In solid tumors, hypoxia is a well-known resistance mechanism to radiation therapy. It was previously shown that microbubbles (MBs), when exposed to an ultrasound pulse (US) can cause vasodilation in muscle tissue. Conceptually, the therapeutic pulse can be localized on the tumor by steering the US beam. This approach is therefore proposed as a targeted image-guided provascular therapy in tumors to reduce hypoxia before radiotherapy. However, the effects of US and MB conditions on the relative

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... ncrease in tumor perfusion remain largely unknown. Endothelial Cells (HUVECs) and a breast cancer cell line (4T1) into the microfluidic channel. The cell monolayers created by both cell lines were successfully treated with an US and MB therapeutic pulse. Our results support that an increase in both, cycles and pressure, release more ATP and cause more cell death. Further, we linked ATP release to cell death by comparing different therapeutic pulses. From this analysis, two trends appeared. With lower energy pulses, ATP release increased sharply with a very small increase in cell death; conversely, with higher energy pulses, ATP release continued to increase with cell death but reached a plateau. Thus, our results support that different mechanisms of ATP release can likely be triggered by MB and US therapy.