In vivo monitoring of elastic changes during cancer development and therapeutic treatment

Abstract : Throughout this PhD thesis, a technique developed at the Institut Langevin called the Supersonic Shear Imaging (SSI) technique, capable of quantifying tissue shear elasticity in real time, was employed for the characterization of biological tissues. Pre-clinical and clinical studies were performed to evaluate the potential of the technique in the monitoring of elastic changes during cancer development and therapeutic treatment. A clinical study was performed on 23 patients presenting breast lesions who underwent chemotherapy treatment at the Institut Curie. The goal of the study was to use for the very first time, 3D-Ultrasound (3D-US) and 3D-Shear Wave Elastography (3D-SWE) during the chemotherapy treatment to estimate tumour volume and tumour global elasticity, respectively. The 3D-US estimated tumour volumes were compared with Magnetic Resonance Imaging (MRI) volume estimations and showed good correlation. The results of the study demonstrated that 3D-SWE allowed the monitoring the tumour reaction to the chemotherapy by offering accurate tumour elasticity measurements in three-dimensions throughout the study. Tumour elasticity was found to be well correlated with the 3D-US and MRI tumour volume estimations. The SSI technique was employed for the monitoring of cancerous tissues, in the frame of two pre-clinical studies performed on nude mice. One of the studies, carried out in collaboration with L'hôpital Européen Georges-Pompidou (HEGP), aimed to understand the pathology underlying stiffness. The SSI technique and US imaging were used to monitor the growth and the reaction to chemotherapy of human carcinomas implanted on mice. The results showed that for this particular tumour model, tumour volume and tumour elasticity were very well correlated. Performed histo-pathological analyses revealed that tumour elasticity also was very well correlated with tumour necrosis and fibrosis. The second pre-clinical study, performed in collaboration with the faculty of Pharmacy of L'Universite Paris V Descartes, intended to evaluate the feasibility of using tissue elasticity to assess the effectiveness of an anti-vascular treatment on a particular type of human colon carcinoma implanted in mice. The results did not show a clear elasticity tendency associated to the treatment. In order to study new additional mechanical parameters (apart from tissue elasticity) which allow a better tissue characterization, a method combining quasi-static axial compressions and the SSI technique was developed to retrieve tissue shear nonlinearity. The first known 2D nonlinearity maps were calculated on tissue mimicking phantoms and on ex-vivo beef liver samples with good accuracy. The fact that the developed technique could be easily implemented on standard imaging probes driven by ultrafast US scanners, make it transferable to clinics.
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Heldmuth Latorre Ossa. In vivo monitoring of elastic changes during cancer development and therapeutic treatment. Medical Physics [physics.med-ph]. Université Paris-Diderot - Paris VII, 2012. English. ⟨pastel-00786531⟩

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