Acousto-optic imaging (AOI) is an emerging technique in the field of biomedical optics which combines the optical contrast allowed by diffuse optical tomography with the resolution of ultrasound (US) imaging. In this work we report the implementation, for that purpose, of a CMOS smart-pixels sensor dedicated to the real-time analysis of speckle patterns. We implemented a highly sensitive lock-in detection in each pixel in order to extract the tagged photons after an appropriate in-pixel post-processing. With this system we can acquire images in scattering samples with a spatial resolution in the 2mm range, with an integration time compatible with the dynamic of living biological tissue.