Photoacoustic microscopy classifies colorectal liver metastasis vascular phenotypes and predicts bevacizumab resistance

Photoacoustic microscopy distinguished angiogenesis-type from vessel-co-option-type colorectal liver metastases in mice. Vessel-co-option metastases showed no significant response to bevacizumab (treated vs untreated vessel density: p=0.56), while angiogenesis-type metastases ha…

• Study design: Preclinical in vivo study using 72 BALB/c nude mice with HCT116-luc or HT29-luc colorectal liver metastasis (CRLM) models; microvascular architecture assessed by high-lateral-resolution PAM and validated by histopathology.
• Angiogenesis-type CRLMs had lower vessel density (15.66% vs 31.44%, p<0.001), lower vessel junction density, and higher vessel diameter and lacunarity compared to vessel-co-option-type, with differences persisting over 8 weeks.
• Key limitation: Preclinical mouse model study without external validation in human patients; clinical translatability to human liver metastases and in vivo photoacoustic imaging remains unproven.

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