Ultrasound en computermodellen samengebracht: een nieuw pad naar drukmetingen in tumoren
De hedendaagse kankerbehandelingen worden bemoeilijkt door de verhoogde vloeistofdruk die tumoren vertonen. Om dit te omzeilen, moet in eerste instantie dit drukverschil gemeten worden. Dit kan vandaag enkel door middel van een invasieve procedure. Deze scriptie ontwikkelt een computermodel dat de basis legt voor de ontwikkeling van een niet-invasief alternatief.
Tot aan de kern, of niet?
Tumoren kan je, net zoals de meeste biologische weefsels, vergelijken met een natte spons. Ze bevatten namelijk kleine ‘poriën’ en in deze gaatjes is (interstitiële) vloeistof aanwezig. Wanneer je het weefsel samendrukt, vloeit, net zoals bij een spons, het vocht eruit.
In het geval van tumoren is de druk van deze interstitiële vloeistof hoger dan die van de vloeistof buiten het kwaadaardige weefsel. Hierdoor is het moeilijker om de kern van de tumor te bereiken met therapeutische middelen, wat de behandeling van kankers bemoeilijkt.
Tot in de kern …
Om deze reden bestaan er tegenwoordig een aantal geneesmiddelen die deze vloeistofdruk proberen te verlagen. Maar zijn deze wel werkzaam bij elke patiënt? En zo ja, in welke mate en hoe snel hebben ze een invloed? Om deze vragen te beantwoorden moet de vloeistofdruk gemeten worden. Dit kan momenteel enkel op een invasieve manier - een naald wordt tot in de kern van de tumor gebracht. Auw!
Een niet-invasief alternatief is daarom wenselijk. Dit zou namelijk leiden tot een verhoogd comfort voor de patiënt en een lagere drempel om de vloeistofdruk in de praktijk te bepalen.
Nieuwe meetmethode
De scriptie onderzoekt of ultrasound - gekend van de echografie bij zwangerschappen - ook bruikbaar kan zijn voor een niet-invasieve drukmeting. Meer bepaald richt ze zich op ‘shear-wave’ elastografie, een techniek waarbij een apparaatje dat tegen de huid wordt geplaatst een ultrasound puls uitzendt. Dit is niet pijnlijk voor de patiënt en is ook onschadelijk voor het lichaam, in tegenstelling tot de invasieve meetmethoden.
De puls veroorzaakt kleine verplaatsingsgolven in het weefsel, net zoals wanneer je een steentje in het water gooit. De voortplantingssnelheid van deze golven wordt beïnvloed door de vloeistofdruk. Door de snelheid te meten, kan dus ook de druk bepaald worden!
© Sami Matias - Unsplash
De kracht van simulaties
De relatie tussen de snelheid en vloeistofdruk is echter nog niet duidelijk voor onderzoekers. Hier grijpt de scriptie in. Ze ontwikkelt namelijk een computermodel voor de weefsels, wat vervolgens gebruikt wordt in simulaties. Zodoende kunnen de tumor en de verplaatsingsgolven op een computer nagebootst worden, en de relatie tussen de vloeistofdruk en de snelheid van de golven bepaald worden. Hierdoor kunnen artsen meer inzicht krijgen die ze kunnen gebruiken tijdens de kankerbehandeling.
Daarnaast kan het model ook verschillende weefsels of meettechnieken simuleren. Hierdoor kunnen we de relatie tussen de vloeistofdruk en de voortplantingssnelheid nog beter begrijpen en de meetmethode verbeteren! Dit is trouwens zowel sneller als goedkoper dan experimentele testen en vermindert het aantal proefdieren die nodig zijn tijdens onderzoek.
Uitbreidingen
Hiermee is de kous echter nog niet af. Het model zal in de toekomst uitgebreid worden om de vloeistofdruk ook bij meer gecompliceerde fenomenen op een niet-invasieve wijze te bepalen, zoals bij een peesontsteking of een vochtophoping in de benen. Hierdoor zal de nieuwe meetmethode nóg breder inzetbaar worden.
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