Bridging Spatial Scales From Radiographic Images to Cellular and Molecular Properties in Cancers

Abstract Multiple studies have demonstrated that substantial regional variations in the genetic properties of cells are commonly observed within a clinical tumor. This heterogeneity is a fundamental barrier to curative therapy and is typically thought to be “somatic evolution” caused by accumulation of random mutations. However, classic Darwinian dynamics in evolution by natural selection are governed by variations in environmental selection forces that promote different adaptive strategies. This link between ecology and evolution allows radiologic imaging to repeatedly and noninvasively demonstrate spatial and temporal variations in key environmental properties, such as blood flow, interstitial edema, and cellular density, affecting response and resistance during local or systemic cancer therapy.