"During minimally invasive procedures, accurate identification of tissue targets is of critical importance to maximise clinical outcomes. Ultrasound imaging is widely used for real-time guidance, but in many clinical contexts it provides inadequate contrast for tissue targets. The overall objective of this translational research proposal is to develop and test a novel framework for guiding minimally invasive procedures that will dramatically enhance image contrast for a wide range of tissue structures. One of the central components of this framework will be a new modality called photoacoustics, which involves acoustic imaging of specific molecular tissue constituents that absorb pulsed excitation light. With Objective 1, we will combine ultrasound imaging with photoacoustic imaging into a novel clinical system that will be optimised for guiding minimally invasive procedures in human patients. With Objective 2, we will obtain multi-spectral photoacoustic images that provide contrast for molecules such as haemoglobins, water, and lipids, and we will co-register them with ultrasound images. With Objective 3, we will perform pre-clinical and clinical pilot studies to assess the potential of the new image guidance framework for improving the accuracy of particular minimally invasive procedures in the field of interventional pain management. This proposal is timely because there is intense scientific and clinical interest in photoacoustic imaging, but this modality has not yet been extended to the guidance of minimally invasive procedures. With a Starting Grant from the ERC, I will initiate a multi-disciplinary translational research group that is focused on developing new imaging technologies for improving the clinical outcomes of minimally invasive procedures."