Ultrasound Localization Microscopy for Cancer Imaging

Abstract

Angiogenesis—the formation of new blood vessels from pre-existing ones—is one of the hallmarks of cancer, regardless of subtype. However, the development of a specific tumor type is a highly heterogeneous process that influences the morphology of the tumor vasculature, which has a direct impact on the malignancy and invasiveness of the lesions. Therefore, the analysis of tumor vascularity without the need for invasive procedures is of fundamental interest for the classification of tumor tissue and the monitoring of therapies. Ultrasound localization microscopy (ULM) is a promising new technique that breaks the resolution limits of conventional ultrasound (US) imaging and allows to detect vascular structures and blood flow down to the capillary level. In this article, we discuss this emerging technique in the context of cancer imaging, focusing on crucial implementation aspects as well as on initial basic research in preclinical and clinical settings.