Three-Dimensional H-Scan Ultrasound Imaging of Early Breast Cancer Response to Neoadjuvant Therapy in a Murine Model

H-Scan Discrimination for Tumor Microenvironmental Heterogeneity in Melanoma

OBJECTIVE

Melanoma is a form of malignant skin cancer that exhibits significant inter-tumoral differences in the tumor microenvironment (TME) secondary to genetic mutations. The heterogeneity may be subtle but can complicate the treatment of metastatic melanoma, contributing to a high mortality rate. Therefore, developing an accurate and non-invasive procedure to discriminate microenvironmental heterogeneity to facilitate therapy selection is an important goal.

METHODS

In vivo murine melanoma models that recapitulate human disease using synchronous implanted YUMM 1.7 (Yale University Mouse Melanoma) and YUMMER 1.7 (Yale University Mouse Melanoma Exposed to Radiation) murine melanoma lines were investigated. Mice were treated with antibodies to modulate the immune response and longitudinally scanned with ultrasound (US). US radiofrequency data were processed using the H-scan analysis, attenuation estimation and B-mode processing to extract five US features. The measures were used to compare different TMEs (YUMMER vs. YUMM) and responses to immunomodulatory therapies with CD8 depletion or programmed cell death protein 1 (PD-1) inhibition.

RESULTS

Multiparametric analysis produced a combined H-scan parameter, resolving significant differences (i) between untreated YUMMER and YUMM and (ii) between untreated, PD-1-treated and CD8-treated YUMMER. However, more importantly, the B-mode and attenuation measures failed to differentiate YUMMER and YUMM and to monitor treatment responses, indicating that H-scan is required to differentiate subtle differences within the TME.

CONCLUSION

We anticipate that the H-scan analysis could discriminate heterogeneous melanoma metastases and guide diagnosis and treatment selection, potentially reducing the need for invasive biopsies or immunologic procedures.

Innovative Experimental Ultrasound and US-Related Techniques Using the Murine Model in Pancreatic Ductal Adenocarcinoma: A Systematic Review

Pancreatic ductal adenocarcinoma (PDAC) is a cancer with one of the highest mortality rates in the world. Several studies have been conductedusing preclinical experiments in mice to find new therapeutic strategies. Experimental ultrasound, in expert hands, is a safe, multifaceted, and relatively not-expensive device that helps researchers in several ways. In this systematic review, we propose a summary of the applications of ultrasonography in a preclinical mouse model of PDAC. Eighty-eight studies met our inclusion criteria. The included studies could be divided into seven main topics: ultrasound in pancreatic cancer diagnosis and progression (n: 21); dynamic contrast-enhanced ultrasound (DCE-US) (n: 5); microbubble ultra-sound-mediated drug delivery; focused ultrasound (n: 23); sonodynamic therapy (SDT) (n: 7); harmonic motion elastography (HME) and shear wave elastography (SWE) (n: 6); ultrasound-guided procedures (n: 9). In six cases, the articles fit into two or more sections. In conclusion, ultrasound can be a really useful, eclectic, and ductile tool in different diagnostic areas, not only regarding diagnosis but also in therapy, pharmacological and interventional treatment, and follow-up. All these multiple possibilities of use certainly represent a good starting point for the effective and wide use of murine ultrasonography in the study and comprehensive evaluation of pancreatic cancer.

Hermite-scan imaging for differentiating glioblastoma from normal brain: Simulations and ex vivo studies for applications in intra-operative tumor identificationa)

Hermite-scan (H-scan) imaging is a tissue characterization technique based on the analysis of raw ultrasound radio frequency (RF) echoes. It matches the RF echoes to Gaussian-weighted Hermite polynomials of various orders to extract information related to scatterer diameter. It provides a color map of large and small scatterers in the red and blue H-scan image channels, respectively. H-scan has been previously reported for characterizing breast, pancreatic, and thyroid tumors. The present work evaluated H-scan imaging to differentiate glioblastoma tumors from normal brain tissue ex vivo. First, we conducted 2-D numerical simulations using the k-wave toolbox to assess the performance of parameters derived from H-scan images of acoustic scatterers (15-150 μm diameters) and concentrations (0.2%-1% w/v). We found that the parameter intensity-weighted percentage of red (IWPR) was sensitive to changes in scatterer diameters independent of concentration. Next, we assessed the feasibility of using the IWPR parameter for differentiating glioblastoma and normal brain tissues (n = 11 samples per group). The IWPR parameter estimates for normal tissue (44.1% ± 1.4%) were significantly different (p < 0.0001) from those for glioblastoma (36.2% ± 0.65%). These findings advance the development of H-scan imaging for potential use in differentiating glioblastoma tumors from normal brain tissue during resection surgery.

