Cancer of the pancreas is one of the most deadly forms of cancer, with less than 5% of patients diagnosed with this disease surviving more than 5 years. While some patients may be treated with surgical resection, in many individuals tumors have invaded the major blood vessels by the time of initial diagnosis and thus are considered unresectable. Tumor vascular invasion is commonly determined via diagnostic imaging with magnetic resonance imaging (MRI) or computed tomography (CT). However, both MRI and CT have demonstrated poor sensitivity for this task, resulting in high rates of untreated patients. This research proposes an alternative imaging approach which uses a minimally-invasive intravascular ultrasound device to image blood flow in both tumor vasculature and systemic circulation in real-time. Recent research has demonstrated that specialized ultrasound transducers are capable of high resolution, highly sensitive imaging of non-linear oscillations of microbubble contrast agents. By designing, fabricating, and testing an intravascular ultrasound probe and an accompanying microbubble contrast agent, this translational research project will demonstrate an approach for imaging blood flow dynamics in real time with high spatial resolution, making it the first imaging technology capable of capturing tumor vascular invasion.
Vascular invasion of healthy vessels by tumor vasculature is an important indicator of whether or not a tumor is operable in many cancers, especially pancreatic cancer, in which 85-90% of tumors are inoperable due to vascular invasion. However, the imaging technologies available for evaluating vascular invasion demonstrate poor sensitivity. Thus a new imaging approach is proposed which uses intravascular ultrasound and microbubble contrast agent to image vascular invasion in real-time via a minimally-invasive procedure.
