# Use of Radiological Clips for Improving Quantitative Ultrasound Imaging

> **NIH NIH R01** · UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN · 2023 · $537,624

## Abstract

Project Summary
Radiological markers or clips are an essential diagnostic and surgical tool. Radiological clips made of titanium
or gold are widely used, compatible with MRI and have proven safe for use in human patients. These clips come
in many shapes and sizes and are visible with both X-ray and ultrasound. The clips provide large ultrasonic
scattering signals because they are made of gold or titanium, which have large impedance mismatch with tissue.
For example, patients with locally advanced breast cancer (LABC) undergoing neoadjuvant chemotherapy have
clips placed in the tumors so that surgeons can locate and excise, with accuracy, residual cancer tissue.
 Over the last fifteen years, we have been developing quantitative ultrasound (QUS) imaging techniques for
a number of applications including monitoring of therapy response. We have demonstrated that QUS techniques
can detect the response of tumors to therapy because QUS is sensitive to the presence of cell death. Recently,
we were able to implement this approach in a small clinical study, where we demonstrated the ability of QUS to
definitively detect and predict the response of LABC patients to chemotherapy between one and four weeks from
therapy onset. We verified that QUS could identify LABC therapy responders and nonresponders.
 However, we hypothesize that accuracies of QUS estimates in humans can be dramatically improved by
incorporating a novel calibration procedure that utilizes appropriate radiological clips as an in situ calibration
target. Clinically, these clips are already being placed in tumors for various diagnostic tasks. By inserting an
appropriate type of clip, the clip can be used as an in situ calibration providing a reference signal for QUS
estimates. The in situ reference will automatically correct for attenuation and transmission losses from overlying
tissue layers. Current reference phantom techniques are incomplete in providing corrections for attenuation and
transmission losses. Therefore, the use of appropriate radiological clips as calibration targets will provides
superior bias and variance of QUS estimates resulting in improved accuracy for identifying LABC response.
 The scientific premise of the proposed research is that radiological markers used for X-ray and conventional
ultrasound can also be used as an in situ calibration target for improving QUS estimates in vivo. Novel calibration
procedures will be tested and refined in phantom studies, in animals models of cancer and finally validated in
human breast cancer patients undergoing neoadjuvant chemotherapy using QUS to identify early responders to
therapy. To verify this scientific premise we propose three specific aims. 1) Develop and refine an in situ
calibration approach in phantom studies that accounts for layering effects on QUS estimates thereby improving
QUS estimate accuracy. 2) Validate the in situ calibration approach in animal models of cancer and quantify
calibration properties in a longitudi...

## Key facts

- **NIH application ID:** 10615670
- **Project number:** 5R01CA251939-04
- **Recipient organization:** UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
- **Principal Investigator:** Michael L. Oelze
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $537,624
- **Award type:** 5
- **Project period:** 2020-08-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10615670

## Citation

> US National Institutes of Health, RePORTER application 10615670, Use of Radiological Clips for Improving Quantitative Ultrasound Imaging (5R01CA251939-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10615670. Licensed CC0.

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