Dual photoacoustic/ultrasound technologies for preclinical research: current status and future trends

Abstract Photoacoustic imaging (PAI), by integrating optical and ultrasound modalities, combines high spatial resolution with deep tissue penetration, making it a transformative tool in biomedical research. This review presents a comprehensive analysis of the current status of dual photoacoustic/ultrasound (PA/US) imaging technologies, emphasising their applications in preclinical research. It details advancements in light excitation strategies, including tomographic and microscopic modalities, innovations in pulsed laser and alternative light sources, and ultrasound instrumentation. The review further explores preclinical methodologies, encompassing dedicated instrumentation, signal processing, and data analysis techniques essential for PA/US systems. Key applications discussed include the visualisation of blood vessels, micro-circulation, and tissue perfusion; diagnosis and monitoring of inflammation; evaluation of infections, atherosclerosis, burn injuries, healing, and scar formation; assessment of liver and renal diseases; monitoring of epilepsy and neurodegenerative conditions; studies on brain disorders and preeclampsia; cell therapy monitoring; and tumour detection, staging, and recurrence monitoring. Challenges related to imaging depth, resolution, cost, and the translation of contrast agents to clinical practice are analysed, alongside advancements in high-speed acquisition, artificial intelligence-driven reconstruction, and innovative light-delivery methods. While clinical translation remains complex, this review underscores the crucial role of preclinical studies in unravelling fundamental biomedical questions and assessing novel imaging strategies. Ultimately, this review delves into the future trends of dual PA/US imaging, highlighting its potential to bridge preclinical discoveries with clinical applications and drive advances in diagnostics, therapeutic monitoring, and personalised medicine.