Cancers | Interview with One of the Authors of the Editor’s Choice Article—Dr. Angie Fasoula

We had the pleasure of speaking with Dr. Angie Fasoula, the first and corresponding author of the Editor’s Choice Article in Cancers (ISSN: 2072-6694). Here, she shares her motivation, sources of inspiration, research journey, and insights into future research.

“Wavelia Microwave Breast Imaging Phase#2 Clinical Investigation: Methodological Evolutions and Multidimensional Radiomics Analysis Towards Controlled Specificity”
by Angie Fasoula, Giannis Papatrechas, Petros Arvanitis, Luc Duchesne, Julio Daniel Gil Cano, John O’Donnell, Sami Abd Elwahab and Michael Kerin
Cancers 2025, 17(18), 2973; https://doi.org/10.3390/cancers17182973
Available online: https://www.mdpi.com/2072-6694/17/18/2973

The following is an interview with Dr. Angie Fasoula.

1. Could you briefly introduce yourself and describe your main research focus?

I am a biomedical/microwave radar engineer, with a PhD in electrical and computer engineering (TUDelft, NL) and nearly 20 years of research and industrial experience in microwave system engineering, radar signal processing and microwave medical imaging, including leading the full development cycle of the Wavelia Microwave Breast Imaging system from concept to clinical trials. I am currently CTO and Co-Founder of MIMA Technologies, a deep-tech medical device startup, developing a next-generation, non-ionizing, compression-free, 3D breast imaging scanner based on microwave radar technology. Our mission is to advance diagnostic accuracy and democratize early diagnosis of cancer, particularly in the underserved population of women with dense breasts.

2. What inspired you to pursue this particular area of cancer research?

Breast cancer is the most common malignancy in women and the second cause of cancer-related deaths. Early detection dramatically improves survival rates, yet current diagnostic technologies face critical limitations: low sensitivity in dense breast tissue and early-stage cancers (mammography detects only ~62-68% in dense breasts); radiation exposure: ionising radiation from mammography makes frequent screening unsafe; high cost and complexity: MRI offers better sensitivity but is expensive, requires contrast agents, and causes discomfort, limiting accessibility; painful compression and claustrophobic procedures deter participation, resulting in ~40% of eligible women in Europe skipping routine breast screening!

Unlike mammography or MRI, Microwave Breast Imaging (MWBI) eliminates radiation risks and painful compression while showing potential for enhanced sensitivity in dense breast tissue and early-stage cancers. In addition, by integrating radar-based (semi-)automated lesion reporting and malignancy scoring, clear potential to reduce radiologist workload and improve workflow efficiency, rendering the modality cost-effective and scalable for widespread adoption, opens up.

Several years ago, I got strongly motivated and persuaded to focus my research on the Microwave Breast Imaging (MWBI) technology and clinical research, driven by the belief that by addressing the aforementioned diagnostic gaps in breast imaging, the MWBI modality holds considerable promise for increasing screening participation, enabling earlier detection, and reducing healthcare costs, thus unlocking access for millions of women currently underserved by existing technologies.

3. In your own words, what are the key findings or main messages of your Editor’s Choice Article?

This study provided overall foundational data, contributing to the rationalization of the MWBI imaging and image analysis outputs, towards standardization, objective interpretability, and ultimate clinical acceptance.

By transitioning from the initial Wavelia#1 Microwave Breast Imaging (MWBI) prototype to the more advanced Wavelia #2 prototype, we have successfully demonstrated in the study that this technology can accurately distinguish between malignant and benign lesions across a more diverse patient population. Moving beyond the three basic features used in the initial study to a multidimensional radiomic approach, the new prototype leveraged complex texture and intensity data to improve the accuracy of lesion classification.

In addition, the qualitative assessment of false positive rates in healthy breasts marks a milestone for this technology, providing the first real-world look at how the system maintains accuracy without over-diagnosing healthy tissue.

4. What were the biggest challenges you encountered during this study, and how did you overcome them?

The clinical investigation of the Wavelia #2 prototype identified critical challenges in aligning microwave imaging (MWBI) results with traditional radiological references due to variations in breast positioning. In several cases, the detected Regions of Interest (ROIs) did not immediately align with the expected clinical and radiological locations within the breast. In the frame of this exploratory study, the system's internal camera views were used to help reconcile such positional discrepancies, providing a visual reference for how the breast was positioned during the scan. To achieve clinical acceptance, future developments will need to focus on standardizing patient positioning and improving the objective interpretability of MWBI scans compared to traditional mammography or ultrasound.

This study also marked the first-ever attempt to identify recurring Microwave Breast Imaging artifacts and categorize them based on their recognizable patterns. Such research required intensive, long-form review sessions where clinical investigators and study radiologists performed side-by-side comparisons of the MWBI datasets against reference imaging. This collaborative, detailed review was essential to (a) establish pattern recognition: distinguishing true biological signals from mechanical or algorithmic artifacts, and (b) ensure radiological alignment: confirming that the MWBI findings correlated with established clinical standards. Only after isolating the recurring imaging artifacts, we were able to conduct a meaningful preliminary analysis of the system's specificity within asymptomatic breasts.

5. How do you see this research evolving or influencing future studies in the field?

Our study highlighted MWBI as a significant area of interest in the future of breast cancer diagnostics. The absence of radiation and the potential for use in dense breasts positions this technology at the forefront of future screening interventions in younger women. Technological advances, reduced screening time and application of artificial intelligence are expected to open possibilities for major clinical applications. Finally, while breast imaging is the current main area of interest, this technology also has potential in diagnostic imaging of other superficial soft-tissue organs, such as the thyroid.