Review of biomedical Čerenkov luminescence imaging applications.

Čerenkov radiation is a fascinating optical signal, which has been exploited for unique diagnostic biological sensing and imaging, with significantly expanded use just in the last half decade. Čerenkov Luminescence Imaging (CLI) has desirable capabilities for niche applications, using specially designed measurement systems that report on radiation distributions, radiotracer and nanoparticle concentrations, and are directly applied to procedures such as medicine assessment, endoscopy, surgery, quality assurance and dosimetry. When compared to the other imaging tools such as PET and SPECT, CLI can have the key advantage of lower cost, higher throughput and lower imaging time. CLI can also provide imaging and dosimetry information from both radioisotopes and linear accelerator irradiation. The relatively short range of optical photon transport in tissue means that direct Čerenkov luminescence imaging is restricted to small animals or near surface human use. Use of Čerenkov-excitation for additional molecular probes, is now emerging as a key tool for biosensing or radiosensitization. This review evaluates these new improvements in CLI for both medical value and biological insight.