Preclinical evaluation of photoacoustic imaging as a novel noninvasive approach to detect an orthopaedic implant infection

Yu Wang, John M. Thompson, Alyssa G. Ashbaugh, Pavlo Khodakivskyi, Ghyslain Budin, Riccardo Sinisi, Andrew Heinmiller, Marleen Van Oosten, Jan Maarten Van Dijl, Gooitzen M. Van Dam, Kevin P. Francis, Nicholas M. Bernthal, Elena A. Dubikovskaya, Lloyd S. Miller

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Diagnosing prosthetic joint infection (PJI) poses significant challenges, and current modalities are fraught with low sensitivity and/or potential morbidity. Photoacoustic imaging (PAI) is a novel ultrasound-based modality with potential for diagnosing PJI safely and noninvasively. Materials: In an established preclinical mouse model of bioluminescent Staphylococcus aureus PJI, fluorescent indocyanine green (ICG) was conjugated to b-cyclodextrin (CDX-ICG) or teicoplanin (Teic-ICG) and injected intravenously for 1 week postoperatively. Daily fluorescent imaging and PAI were used to localize and quantify tracer signals. Results were analyzed using 2-way analysis of variance. Results: Fluorescence clearly localized to the site of infection and was significantly higher with Teic-ICG compared with CDX-ICG (P = 0.046) and ICG alone (P = 0.0087). With PAI, the photoacoustic signal per volumetric analysis was substantially higher and better visualized with Teic-ICG compared with CDX-ICG and ICG alone, and colocalized well with bioluminescence and fluorescence imaging. Conclusion: Photoacoustic imaging successfully localized PJI in this proof-ofconcept study and demonstrates potential for clinical translation in orthopaedics.

Original languageEnglish (US)
Pages (from-to)S7-S12
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume25
DOIs
StatePublished - 2017

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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