Quantitative Ultrasound Characterization of Responses to Radiotherapy in vitro and in vivo

In clinical oncology and experimental therapeutics, changes in tumour growth rate or volume have been traditionally the first indication of treatment response. These changes typically occur late in the course of therapy. Currently, no routinely available imaging modality is capable of assessing tumour response to cancer treatment within hours or days after delivery of radiation treatment. Therefore, the goal of this thesis is to develop the use of ultrasound imaging and ultrasound characterization methods with frequencies of 10 to 30 MHz to assess non-invasively tumour response to radiotherapy, early, within hours to days after delivery of radiotherapy. Responses to radiotherapy were characterized initially in vitro in a well-controlled environment using cell samples. It was demonstrated experimentally that the changes in ultrasound integrated backscatter and spectral slopes were the direct consequences of cell and nuclear morphological changes associated with cell death. The research in vitro provided a basis for the in vivo research that characterized responses to radiotherapy in cancer mouse models. The results from mouse tumour models indicated that quantitative ultrasound could detect the regions in a tumour that corresponded in histology to areas of cell death. In order to understand the cellular morphological changes responsible for ultrasound scattering at these frequencies and assist in the interpretation of experimental data, numerical simulations of ultrasound scattering from four different cell lines exposed to radiotherapy were conducted and compared to experimental results. It was concluded that the increases measured in ultrasound backscatter could in part be explained by the increase in the randomization of cell nuclei resulting from the increase in the variance of cell sizes following cell death. In this thesis, it is demonstrated that ultrasound imaging and quantitative ultrasound methods were able to detect non-invasively early responses to radiotherapy in vitro and in vivo. The mechanism behind this detection was linked to changes in the acoustic properties of nuclei and changes in the spatial organization of cells and nuclei following cell death. This provides the groundwork for future investigations regarding the use of ultrasound in cancer patients to individualize treatments non-invasively based on their responses to specific interventions.Ph