Photoacoustic imaging: a unique imaging examination for the assessment of diabetic vascular disease

As an emerging medical imaging technique, photoacoustic imaging (PAI) holds promise as a significant tool in the field of medical imaging due to its combination of high-resolution optical characteristics and deep penetration acoustic properties. This method non-invasively provides high-contrast biological information imaging and offers substantial advantages in assessing vascular structure and function. The core pathological issue in the clinical diagnosis and treatment of diabetes mellitus is the microvascular and macrovascular complications resulting from hyperglycemia and other factors. However, clinical imaging assessments of vascular lesions are still limited, whereas PAI has demonstrated unique advantages in the early diagnosis, disease monitoring, and therapeutic evaluation of diabetic vascular lesions. PAI not only allows for the calculation of vascular parameters such as vessel diameter and density but also enables real-time monitoring of hemodynamic and blood oxygen saturation dynamics, providing a new approach for the dynamic assessment of diabetic vascular lesions. This article reviews the current research on PAI in diabetic vascular disease, including animal experiments and human studies on microvascular lesions, peripheral vascular disease, diabetic foot, and chronic wounds, showcasing the strengths and limitations of this imaging method to clinicians. This review aims to lay the foundation for further clinical development and application.