H-Scan Ultrasound Monitoring of Breast Cancer Response to Chemotherapy and Validation With Diffusion-Weighted Magnetic Resonance Imaging

OBJECTIVES

H-scan ultrasound (US) imaging is a novel tissue characterization technique to detect apoptosis-induced changes in cancer cells after the initiation of effective drug treatment. The objective of the proposed research was to assess the sensitivity of 3-dimensional (3D) H-scan US technique for monitoring the response of breast cancer-bearing animals to neoadjuvant chemotherapy and correlate results to diffusion-weighted magnetic resonance imaging (DW-MRI) measurements of programmed cancer cell death.

METHODS

Experimental studies used female mice (N = 18) implanted with human breast cancer cells. Animals underwent H-scan US and DW-MRI imaging on days 0, 1, 3, 7, and 10. After imaging at day 0, breast tumor-bearing nude mice were treated biweekly with an apoptosis-inducing drug. Texture analysis of H-scan US images explored spatial relationships between local US scattering. At day 10, H-scan measurements were compared with DW-MRI-derived apparent diffusion coefficient (ADC) values and histological findings.

RESULTS

H-scan US imaging of low and high dose cisplatin-treated cancer-bearing animals revealed changes in image intensity suggesting a progressive decrease in aggregate US scatterer size that was not observed in control animals. Longitudinal trends discovered in H-scan US result matched with texture analysis and DW-MRI (P < .01). Further, analysis of the H-scan US image intensity and corresponding DW-MRI-derived ADC values revealed a strong linear correlation (R²  = .93, P < .001). These changes were due to cancer cell apoptotic activity and consider as early detectable biomarker during treatment.

CONCLUSIONS

The 3D H-scan technique holds promise for assisting clinicians in monitoring the early response of breast cancer tumor to neoadjuvant chemotherapy and adding value to traditional diagnostic ultrasound examinations.

High-Resolution Ultrasound Characterization of Local Scattering in Cancer Tissue

Ultrasound (US) has afforded an approach to tissue characterization for more than a decade. The challenge is to reveal hidden patterns in the US data that describe tissue function and pathology that cannot be seen in conventional US images. Our group has developed a high-resolution analysis technique for tissue characterization termed H-scan US, an imaging method used to interpret the relative size of acoustic scatterers. In the present study, the objective was to compare local H-scan US image intensity with registered histologic measurements made directly at the cellular level. Human breast cancer cells (MDA-MB 231, American Type Culture Collection, Manassas, VA, USA) were orthotopically implanted into female mice (N = 5). Tumors were allowed to grow for approximately 4 wk before the study started. In vivo imaging of tumor tissue was performed using a US system (Vantage 256, Verasonics Inc., Kirkland, WA, USA) equipped with a broadband capacitive micromachined ultrasonic linear array transducer (Kolo Medical, San Jose, CA, USA). A 15-MHz center frequency was used for plane wave imaging with five angles for spatial compounding. H-scan US image reconstruction involved use of parallel convolution filters to measure the relative strength of backscattered US signals. Color codes were applied to filter outputs to form the final H-scan US image display. For histologic processing, US imaging cross-sections were carefully marked on the tumor surface, and tumors were excised and sliced along the same plane. By use of optical microscopy, whole tumor tissue sections were scanned and digitized after nuclear staining. US images were interpolated to have the same number of pixels as the histology images and then spatially aligned. Each nucleus from the histologic sections was automatically segmented using custom MATLAB software (The MathWorks Inc., Natick, MA, USA). Nuclear size and spacing from the histology images were then compared with local H-scan US image features. Overall, local H-scan US image intensity exhibited a significant correlation with both cancer cell nuclear size (R2 > 0.27, p < 0.001) and the inverse relationship with nuclear spacing (R2 > 0.17, p < 0.001).

