Investigating the biomechanical phenotype of bladder cancer using elastography and its association with the immune landscape and radiation response.

Cancer-associated fibroblast (CAF) mediated increased deposition and cross-linking of collagen increases tumour stiffness and may help cancer evade the immune system response to radiation by preventing immune cells from entering the tumour.

Leveraging ultrasound and magnetic resonance elastography techniques, we will map the tumour biomechanical properties in bladder cancer models, and establish spatial correlations with collagen density and structure, CAF distribution, and immune cell infiltration, as well as tracking changes during radiotherapy.

We propose that greater understanding of the interplay between tumour biomechanics, the immune landscape and radiation-induced fibrosis and the identification of clinically translatable US and MR imaging biomarkers will lead to optimisation of radiotherapy, and strategies that combine tumour microenvironment modulation with radiation.