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Review | Open Access

Cancer Drug Resistance

Choi et al. Cancer Drug Resist. 2026;9:12 DOI:10.20517/cdr.2025.223

Ultrasonic modulation of brain glymphatic transport:
from observations to theranostic applications

Wonseok Choi , Min-Hyeok Jang , Chulhong Kim , Eun-Yeong Park 4
1
2
3
Keywords:
Glymphatic system, brain,
ultrasound modulation, drug
delivery

Citation: Choi W, Jang MH,
Kim C, Park EY. Ultrasonic
modulation of brain
glymphatic transport: from
observations to theranostic
applications. Cancer Drug
Resist. 2026;9:12.
https://dx.doi.org/10.20517
/cdr.2025.223

Received: 12 Dec 2025
First Decision: 26 Jan
2026
Revised: 9 Feb 2026 Abstract
Accepted: 23 Mar 2026
Published: 21 Apr 2026 The glymphatic system in the brain controls the cerebrospinal fluid (CSF) circulation and
metabolic waste clearance, which is crucial for understanding the mechanisms and
Academic Editor: therapeutic opportunities of various brain pathologies. With the rapidly growing interest in
Jianliang Shen
Copy Editor: its relationship with neurodegenerative conditions, including Alzheimer’s disease, its
Pei-Yun Wang underlying processes are still not fully understood and remain under active investigation. A
Production Editor: representative finding is that the glymphatic flow is passively driven by factors such as
Pei-Yun Wang
vascular pulsation, and studies have been conducted to modulate the glymphatic system
using external stimuli to enhance waste clearance or to leverage CSF pathways for
delivering chemotherapeutic agents. Particularly, glymphatic flow modulation holds great
potential for improving drug delivery to the brain via intrathecal administration as an
alternative to conventional systemic delivery, which is restricted by the blood-brain barrier
(BBB). This review focuses on ultrasound (US) techniques for glymphatic system
modulation, with the aim of augmenting glymphatic flow and ultimately improving drug
delivery for brain cancer therapy. Given the limited number of cancer-related studies in the

1 Department of Biomedical Engineering and Medical Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591,
Republic of Korea.
2 Department of Plant Science, Seoul National University, Seoul 08826, Republic of Korea.
3 Departments of Convergence IT Engineering, Electrical Engineering, Mechanical Engineering, and Medical Science and Engineering,
POSTECH-CATHOLIC Biomedical Engineering Institute, Medical Device Innovation Center, Pohang University of Science and Technology,
Pohang 37673, Republic of Korea.
4 Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea.

Correspondence to: Prof. Eun-Yeong Park, Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology,
Daejeon 34141, Republic of Korea. E-mail: ey.park@kaist.ac.kr

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