Ultrasound mediated blood-brain barrier opening increases brain tumor biomarkers: A review of preclinical and clinical trials.

The diagnosis of brain tumors typically relies on magnetic resonance imaging (MRI), computed tomography (CT), and invasive procedures like biopsies or surgical resection for confirmation and genetic profiling. However, these methods have limitations, especially in distinguishing treatment effects like pseudo-progression from actual tumor progression, and repeated biopsies pose risks. Liquid biopsy (LB) offers a non-invasive alternative, detecting tumor-derived biomarkers in blood and cerebrospinal fluid (CSF). Despite its potential, the low concentration of brain tumor biomarkers in blood due to the blood-brain barrier (BBB), limits the clinical utility of LB. MRI-guided focused ultrasound (MRgFUS) combined with microbubbles provides a novel solution by temporarily disrupting the BBB, facilitating the passage of therapeutic agents, and enabling tumor biomarker detection. This technique, termed "sonobiopsy," enables non-invasive biomarker collection for liquid biopsy, potentially improving brain tumor diagnosis and monitoring<b>.</b>

Introduction

Purpose Sonobiopsy

Study Objective To review and summarize the current literature on the use of MRI-guided focused ultrasound (MRgFUS) or 'sonobiopsy' to enable blood-based liquid biopsy for diagnosis and monitoring of brain tumors.

Disease model brain tumors

MRI or image guidance method MRI-guided (MRgFUS)

Outcomes and Safety

Summary of Outcomes MRI-guided focused ultrasound with microbubbles (sonobiopsy) transiently opens the blood–brain barrier and safely increases release of brain tumor biomarkers into the bloodstream, with preclinical and clinical studies demonstrating feasibility and safety. The paper does not report specific FUS sonication or microbubble parameter sets shown to be successful, instead noting that sonication/MB parameters and blood collection timing require optimization in future work.

Safety-related matter Preclinical and clinical studies demonstrated the feasibility and safety of FUS-mediated BBB disruption for releasing brain tumor biomarkers, and the paper describes sonobiopsy as a safer, minimally invasive alternative; no specific adverse effects are mentioned in the excerpt. The authors note the need for further work to optimize parameters and to assess long-term safety of blood–brain barrier opening (BBBO).

Brain Region

Visualization unavailable

Ultrasound Parameters

Focal Characteristics focal depth: None, focal length: None, aperture size: None

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