Advanced Ultrasound Imaging for Early Cancer Detection and Diagnosis

Background: Early detection and clinical intervention of cancer can significantly increase chances of patient survival. Imaging of the microvasculature provides opportunities for early detection, diagnosis and monitoring of cancer. Current clinical imaging modalities (e.g.

MRI, CT, standard ultrasound (US)) cannot resolve these microscopic structures, while optical microscopy can only resolve these at superficial depths. Thus, there is a crucial clinical need for imaging techniques that can fill this resolution gap.

Contrast enhanced US (CEUS) provides improved visualisation of organs and blood vessels within the body compared to standard US.

Furthermore, super-resolution US (SRUS) uses CEUS to uncover both the structure and flow of microvascular networks within the body, previously concealed with standard US. SRUS has the unique advantage of being able to achieve this level of visualisation deep within the body. Nevertheless, its feasibility for early detection and diagnosis (ED&D) is yet to be explored.

Aims: In this project, we aim to develop SRUS technology for the detection and diagnosis of early cancerous changes of the vasculature.

We aim to identify and quantify trends in vascular changes that can differentiate normal tissue from early cancerous tissue. Methods: We will design, develop and optimise a 3D CEUS acquisition protocol for SRUS ED&D.

We will perform in vivo tumour growth models of two cancers where vasculature plays a critical role, the liver and brain.

We will generate longitudinal in vivo 3D pilot data and use this to derive local and global metrics to examine and quantify vascular characteristics related to morphology, and functionality of the tumour microenvironment.

We will use advanced image analysis and computer vision to extract information from both CEUS and SRUS, and establish image-derived biomarkers able to characterise and quantify changes associated with cancer progression.

How results will be used: This feasibility study will lead to the generation of a larger study to refine clinically meaningful metrics for ED&D and risk stratification. SRUS has potential for impact in a wide-range of cancer sites, including those with unmet clinical need.

Furthermore, this in vivo research platform could improve our understanding of microvascular changes in tumour development by enabling the longitudinal monitoring of vasculature both pre-clinically and clinically.

Summary: Developing an affordable imaging technique that is able to analyse 3D architecture and functionality of blood vessels at unprecedented, high resolution could enable the detection, diagnosis, and stratification of early cancer development, as well as timely intervention and treatment monitoring.