Abstract
Recently, researchers have discovered the direct impact of the tumor mechanical environment on the growth, drug uptake and prognosis of tumors. While estimating the mechanical parameters (solid stress, fluid pressure, stiffness) can aid in the treatment planning and monitoring, most of these parameters cannot be quantified noninvasively. Shear wave elastography (SWE) has shown promise as a means of noninvasively measuring the stiffness of soft tissue. However, stiffness is still not a recognized imaging biomarker. While SWE has been shown to be capable of measuring tumor stiffness in humans, much important research is done in small animal preclinical models, where tumors are often too small for the resolution of traditional SWE tools. Single-track location SWE (STL-SWE) has previously been shown to overcome the fundamental resolution limit of SWE imposed by ultrasound speckle, which may make it suitable for preclinical imaging. Using STL-SWE, in this work, we demonstrate, for the first time, that the stiffness changes occurring inside metastatic murine pancreatic tumors can be monitored over long time scales (up to 9 weeks). To prevent the respiration motion from degrading the STL-SWE estimates, we developed a real-time software-based respiration gating scheme that we implemented on a Verasonics ultrasound imaging system. By imaging the liver of three healthy mice and performing correlation analysis, we confirmed that the respiration-gated STL-SWE data was free from motion corruption. By performing coregistered power-doppler imaging, we found that the local variability in liver shear wave speed (SWS) measurements increased from 5.4% to 9.9% due to blood flow. We performed a longitudinal study using a murine model of pancreatic cancer liver metastasis to assess the temporal changes (over nine weeks) in SWS in two groups: a controlled group receiving no treatment (n=8), and an experimental group (n=6) treated with Gemcitabine, a chemotherapy agent. We independently evaluated tumor burden using bioluminescence imaging (BLI). The initial and endpoint SWS measurements were statistically different (p<0.05). Additionally, when the liver SWS exceeded 2.5 ± 0.3 and 2.73 ± 0.34 m/s in untreated and treated mice, respectively, the death of the mice was imminent within approximately 10 days. The time taken for the SWS to exceed the thresholds was 17 days (on average) longer in Gemcitabine treated mice compared to the untreated ones. The survival statistics corroborated the effectiveness of Gemcitabine. Spearman correlation analysis revealed a monotonic relationship between SWE measurements (SWS) and BLI measurements (radiance) for tumors whose radiance exceeded 1×10(7) photons/s/cm(2)/sr. Longitudinal measurements on the liver of four healthy mice revealed a maximum coefficient of variation of 11.4%. The results of this investigation demonstrate that with appropriate gating, researchers can use STL-SWE for small animal imaging and perform longitudinal studies using preclinical cancer models.