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Aims To evaluate whether Optical Ultrasound (OpUS), a novel method for performing ultrasound imaging, could provide compelling, real-time visualizations of coronary vasculature. Methods and results With current commercial intravascular ultrasound (IVUS) devices, piezoelectric transducers are used to electrically generate and receive Ultrasound (US). With this paradigm, there are several challenges that limit further improvement in image resolution. Firstly, with increasing miniaturization of these piezoelectric transducers it can be difficult to achieve adequate sensitivity and bandwidth for high resolution imaging. Secondly, the complexities associated with fabricating and electrically connectorising broadband piezocomposite transducers can result in high manufacturing costs. Lastly, with increasing interest in identifying the molecular composition of atherosclerotic plaque, it has been challenging to achieve high resolution and high imaging depths, whilst also allowing for hybrid imaging with photoacoustics (PA) or near-infrared spectroscopy (NIRS). With OpUS, US is generated at the surface of a fibre optic transducer via the photoacoustic effect. Here, pulsed or modulated light from a laser source is transmitted along the fibre, absorbed in a coating on the fibre surface and converted to thermal energy. The subsequent heat rise leads to a corresponding pressure rise within the coating which propagates as ultrasound. This process is facilitated through the use of custom, engineered nanocomposite materials comprising an optical absorber with an elastomeric host. US reflections from tissue are received with optical interferometry in a method similar to optical coherence tomography (OCT) signal interrogation. For this study we included these elements into a probe and imaged ex-vivo coronary artery tissue. A novel, optically-selective nanocomposite coating enabled concurrent OpUS and PA imaging for molecular contrast using the same imaging probe. Using OpUS we demonstrated high resolution imaging (&amp;lt;40 microns axial), large imaging depths (&amp;gt;2 cm) of coronary tissue and performed a comparison with histology. Numerous features of atherosclerotic plaque were identifiable, including a lipid pool, a calcified nodule, and the different layers comprising the vessel wall. The fiber-optic transducer generated ultra-high pressures and bandwidths: 21.5 MPa and 39.8 MHz respectively. Hybrid imaging using OpUS and PA was also demonstrated, highlighting regions with high lipid content. Conclusion This new platform for intravascular imaging offers high resolution equivalent to 60 Mhz high-definition IVUS whilst maintaining deep tissue penetration. Hybrid imaging with PA can be used for directly visualizing lipid plaque. OpUS transducers are highly flexible, with small diameters (&amp;lt;400 microns) and have low fabrication costs, making them well suited for incorporation into interventional devices. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Wellcome Trust/EPSRC, National Institute for Health Research Biomedical Research Centre - University College London

Optical ultrasound (OpUS): a novel concept for intravascular imaging