The 4- year “FORCE, imaging the Force of Cancer” project was awarded to a consortium of 16 partners and collaborators across Europe and beyond, headed by Professor Ralph Sinkus, King’s College London, Division of Imaging Sciences and Biomedical Engineering.

Cancer is a worldwide epidemic presenting significant challenges to patients, patient treatment and healthcare systems worldwide.  The World Health Organization (WHO) predicts a 70% increase in the number of new cases per annum over the next two decades (World Cancer Report, 2014). Significant investment in prevention, early detection, and treatment have dramatically improved cancer outlook, but despite this improvement, cancer remains among the leading causes of morbidity and mortality worldwide. The impact of cancer reverberates through world healthcare systems and the lives of those it affects.

The FORCE project focuses specifically on cancer in breast, liver and brain.

FORCE  aims to address a fundamental need in planning and monitoring of cancer treatment by measuring the forces active in cancer,  such as tumour Interstitial Fluid Pressure (IFP) and Cell Traction Force (CTF) at the tumour border zone , which are thought to be key indicators of whether cancer therapy is working as well as the likelihood of the cancer spreading to other organs.

Measuring these forces non-invasively is currently not possible but is paramount for therapy planning and evaluating treatment efficacy:  the treatment of primary tumour sites is vital, but gauging the metastatic potential for cancer spread is increasingly important for ensuring appropriate therapy is given.

The FORCE project will tackle these needs by integrating fundamental developments in engineering and Magnetic Resonance (MR) imaging to develop Magnetic Resonance Force (MRF) Imaging – a novel non-invasive modality for directly measuring the change in apparent tissue stiffness under varying load conditions. Unlike current tumour biomarkers, MRF directly assesses the Stiffness Load Relation (SLR) of tissue, providing a picture of the forces active within tumours. Using biomechanical principles, we will develop biomarkers for IFP and border zone CTF derived directly from MRF images.

The effectiveness of these noninvasive MRF biomarkers will be systematically assessed all over the duration of the project, examining their ability to predict therapy outcomes and metastatic potential in a series of pre-clinical and clinical contexts. FORCE  will not only explore the passive acquisition of cancer forces but also examine the efficacy of actively manipulating the mechanoenvironment through mechanosignaling in tumours.

Developments of the FORCE project will, for the first time, enable the measurement and manipulation of cancer forces in vivo; providing a new paradigm for predicting metastatic potential, gauging the efficacy of drug delivery for cancer therapy, and clinically observing therapy progression through imaging.

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