Mitigating skin tone bias in linear array in vivo photoacoustic imaging with short-lag spatial coherence beamforming

Photoacoustic (PA) imaging has the potential to deliver non-invasive diagnostic information. However, skin tone differences bias PA target visualization, as the elevated optical absorption of melanated skin decreases optical fluence within the imaging plane and increases the presence of acoustic clutter. This paper demonstrates that short-lag spatial coherence (SLSC) beamforming mitigates this bias. PA data from the forearm of 18 volunteers were acquired with 750-, 810-, and 870-nm wavelengths. Skin tones ranging from light to dark were objectively quantified using the individual typology angle (ITA$$). The signal-to-noise ratio (SNR) of the radial artery (RA) and surrounding clutter were measured. Clutter was minimal (e.g., -16 dB relative to the RA) with lighter skin tones and increased to -8 dB with darker tones, which compromised RA visualization in conventional PA images. SLSC beamforming achieved a median SNR improvement of 3.8 dB, resulting in better RA visualization for all skin tones.