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Currently, the application of the technologies is mainly limited by moderate speed. In this study, we developed a real\u2010time IVPA\/IVUS\/OCT tri\u2010modality system by overcoming synchronization challenges and suppressing electromagnetic interference via hardware\/software improvements. Ex\u00a0vivo pulsing vessels imaging was performed to obtain the comprehensive information without motion artifacts. Furthermore, the alive intravascular blood environment was simulated by flowing intralipid (comparable scattering factor with blood) inside the ex\u00a0vivo vessels. Benefitted from the improved imaging speed, PA and OCT signal changes of the vessels were smoothly recorded throughout manual flushing and analyzed quantitatively. To the best of our knowledge, it's the first real\u2010time intravascular tri\u2010modality imaging system, enabling dynamic flushing observation and providing the possibility for systematic analysis of the signal levels and distributions.<\/jats:p>","DOI":"10.1002\/jbio.70290","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T08:17:09Z","timestamp":1779956229000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010Time Intravascular Photoacoustic\/Ultrasound\/Optical Coherence Tomography Imaging of Pulsing Vessels Ex\u00a0Vivo With and Without \u201cBlood\u201d Flushing"],"prefix":"10.1002","volume":"19","author":[{"given":"Xiaoran","family":"Wang","sequence":"first","affiliation":[{"name":"College of Physics, National Demonstration Center for Experimental Applied Physics Education, Qingdao University  Qingdao China"},{"name":"Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Tan","sequence":"additional","affiliation":[{"name":"Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"},{"name":"Department of Control Science and Engineering Harbin Institute of Technology Harbin  Harbin Heilongjiang People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyou","family":"Shu","sequence":"additional","affiliation":[{"name":"Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinke","family":"Zhang","sequence":"additional","affiliation":[{"name":"Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riqiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongcheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"College of Physics, National Demonstration Center for Experimental Applied Physics Education, Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjian","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Control Science and Engineering Harbin Institute of Technology Harbin  Harbin Heilongjiang People's Republic of China"},{"name":"Department of Control Science and Engineering Harbin Institute of Technology  Weihai Shandong China"},{"name":"Shandong Laboratory of Advanced Biomaterials and Medical Devices in Weihai  Weihai Shandong China"},{"name":"Harbin Institute of Technology Suzhou Research Institute Suzhou  Suzhou P. 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihua","family":"Xie","sequence":"additional","affiliation":[{"name":"Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-3522","authenticated-orcid":false,"given":"Xiaojing","family":"Gong","sequence":"additional","affiliation":[{"name":"Research Center for Biomedical Optics and Molecular Imaging, Key Laboratory of Biomedical Imaging Science and System, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.11.041"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2024.12.004"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.1.JNS142452"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.10.017"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00282-4"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31922-5"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.01.034"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2020.02.02"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1063\/1.4929584"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1364\/OE.21.021472"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.2.003072"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JBO.20.5.056005"},{"issue":"3","key":"e_1_2_10_14_1","first-page":"133","article-title":"Method Analysis for Optimal Continuous Imaging Using Intravascular Optical Coherence Tomography","volume":"47","author":"Asawa K.","year":"2006","journal-title":"Journal of Cardiology"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnm.2657"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2020.00119"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-018-0953-3"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1142\/S1793545823500165"},{"issue":"3","key":"e_1_2_10_19_1","article-title":"Intravascular Photoacoustic, Ultrasonic, Optical Coherence Tomography, and Photoacoustic Elastic Multimodal Imaging Method and System","volume":"50","author":"Wan Y. 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