Seeing blood vessels without using a needle: imaging makes early heart disease visible through the skin

One of the earliest warning signs of cardiovascular disease happens deep within the smallest blood vessels: tiny changes in their ability to expand and contract, known as microvascular endothelial dysfunction (MiVED). Until now, it has been extremely difficult to detect or measure these changes in humans. Researchers from Helmholtz Munich and the Technical University of Munich (TUM), member institutions of the German Centre for Cardiovascular Research (DZHK), have developed a solution: fast-RSOM.

The new technique uses pulses of light that generate ultrasound to create extremely detailed 3D images of the skin and the smallest blood vessels. This makes it possible to detect early changes that remain invisible to conventional methods.

“With fast-RSOM, we can, for the first time, non-invasively assess endothelial dysfunction at single-capillary and skin-layer resolution in humans,” says Dr. Hailong He, first author of the study and researcher at the Institute of Biological and Medical Imaging at Helmholtz Munich and TUM. Dr Angelos Karlas, co-first author, Vascular Surgeon and Senior Research Scientist at TUM University Hospital, adds: “Our novel approach offers an unprecedented view of how cardiovascular disease manifests at the microvascular level.”

Until now, clinicians have lacked a precise and non-invasive way to detect or measure these early changes in humans. Fast-RSOM can support cardiovascular health on several levels. It provides indications of increased risk before symptoms occur, helps tailor lifestyle changes or therapies more precisely, and enables monitoring of whether preventive measures or treatments are effective.

From research to clinical practice

The research team now aims to test fast-RSOM in larger and more diverse patient groups and to integrate the high-resolution MiVED biomarkers provided by fast-RSOM into routine clinical practice. The device is portable, quick to deploy and non-invasive, meaning it could in future be used in hospitals and GP surgeries to regularly assess cardiovascular risk and monitor heart health in patients.

What is RSOM?

RSOM (Raster Scan Optoacoustic Mesoscopy) is a non-invasive imaging technology that uses pulses of light to generate ultrasound signals, producing highly detailed 3D images of structures beneath the skin. It can detect tiny changes in blood vessels, oxygen levels, and tissue composition that are invisible to traditional imaging. By combining high contrast with depth, RSOM enables early detection of diseases such as cardiovascular problems and diabetes. Its compact design could make advanced diagnostics more accessible outside specialized labs. The technology was developed by the team led by Prof. Vasilis Ntziachristos. He is a Principal Investigator at the German Centre for Cardiovascular Research, Director of the Bioengineering Center at Helmholtz Munich, and Professor of Biological Imaging at the Technical University of Munich.

Source: DZHK