In a promising sign of the potential of focused sound waves to improve the treatment of brain tumors, UVA Health researchers have determined that tumors called gliomas may be even more amenable to targeted drug delivery than normal brain tissue.
Although the research is still in its early stages, the findings help allay concerns that brain tumors may be stubbornly resistant to cutting-edge approaches. UVA scientists are using tiny “microbubbles” activated by sound waves to open the brain’s natural protective barrier known as the “blood-brain barrier,” allowing drugs to enter exactly where they are needed.
Inside a brain tumor, cancer cells mutate the structure of the blood-brain barrier, making its function unpredictable. This raises the question of how effectively focused ultrasound can provide therapy in the brain tumor setting and what size drug molecules can be delivered most effectively. A new study from UVA Health’s Focused Ultrasound Cancer Immunotherapy Center provides important insights on both fronts.
To address this central question, Dr. Wilson-Miller, in collaboration with my graduate student Matthew Hock, developed an MRI approach that enables drug delivery measurements with unprecedented resolution. This approach has not previously been integrated with focused ultrasound. This result is interesting because it means that the performance of focused ultrasound delivery is not expected to be reduced in brain tumors. In fact, some treatments may even enhance it. ”
Dr. Richard J. Price, Researcher and Co-Director, UVA Health Focused Ultrasound Cancer Immunotherapy Center
better brain tumor treatment
Glioma is the most common primary brain tumor in adults. This group includes glioblastoma, the most deadly of brain tumors. Although there are treatments that can prolong survival and improve quality of life, glioblastoma is most often fatal within 5 to 10 years, so new and better treatments are desperately needed. More than 10,000 people die from glioblastoma each year in the United States alone.
Part of the difficulty in treating glioblastoma is getting the drug through the brain’s natural defenses. The blood-brain barrier exists for an important reason. It prevents the invasion of harmful bacteria and toxins. For this reason, doctors have been working carefully to open the gates, fearing dangerous intruders may enter.
But now, using focused ultrasound, doctors can open the barrier with great precision and in a short time, allowing beneficial drugs to slip inside without unwanted companions. Price’s approach uses low-frequency sound waves to deliver small, rotating drug molecules directly into tumor cells. This is done without the need to make an incision in the skull.
In addition to showing that gliomas in laboratory mice are vulnerable to this approach, Dr. Price’s latest research also sheds light on the size of molecules that are most effective. He and his collaborators have identified a “Goldilocks” size range in which the molecule functions optimally. Very small molecules deliver drugs less efficiently than large molecules, which in turn are less effective than medium-sized molecules. (Of course, this is relative; all molecules are much smaller than can be seen with the naked eye.)
With great promise for focused ultrasound to improve the ability of immunotherapy to treat cancer, UVA launched the Center for Focused Ultrasound Cancer Immunotherapy in 2022, the world’s first center dedicated to that purpose.
UVA is currently enhancing its research tools with the addition of a state-of-the-art MRI-guided focused ultrasound system for drug delivery to the brain. This system by Insightec is equipped with an advanced magnetic resonance imaging unit that provides an amazing view inside the brain. This will allow researchers to understand exactly what happens when sound waves are used to deliver drug molecules into tumors.
“This new MRI-guided focused ultrasound system will allow researchers to deliver treatments and monitor their effectiveness with great precision,” said James Stone, MD, of UVA Health. “This combination will advance our understanding of how to optimize drug delivery for brain tumors and bring promising treatments closer to clinical care.”
“At UVA, we are deeply committed to advancing the care of patients at home and abroad through important research like this,” said Colin P. Durdin, M.D., interim dean of the UVA School of Medicine. “We continue to be a leader in focused ultrasound research through the efforts of our outstanding investigators, federal funding for their research, and collaboration with industry.”
Although more research is needed, the promising results bode well for the efforts of the UVA Cancer Center and UVA’s Paul and Diane Manning Institute for Bioengineering to develop new options for brain tumor patients. (The Manning Institute at UVA was created to rapidly develop new treatments and cures for the most difficult diseases to benefit patients in Virginia and beyond.)
“We hope this study shows how advanced MR imaging techniques can be used to improve focused ultrasound therapy in the clinic,” Price said. “In particular, it is exciting to think about how these technologies can be combined with future gene therapies by Manning Institute researchers and companies aimed at treating brain tumors.”
Publication of survey results
Price and his collaborators published their results in the scientific journal Radiology. The research team consisted of Matthew R. Hoch, Victoria R. Breza, G. Wilson Miller, and Price. Price is part of UVA’s Department of Biomedical Engineering, a joint program between the School of Medicine and the School of Engineering and Applied Sciences, and also part of the School of Medicine’s Department of Radiology and Medical Imaging.
UVA’s research was supported by the National Institutes of Health, grants R01EB030409, R01EB030744, R21NS118278, and R01CA226899, and the UVA Focused Ultrasound Cancer Immunotherapy Center.
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University of Virginia Health System
Reference magazines:
Mr. Hoch, MR. and others. (2026). Quantitative susceptibility mapping demonstrates size-dependent focused ultrasound-mediated therapeutic delivery to mouse naive brain and glioma. Radiology. DOI: 10.1148/radiol.251005. https://pubs.rsna.org/doi/10.1148/radiol.251005