Generalized mathematical framework for contrast-enhanced ultrasound imaging with pulse inversion spectral deconvolution

A generalized mathematical framework for performing contrast-enhanced ultrasound (CEUS) imaging is introduced. Termed pulse inversion spectral deconvolution (PISD), this CEUS approach is founded on Gaussian derivative functions (GDFs). PISD pulses are used to form two inverted pulse sequences, which are then used to filter backscattered ultrasound (US) data for isolation of the nonlinear (NL) microbubble (MB) signal component. An US scanner equipped with a linear array transducer was used for data acquisition. With a vascular flow phantom perfused with MBs, data was collected using PISD and NL-based CEUS imaging. The role of wide-beam transmit aperture size (32 or 64 elements) was also evaluated using an US pulse frequency of 6.25 MHz. Image enhancement was quantified by a contrast-to-noise ratio (CNR). Preliminary in vivo data was collected in the hindlimb and kidney of healthy rats. Overall, in vitro wide-beam CEUS imaging using an aperture size of 64 elements yielded improved CNR values. Specifically, PISD-based CEUS imaging produced CNR values of 37.3 dB. For comparison, CNR values obtained using B-mode US or NL approaches were 2.1 and 12.1 dB, respectively. In vivo results demonstrated that PISD-based CEUS imaging improved vascular visualization compared to the NL imaging strategy.

3-D H-scan ultrasound imaging of relative scatterer size using a matrix array transducer and sparse random aperture compounding

H-scan ultrasound (US) is a high-resolution imaging technique for soft tissue characterization. By acquiring data in volume space, H-scan US can provide insight into subtle tissue changes or heterogenous patterns that might be missed using traditional cross-sectional US imaging approaches. In this study, we introduce a 3-dimensional (3-D) H-scan US imaging technology for voxel-level tissue characterization in simulation and experimentation. Using a matrix array transducer, H-scan US imaging was developed to evaluate the relative size of US scattering aggregates in volume space. Experimental data was acquired using a programmable US system (Vantage 256, Verasonics Inc, Kirkland, WA) equipped with a 1024-element (32 × 32) matrix array transducer (Vermon Inc, Tours, France). Imaging was performed using the full array in transmission. Radiofrequency (RF) data sequences were collected using a sparse random aperture compounding technique with 6 different data compounding approaches. Plane wave imaging at five angles was performed at a center frequency of 8 MHz. Scan conversion and attenuation correction were applied. To generate the 3-D H-scan US images, a convolution filter bank (N = 256) was then used to process the RF data sequences and measure the spectral content of the backscattered US signals before volume reconstruction. Preliminary experimental studies were conducted using homogeneous phantom materials embedded with spherical US scatterers of varying diameter, i.e., 27 to 45, 63 to 75, or 106-126 μm. Both simulated and experimental results revealed that 3-D H-scan US images have a low spatial variance when tested with homogeneous phantom materials. Furthermore, H-scan US is considerably more sensitive than traditional B-mode US imaging for differentiating US scatterers of varying size (p = 0.001 and p = 0.93, respectively). Overall, this study demonstrates the feasibility of 3-D H-scan US imaging using a matrix array transducer for tissue characterization in volume space.

Photoacoustic graphic equalization and application in characterization of red blood cell aggregates

A photoacoustic (PA) graphic equalization (PAGE) algorithm was developed to characterize the relative size of optical absorbing aggregates. This technique divides the PA signal into frequency bands related to different-sized optical absorbers. Simulations of a material containing optical absorbing microparticles of varying size were used to assess PAGE performance. Experiments were performed on phantom materials containing microspheres of varying size and concentration. Additional experiments were performed using tubes with fresh clotting blood. PA data was obtained using a Vevo LAZR-X system (FUJIFILM VisualSonics Inc). PAGE imaging of phantoms with varying-sized optical absorbers found a 1.5-fold difference in mean image intensity (p < 0.001). Conversely, PA images from these same materials exhibited no intensity changes (p = 0.68). PAGE imaging results from clotting blood exhibited differences for clot sizes in the range 0.30-0.64 mm (p < 0.001). In summary, PAGE imaging can distinguish optical absorbing aggregates of varying size.