conclusion: Combining clinical PET with a realistic digital twin and corresponding motion-free ground truth enabled objective validation of respiratory MoCo beyond conventional clinical evaluation. Larger correction-induced quantitative changes should not be equated with greater quantitative accuracy. Instead, MoCo performance was region- and metric-dependent, highlighting the value of ground-truth-based validation for developing and benchmarking respiratory motion correction and quantitative PET on LAFOV PET/CT systems.

Dynamic positron emission tomography (PET) with long axial field-of-view (LAFOV) scanners enables multi-organ imaging and kinetic quantification beyond static (late-phase) imaging; however, the long times typically required for dynamic acquisitions remain clinically impractical. This study evaluates a deep learning (DL) framework to enable abbreviated dynamic PET acquisitions, comparing single-time-window (STW, early dynamic data only) and dual-time-window (DTW, early dynamic data plus a late 5-min static frame) protocols with early dynamic scan durations of 5-30 min and dose levels ranging from 360 MBq to 18 MBq. Seventeen 60-min dynamic [18F]FDG datasets were first motion-corrected using a staggered FALCON pipeline and then used to train and test a spatiotemporal DL model for autoregressive frame prediction. Performance was assessed across the full quantitative workflow, from DL-predicted frames and time-activity curves to organ-based kinetic modeling and voxel-wise parametric imaging in multiple tissues and two patient cohorts. DTW protocols consistently outperformed STW, better preserving late-phase kinetics. For a 15-min early dynamic scan, adding a late 5-min scan reduced mean absolute Ki difference from 23% (STW) to 17% (DTW) in the liver and from 26% to 15% in the thalamus. DTW + DL further reduced errors to [&le;]10% in the liver, thalamus, and breast lesion, and 16% in muscle. Our recommended protocol, 15-min early dynamic scan plus a 5-min late scan with DL, remained robust to up to a 5-fold dose reduction (~74 MBq). Overall, these findings support DL-enabled abbreviated, low-dose dynamic LAFOV PET as a clinically feasible approach for accurate kinetic quantification

High-speed three-dimensional imaging in scattering tissues remains challenging because volumetric microscopy generally requires scanning, whereas snapshot light-field approaches divide limited detector pixels among multiple views. This constraint is particularly severe in the second near-infrared window (NIR-II), where commonly used InGaAs cameras typically have relatively small sensor formats and high detector noise. Here we introduce NIR-II squeezed light-field microscopy (NIR-II SLIM), which optically rotates and compresses multiple perspective views before detection, allowing efficient use of camera pixels while retaining complementary spatial information for three-dimensional reconstruction. NIR-II SLIM acquires volumes at up to 600 volumes s-1 with a reconstructed lateral sampling grid of 512 x 512 pixels. We use the method for label-free four-dimensional imaging of cardiac dynamics in pigmented late-larval zebrafish, resolving chamber deformation and millisecond-scale atrioventricular-valve motion, and for NIR-II fluorescence imaging of vascular and lymphatic transport in mice. NIR-II SLIM provides a detector-efficient approach for high-speed volumetric imaging of rapid biological dynamics in scattering tissues.

Purpose: To determine the feasibility of a 2-minute multi-echo UTE (mecho-UTE) for CT-like bone-weighted contrast and T2* quantification of tissues with short T2/T2*. Methods: Mecho-UTE data acquired from four patients and five healthy subjects were used to assess image quality of the CT-like contrast. All data were reconstructed using conventional gridding (GRID+CONV) and compared with those reconstructed using conjugate gradient SENSE combined with deep learning-based denoising (CG+DLR). Image resolution and sharpness of the CT-like images were assessed using the full width at half maximum (FWHM) and relative edge sharpness (RESH), respectively. Calimetrix UTE-T2* phantom was used to assess the accuracy of T2* quantification of the mecho-UTE sequence. Results: Two-minute mecho-UTE with CG+DLR has similar accuracy (0.37 {+/-} 0.27 vs. 0.67 {+/-} 0.54 ms, p=0.20) and better precision (0.28 {+/-} 0.16 vs. 1.23 {+/-} 0.29 ms, p<0.001) compared to the 5-minute mecho-UTE with GRID+CONV. The 2-minute mecho-UTE with CG+DLR has higher resolution and sharpness compared to the 5-minute scan with GRID+CONV. Conclusion: It is feasible to achieve simultaneous CT-like contrast and T2* quantification of short-T2 tissues in two minutes. When appropriately used, it may simplify logistics, reduce costs, and eliminate radiation exposure risks.

