Breaking (Light) Barriers: Photoacoustics in Atherosclerotic Diseases

Photoacoustic imaging (PAI) is an emerging imaging modality that provides high-resolution, spatiotemporal insights into anatomical structures, functional parameters and molecular characteristics of tissues. By leveraging both endogenous absorbers, such as lipids and collagen, and exogenous contrast agents like nanoparticles and molecular dyes, PAI offers a comprehensive approach to characterising atherosclerosis. This review describes the technical principles underlying various PAI modalities and spectral unmixing techniques. Furthermore, it addresses the application of endogenous PAI for assessing atherosclerotic plaque stability and the utility of exogenous contrast. We examine the current landscape of PAI in cardiovascular research, its strengths in evaluating plaque vulnerability and the challenges and future directions for its clinical translation.