Transfontanelle photoacoustic imaging of intraventricular brain hemorrhages in live sheep

Juliana Benavides-Lara; Rayyan Manwar; Laura S McGuire; Md Tarikul Islam; Anthony Shoo; Fady T Charbel; Martha G Menchaca; Amanda P Siegel; De-Ann M Pillers; Juri G Gelovani; Kamran Avanaki

doi:10.1016/j.pacs.2023.100549

Transfontanelle photoacoustic imaging of intraventricular brain hemorrhages in live sheep

Photoacoustics. 2023 Aug 24:33:100549. doi: 10.1016/j.pacs.2023.100549. eCollection 2023 Oct.

Authors

Affiliations

¹ Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, United States.
² Department of Neurological Surgery, University of Illinois at Chicago - College of Medicine, Chicago, IL, United States.
³ Section of Neonatology, Department of Pediatrics, UIHealth Children's Hospital of the University of Illinois at Chicago, Chicago, IL, United States.
⁴ Provost Office, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, UAE.
⁵ Department of Biomedical Engineering, College of Engineering and School of Medicine, Wayne State University, Detroit, MI 48201, United States.
⁶ Dept. Radiology, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
⁷ Department of Dermatology, University of Illinois at Chicago, Chicago, IL, United States.

Abstract

Intraventricular (IVH) and periventricular (PVH) hemorrhages in preterm neonates are common because the periventricular blood vessels are still developing up to 36 weeks and are fragile. Currently, transfontanelle ultrasound (US) imaging is utilized for screening for IVH and PVH, largely through the anterior fontanelle. However for mild hemorrhages, inconclusive diagnoses are common, leading to failure to detect IVH/PVH or, when other clinical symptoms are present, use of second stage neuroimaging modalities requiring transport of vulnerable patients. Yet even mild IVH/PVH increases the risk of moderate-severe neurodevelopmental impairment. Here, we demonstrate the capability of transfontanelle photoacoustic imaging (TFPAI) to detect IVH and PVH in-vivo in a large animal model. TFPAI was able to detect IVH/PVH as small as 0.3 mL in volume in the brain (p < 0.05). By contrast, US was able to detect hemorrhages as small as 0.5 mL. These preliminary results suggest TFPAI could be translated into a portable bedside imaging probe for improved diagnosis of clinically relevant brain hemorrhages in neonates.

Keywords: IVH; Intraventricular hemorrhage; Neonates; PVH; Periventricular hemorrhage; Photoacoustic imaging; Transfontanelle.