The lifetime of fluorescent molecules provides an orthogonal readout to fluorescence intensity, opening experimental possibilities of measuring changes in local molecular environments, mechanical tension, and metabolism, among other factors. These changes are best studied live and in vivo; however, limitations of slow imaging speeds, high phototoxicity, and increased data size and complexity have significantly impeded progress on this front. Here, we present a complete and transferable pipeline consisting of a light sheet FLIM microscope and an accompanying machine learning model for data processing that renders long-term and/or high-speed volumetric FLIM (vFLIM) tractable in living systems. We benchmark this pipeline across several biological use cases, model systems, lifetime ranges, and spatiotemporal scales, showcasing a suite of possibilities that our workflow enables. This comprehensive pipeline from imaging to analysis is a crucial step forward towards disseminating the power of live vFLIM to the broader bioimaging community.

Peripheral artery disease (PAD) spans a continuum from large-vessel obstruction to distal microvascular dysfunction, yet routine non-invasive tests, including the ankle-brachial index (ABI), do not provide structurally resolved assessment of the foot microvascular bed and may be unreliable in the setting of medial arterial calcification or perioperative follow-up. Here we developed a clinic-oriented multispectral compound-scanning photoacoustic tomography system (MCPATS) for compression-free distal toe imaging, and an interpretable photoacoustic tomography distal microcirculation score, termed PACT-DMS, for phenotyping PAD-related distal vascular abnormalities. PACT-DMS was derived from anatomically standardized distal toe sections and integrated seven prespecified vascular features spanning trunk-vessel morphology, microvascular distribution and pulsation-related dynamics through a traceable linear support vector machine. In a prospective single-centre cohort of 45 participants, the bilateral fusion PACT-DMS model distinguished patients with PAD from healthy controls with an area under the receiver operating characteristic curve of 0.964 (95% CI, 0.907-1.000) and an accuracy of 91.1% (95% CI, 82.2%-97.8%) under subject-level leave-one-out cross-validation, supported by complementary robustness analyses. Exploratory analyses further showed that PACT-DMS identified abnormal distal vascular phenotypes in 6 of 9 clinically diagnosed PAD limbs with non-abnormal ABI and visualized distal vascular-bed changes before and after revascularization. These findings support MCPATS-enabled interpretable photoacoustic vascular phenotyping as a candidate adjunctive approach for distal microcirculatory assessment in PAD; larger multicentre studies with external validation and prespecified analysis protocols will be required to define its clinical role.

Missing or degraded sequences can limit prostate multiparametric MRI. We developed MSCNet, a sequence-conditioned cross-modal generative framework for reconstructing unavailable contrasts and restoring degraded acquisitions. Across ten completion tasks, task-specific MSCNet achieved mean structural similarity of 0.818 versus 0.798 for the strongest task-matched comparators; matched-capacity analyses showed larger differences in lesion fidelity and boundary preservation. In a blinded 1,000-case reader study, overall image quality met the prespecified non-inferiority criterion for DWI, ADC and T2W completion, but not T1W. In a separate 200-case diagnostic assessment, AUCs for clinically significant cancer were 0.860 with acquired images, 0.841 with MSCNet and 0.797 with baseline-generated images. A locked 186-case three-hospital cohort supported multicentre transportability. These retrospective results support quality-controlled cross-modal reconstruction as an adjunct to acquired prostate MRI.

Functional near-infrared spectroscopy (fNIRS) and functional magnetic resonance imaging (fMRI) both rely on the phenomenon of neurovascular coupling (NVC) to probe brain activity through their sensitivity to cerebral blood oxygenation. However, the relationship between fNIRS chromophores (oxy- and deoxyhaemoglobin, HbO and HbR), and fMRI (Blood Oxygen Level Dependent and Arterial Spin Labeling, BOLD and ASL) measurements, and whether this relationship remains consistent across subjects and physiological conditions, has only been partially characterised.. We acquired concurrent continuous-wave fNIRS and gradient-echo (GE) and spin-echo (SE) BOLD-ASL fMRI in healthy adults (n = 10) during visual stimulation. By applying calibrated fMRI methodology, we examined the relationships between fNIRS-derived haemoglobin modulations and fMRI-derived modulations in macrovascular (GE-) and microvascular (SE-) BOLD signals, cerebral blood flow (CBF), and oxygen metabolism (CMRO2). Group-level results showed strong temporal cross-modal agreement, with HbO and HbR tightly mirroring all fMRI signal time-courses (|r| > 0.8). A quantitative analysis of trial-by-trial modulations revealed distinct state-dependent behaviours: HbO maintained a stable relationship with the fMRI-derived metrics across conditions, whereas cross-modal relationships between HbR and fMRI-derived metrics substantially strengthened at higher flow-metabolism coupling (FMC), the ratio of CBF to CMRO2 change, an index of the strength of NVC. Both HbO and HbR were more strongly associated with GE-BOLD than with SE-BOLD. These findings provide a rigorous physiological grounding for fNIRS signal interpretation, demonstrating its utility as a surrogate marker for specific haemodynamic and metabolic parameters.

