When preparing for radiation therapy, patients with pelvic cancers—such as prostate, rectal, or gynecologic—are told to drink water and wait. The goal: to fill the bladder to just the right volume. It’s a crucial step, but often an unpredictable one. Too much water causes discomfort and delays. Too little can mean canceled sessions or excess radiation exposure to surrounding healthy tissue. These challenges disrupt care, stalling nearly half of treatment sessions and frustrating both patients and providers.
Now, a team of innovators at the Medical College of Wisconsin (MCW) is working to improve the treatment experience before the radiation beam even turns on. Their solution? Sonoptima, a wearable, AI-powered ultrasound device that provides real-time insight into bladder fullness without additional imaging, radiation, or guesswork.
“Historically, it has always been the same question for both the patient and radiation oncologist: ‘How close are we to ready?’ This system answers that instantly. No extra scans. No waiting rooms filled with anxious patients. Just precision and clarity,” said William Hall, MD, Professor and Chair of Radiation Oncology and Sonoptima Co-Founder.
Each year, more than 200,000 people in the U.S. receive pelvic radiation therapy, and nearly all experience challenges with bladder preparation. Delays caused by inadequate filling can extend treatment days for patients, strain clinical workflows, require repeated imaging, and limit how many patients a clinic can safely treat each day. “Sonoptima was created to address this common and costly barrier in cancer care,” said Dr. Hall, who first envisioned the solution in 2022 after a conversation with a patient revealed just how frustrating the process could be.
“He was a former CEO who had spent his career making high-stakes decisions, but when it came to preparing for his daily radiation treatments, he felt powerless. Not knowing whether his bladder was full enough made him feel like he had lost control of his own body,” Dr. Hall recalled. “That stuck with me. I knew we could do better.”
Three years later, that insight has become a breakthrough device now in clinical trials, reinforcing MCW’s role as a leader not just in research, but in delivering real-world cancer solutions. If successful, Sonoptima could have broad applications in pediatric imaging, prenatal care, and any setting where bladder volume affects diagnosis or treatment.
From Concept to Clinic: Sonoptima in Action
In spring 2025, Sonoptima entered clinical testing through the LEOPARD-IG trial, short for Learnable Engineered Output Platform for AI-guided Radiation Delivery using Image Guidance. Led by Fan Zhu, MD, Assistant Professor of Radiation Oncology, the study evaluates how effectively the device measures bladder fullness during treatment preparation, without the participants needing help from technicians or providers.
“LEOPARD-IG serves as a critical step toward validating Sonoptima’s accuracy, comfort, and overall impact on workflow. Because it’s non-invasive and uses no radiation, its side effects are minimal, which may open the door to broader applications,” said Dr. Zhu.
The system includes a soft, adjustable belt with embedded ultrasound sensors and a small external computing pack. As the bladder fills, the sensors collect continuous data on its shape and volume. Proprietary AI software analyzes the data in real time, not only showing how full the bladder is but also predicting how long it will take to reach treatment-ready volume. Instead of generating a traditional grayscale image, the device displays a simple bar graph or progress indicator, offering a clear, visual cue to both the patient and care team.
“Sonoptima flips the script on how we think about medical imaging,” said Dr. Hall. “Instead of creating an image to interpret later, it gives you real-time guidance, before the patient even reaches the treatment room.”
“We plan to enroll five healthy volunteers and 10 patients with pelvic cancers over six months. This approach allows us to evaluate comfort and usability under ideal conditions before applying it in more complex settings,” said Genitourinary Clinical Research Manager Jaime Goeldner, who played a key role in activating the study.
“Streamlining care is really at the heart of this trial. If successful, this device may change how radiation therapy is delivered in a truly patient-centered way,” said Goeldner.
The trial reflects a broader transformation in the landscape of radiation oncology at MCW, where technology like Sonoptima and Wisconsin’s first compact proton therapy system, launching later this year, are making cancer care more precise and more tolerable for patients.
Building a Biotech Future
Sonoptima is more than a clinical breakthrough—it’s a powerful example of how MCW is accelerating innovation through commercialization.
After conceptualizing the idea, Dr. Hall partnered with Eric Paulson, PhD, Chief of Medical Physics, Department of Radiation Oncology, to file an invention disclosure with MCW’s Office of Technology Development (OTD). With support from OTD and entrepreneur Michael Sealander, they launched Sonoptima and secured $700,000 in seed funding from Wisconsin-based firms Gateway Capital Partners and Winnow Fund.
“What made me confident our technology was feasible was the convergence of three factors: the team, the MCW ecosystem, and a clear clinical need. We brought together expertise in engineering, data science, and clinical trials, which helped us move quickly and efficiently from concept to prototype. The support we received shows that MCW is truly primed for biohealth commercialization,” said Dr. Paulson.
“Sonoptima stood out early on because the team was deeply engaged, and the technology addressed a real need for both patients and clinics,” added Landon Olp, PhD, Senior Licensing Manager in the OTD.
“This project highlights the strength of MCW’s faculty and learners—their drive to improve patient care, their creativity, and their willingness to collaborate across disciplines,” said Kevin Boggs, MBA, PhD, Director of the OTD. “It also shows how stronger ties to regional investors and entrepreneurs can help translate high-potential technologies into real-world impact.”
To fuel more breakthroughs like Sonoptima, the MCW Cancer Center is launching the BioHub—a state-of-the-art space on the first floor of the new MCW Center for Cancer Discovery, opening August 5, 2025. The BioHub helps fast-track cancer innovations by providing lab and office space, startup support, and access to MCW’s scientific and clinical expertise. It also plays a key role in the Wisconsin Biohealth Tech Hub, a federally designated initiative that recently secured $49 million in funding from the U.S. Department of Commerce to grow the state’s leadership in personalized medicine and biotech.
By helping move research from the lab to the real world, the BioHub keeps MCW at the forefront of cancer discovery, driving progress for patients and strengthening Wisconsin’s biotech economy. It also reflects an evolving culture at MCW: one committed to turning scientific discovery into impact.
“We’re not just publishing papers, we’re solving problems,” said Dr. Hall. “Sonoptima is proof that when you have the right idea, the right people, and the right support, you can bring something to life that truly changes care.”
Disclosure: Drs. Hall and Paulson are shareholders and consultants for Sonoptima Inc.