Fabian Kiessling

University Hospital Aachen, Germany

Title: Molecular and superresolution ultrasound imaging to characterize breast cancer


Neoadjuvant chemotherapy (NAC) is the standard treatment for high-risk breast cancer, but less than 30% of patients achieve a complete response, so there is a need for better pre-selection and monitoring. In this context, ultrasound is one of the standard clinical diagnostic modalities, but as implemented, it falls far short of its capabilities. Super-resolution ultrasound imaging (in particular motion model ultrasound localisation microscopy, mULM) is a technique that could change this. mULM was first presented conceptually by us in 20111 and clinically tested in breast cancer patients in 20182 . New clinical results underline the high potential of the method for tumour characterisation and show that it can be used to predict chemotherapy response in breast cancer. Functional vascular characterisation using contrast-enhanced ultrasound imaging can be combined with molecular ultrasound using targeted microbubbles3 . We have shown that VEGFR2-specific microbubbles, which are currently in clinical trials, behave similarly to untargeted microbubbles in tumours in the early accumulation phase, but provide molecular information about VEGFR2 in the late phase. In preclinical studies, however, molecular information has been shown to be more sensitive for assessing anti-angiogenic therapeutic effects. In this talk, I will summarise our research on superresolution and molecular ultrasound imaging of breast cancer, the transition from preclinical research to the clinic, and share my view on the future clinical implementation of these technologies.