Background: Positron emission tomography (PET) myocardial perfusion imaging (MPI) provides complementary information on perfusion, myocardial blood flow and ventricular function. While these markers are often considered collectively during interpretation, their quantitative integration with imaging and clinical data into a unified predictive framework remains limited. We developed a multimodal artificial intelligence framework that combines PET polar maps with quantitative imaging and clinical features to improve obstructive coronary artery disease (CAD) detection. Methods: We retrospectively analyzed the multicenter REFINE PET registry. Among 38,682 PET MPI studies from 14 sites, 2,833 patients without known prior CAD underwent invasive coronary angiography within 180 days. Obstructive CAD was defined as >=50% left main stenosis or >=70% stenosis in other major epicardial coronary arteries. We developed a two-stage contrastive learning framework to learn multimodal PET representations from studies without angiographic labels and transfer them to supervised CAD prediction. In Stage 1, PET image and tabular encoders were pretrained on 12,225 PET MPI studies from eight development sites using 15-channel PET polar maps, quantitative PET perfusion, flow and gated functional measures, and clinical variables. In Stage 2, the pretrained encoders and a lightweight classification head were fine-tuned in 968 angiography-labeled patients, using lower encoder learning rates to limit overfitting. The model was externally validated for angiographically defined obstructive CAD detection in 1,865 patients from six independent sites and compared with standard PET MPI metrics. Results: The prevalence of obstructive CAD was 60% in the training cohort (66% male, median age of 70 years [63, 77]), and 55% in the external validation cohort (64% male, median age of 67 years [60-74]). In external validation, the AI model achieved an AUC of 0.85 (95% confidence interval (CI), 0.83-0.87) for obstructive CAD detection and outperformed conventional quantitative PET metrics (all P < 0.001). At a specificity matched to visual summed stress score, the AI model achieved higher sensitivity (89% [95% CI, 87-91] versus 85% [95% CI, 82-87]) and negative predictive value (81% [95% CI, 77-84] versus 73% [95% CI, 69-77]; both p<0.001). The overall net reclassification improvement was 8.9% (95% CI, 4.2-13.6%; p = 0.001). Conclusions: Multimodal contrastive pretraining improved obstructive CAD detection from PET imaging beyond conventional perfusion-based scoring in independent multisite external validation.

Direct modulation of neural activity with high spatiotemporal precision is a cornerstone in experimental neuroscience. Here, we present a blood-mediated optoacoustic stimulation (BOAS) approach that utilizes blood as an endogenous transducer for brain stimulation. By delivering 532-nm nanosecond pulsed laser to the cortex, we demonstrate that the absorption of hemoglobin generates sufficient acoustic pressure to trigger neuronal activity. By integrating BOAS with calcium imaging in GCaMP6f-expressing mice, localized neuronal responses were observed. Quantitative analysis reveals that BOAS produces responses comparable to natural visual stimulation and is significantly more efficient than the photothermal stimulation. Furthermore, we show that the response is dose-dependent. At high energy doses, BOAS induces cortical spreading depression. Histological evaluation confirmed that the brain maintains tissue integrity even under these stimulation parameters. Together, this work establishes a versatile method for precise brain stimulation as an alternative method for stimulating neuron at cortex.

Chronic, mechanically resilient thrombi remain difficult to remove rapidly and safely using existing therapies, which are limited by slow treatment speeds, reduced efficacy against aged clots and risks associated with embolic debris. Here we introduce Constrained Laser-Induced Cavitation (CLIC), a novel approach that confines laser-induced cavitation bubble generation and collapse within a miniaturized waveguide to enhance thrombolysis. Optimized CLIC removed retracted clots at a mass-loss rate of 393.5 mg/min, [~]40-fold higher than reported state-of-the-art sonothrombolysis under similar conditions. Systematic variation of channel length and laser parameters showed that CLIC efficacy depends strongly on treatment geometry and cavitation dynamics. Post-treatment analysis revealed cylindrical channels consistent with clot removal dominated by fluid jetting and suction-driven evacuation, with cavitation shockwaves likely contributing a secondary role. Debris fragment measurements remained predominantly below a 1 mm embolic-risk threshold, consistent with a promising embolic safety profile. These findings establish CLIC as a viable strategy for rapid thrombolysis of chronic, mechanically resistant thrombi.