Ultrasound imaging of breast cancer offers a non-invasive method to monitor treatment effectiveness.

While immunotherapy holds great promise, many patients do not respond to current treatment methods. A major challenge has been the ability to predict and track the response of individual tumors to therapy, complicated by significant heterogeneity observed among different patients, explains Marjan Rafat, an assistant professor in the Department of Chemical and Biomolecular Engineering.

An innovative study published in the journal Theranostics illustrates how ultra-fast energy Doppler ultrasound can provide crucial insights into the complex vascular interactions in the tumor microenvironment, potentially transforming personalized cancer treatment strategies.

“A distinctive feature of this research is its ability to non-invasively monitor changes in the tumor that are typically detectable through biopsy or imaging techniques, which may not reflect the entire response. This ultrasound method allows for observing the patient's tumor response to treatment, which can facilitate quicker clinical decision-making,” says Shannon Martello, the lead author of the study and a graduate student in Rafat’s Tumor and Tissue Microenvironment Lab.

The interdisciplinary team developed an innovative approach using ultra-fast energy Doppler ultrasound to monitor tumor vessels in real-time across two breast cancer models – metastatic and non-metastatic. By tracking changes in the blood vessel network, researchers can now gain unprecedented insights into how tumors respond to radiation therapy.

Ultrasound measurements revealed a sustained decrease in the tumor vascular index following radiation and immunotherapy, which correlated with significant infiltration of CD8+ T cells in the tumors. These T cells play a critical role in immune defense against malignant cells.

The team also observed an early increase in the number of splenic CD8+ T cells post-irradiation. The spleen serves as a key site for their activation and proliferation against pathogenic microorganisms carried by the blood, as well as performing the immune function of eliminating cancer cells.

“The results suggest that ultra-fast energy Doppler ultrasound could become a vital tool in personalizing cancer treatment. By providing accurate treatment efficacy metrics, physicians will be able to select therapies more quickly and accurately,” says Rafat.

Although the study is preliminary, it opens exciting possibilities for improving treatment outcomes for patients with triple-negative breast cancer.

Monitoring vascular changes to predict response to therapy and shifts in the tumor immune landscape could enhance outcomes for patients with limited treatment options.