SUMMARY
The research focus of Azra Alizad, M.D., includes the development of innovative ultrasound imaging technologies for the detection, characterization and monitoring of cancer and other tissue abnormalities. Dr. Alizad leads a translational research program that integrates advanced imaging physics, quantitative biomarker development and artificial intelligence (AI) to create noninvasive, accessible and clinically translatable diagnostic tools. The overarching goal of her research is to improve early disease detection, monitor disease progression and evaluate treatment response using advanced ultrasound-based imaging approaches.
Dr. Alizad collaborates with multidisciplinary teams of scientists and clinicians across Mayo Clinic and nationwide to translate novel imaging technologies from the laboratory into clinical practice. Her research program is supported by funding from the National Institutes of Health, including the National Cancer Institute; National Heart, Lung, and Blood Institute; National Cancer Institute and the National Institute of Biomedical Imaging and Bioengineering; National Institute of Diabetes and Digestive and Kidney Diseases; and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Her work spans the full spectrum of discovery science, technology development and clinical translation.
Focus areas
- Quantitative high-definition microvasculature imaging (qHDMI). Supported by the National Cancer Institute, Dr. Alizad and her colleagues have developed qHDMI, a novel contrast-free ultrasound technique capable of visualizing microvessels as small as 70 microns using advanced image processing and vessel enhancement algorithms. This technology enables the extraction of novel quantitative biomarkers that characterize tumor microvascular architecture and orientation, providing powerful tools for cancer detection and treatment monitoring. These biomarkers are inherently cost-effective, widely accessible and well suited for clinical implementation. By improving the specificity of ultrasound imaging, qHDMI has the potential to substantially reduce unnecessary biopsies while facilitating earlier and more accurate cancer detection and predicting lymph node metastasis and therapeutic response.
- Ultrasound perfusion imaging for peripheral arterial disease. Dr. Alizad's work in microvascular ultrasound imaging also has led to the development of innovative approaches for quantitative perfusion assessment in soft tissues, particularly in patients with peripheral arterial disease (PAD). Dr. Alizad and her colleagues developed a novel ultrasound method for ultrasonic perfusion estimation, enabling noninvasive assessment of tissue blood flow and vascular reactivity. This work led to the development of Angio Flow Reactivity Analysis, an advanced imaging technique that measures microvascular blood-flow responses in the lower-leg muscles during physiological stimuli such as cuff compression and submaximal exercise. This contrast-free method provides a powerful tool to diagnose PAD, monitor disease progression and evaluate treatment response, and has been supported by a five-year NHLBI R01 grant.
- Integration of AI in ultrasound imaging. Dr. Alizad is actively integrating AI and deep learning methods into advanced ultrasound imaging platforms to improve diagnostic accuracy and efficiency. Her current research focuses on combining AI with microvascular imaging technologies to enhance image acquisition, motion correction and quantitative analysis. Through multidisciplinary collaboration, her team has developed AI-driven algorithms for automated segmentation and classification of breast masses, thyroid nodules and axillary lymph nodes, significantly improving the precision and speed of ultrasound-based diagnostics. These efforts aim to support earlier detection, improved treatment monitoring and better patient outcomes, while also enhancing the efficiency of clinical workflows.
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Combined acoustic imaging and elasticity assessment. Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Dr. Alizad's pioneering work in ultrasound for bone characterization using a vibro-acoustic method led to the development of a quantitative ultrasound-acoustic tool for assessing infant bone properties, thereby expanding clinical applications of ultrasound.
Dr. Alizad also has advanced noninvasive multispectral ultrasound imaging, which integrates acoustic imaging with elasticity assessment to improve the accuracy of cancer diagnosis. Supported by the National Cancer Institute, the work to develop this technique was initially focused on the detection of breast cancer. With subsequent support from the National Institute of Biomedical Imaging and Bioengineering, this research was expanded to focus on the diagnosis of thyroid cancer using noninvasive multispectral imaging combined with elasticity assessment.
In collaboration with investigators from Boston University, the University of Southern California and the University of Wisconsin, Dr. Alizad has contributed to the development of quantitative nonlinear ultrasound elastography for characterizing tissue mechanical properties. This cutting-edge imaging approach was developed with support from the National Cancer Institute. It measures nonlinear elasticity parameters that serve as potential biomarkers for distinguishing benign and malignant breast lesions. The project has been supported by an NIH R01 grant, advancing ultrasound-based techniques for improved breast cancer diagnosis.
- Assessment of bladder function by ultrasound. Aging, spinal cord injury and certain diseases can affect bladder function, making this complex organ challenging to evaluate. Supported by the National Institute of Diabetes and Digestive and Kidney Diseases, Dr. Alizad co-leads a project with Mostafa Fatemi, Ph.D., to develop novel, noninvasive ultrasound-based methods for assessing bladder mechanical function, with the goal of providing an alternative to the current clinical approach, urodynamic studies.
Significance to patient care
Dr. Alizad's research focuses on developing new ultrasound tools that can help doctors diagnose and monitor diseases without surgery or invasive procedures. Her work translates scientific discoveries from the laboratory into tools that can be used in everyday patient care. These technologies can help detect diseases earlier, track how diseases change over time and evaluate how well treatments are working. Because ultrasound is safe, radiation-free and relatively low cost, these methods could improve patient care and make advanced medical imaging more available to patients around the world.
Professional highlights
- Elected fellow, American Institute for Medical and Biological Engineering, 2014-present.
- Elected fellow, American Institute of Ultrasound in Medicine, 2012-present.
- Member, Minority-Serving Institution Faculty Scholar Awards Committee, Minorities in Cancer Research, American Association for Cancer Research, 2011-present.
- Mayo Clinic:
- Research Career Impetus Award, 2026-2030.
- First research highlight, "Advancing ultrasound microvessel imaging and AI to improve cancer detection," Dec. 19, 2023.
- Featured, Discovery's Edge, Oct. 13, 2023.
- Featured in National Institute of Biomedical Imaging and Bioengineering Science Highlights, "How the Combination of Advanced Ultrasound and AI Could Upgrade Cancer Diagnostics," National Institute of Biomedical Imaging and Bioengineering, June 2, 2023.
- Chartered standing member, Medical Imaging Study Section, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, 2013-2019.