Impact of tumor position, conductivity distribution and tissue homogeneity on the distribution of tumor treating fields in a human brain: A computer modeling study
Publication Date
June 12, 2017
Authors
Anders Rosendal Korshoej, Frederik Lundgaard Hansen, Axel Thielscher, Gorm Burckhardt Von Oettingen, et al
Volume
12
Issue
6
Pages
e0179214
DOI
https://dx.plos.org/10.1371/journal.pone.0179214
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0179214
Scopus
85020720841
Mendeley
http://www.mendeley.com/research/impact-tumor-position-conductivity-distribution-tissue-homogeneity-distribution-tumor-treating-field
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Mendeley | Further Information

{"title"=>"Impact of tumor position, conductivity distribution and tissue homogeneity on the distribution of tumor treating fields in a human brain: A computer modeling study", "type"=>"journal", "authors"=>[{"first_name"=>"Anders Rosendal", "last_name"=>"Korshoej", "scopus_author_id"=>"15925366100"}, {"first_name"=>"Frederik Lundgaard", "last_name"=>"Hansen", "scopus_author_id"=>"57194541730"}, {"first_name"=>"Axel", "last_name"=>"Thielscher", "scopus_author_id"=>"6603366617"}, {"first_name"=>"Gorm Burckhardt", "last_name"=>"Von Oettingen", "scopus_author_id"=>"6603500642"}, {"first_name"=>"Jens Christian Hedemann", "last_name"=>"Sørensen", "scopus_author_id"=>"35548632500"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"616749226", "issn"=>"19326203", "isbn"=>"1111111111", "doi"=>"10.1371/journal.pone.0179214", "scopus"=>"2-s2.0-85020720841", "pmid"=>"28604803", "sgr"=>"85020720841"}, "id"=>"2262de24-7f20-3c31-843c-01ed187210b2", "abstract"=>"BACKGROUND Tumor treating fields (TTFields) are increasingly used in the treatment of glioblastoma. TTFields inhibit cancer growth through induction of alternating electrical fields. To optimize TTFields efficacy, it is necessary to understand the factors determining the strength and distribution of TTFields. In this study, we provide simple guiding principles for clinicians to assess the distribution and the local efficacy of TTFields in various clinical scenarios. METHODS We calculated the TTFields distribution using finite element methods applied to a realistic head model. Dielectric property estimates were taken from the literature. Twentyfour tumors were virtually introduced at locations systematically varied relative to the applied field. In addition, we investigated the impact of central tumor necrosis on the induced field. RESULTS Local field \"hot spots\" occurred at the sulcal fundi and in deep tumors embedded in white matter. The field strength was not higher for tumors close to the active electrode. Left/right field directions were generally superior to anterior/posterior directions. Central necrosis focally enhanced the field near tumor boundaries perpendicular to the applied field and introduced significant field non-uniformity within the tumor. CONCLUSIONS The TTFields distribution is largely determined by local conductivity differences. The well conducting tumor tissue creates a preferred pathway for current flow, which increases the field intensity in the tumor boundaries and surrounding regions perpendicular to the applied field. The cerebrospinal fluid plays a significant role in shaping the current pathways and funnels currents through the ventricles and sulci towards deeper regions, which thereby experience higher fields. Clinicians may apply these principles to better understand how TTFields will affect individual patients and possibly predict where local recurrence may occur. Accurate predictions should, however, be based on patient specific models. Future work is needed to assess the robustness of the presented results towards variations in conductivity.", "link"=>"http://www.mendeley.com/research/impact-tumor-position-conductivity-distribution-tissue-homogeneity-distribution-tumor-treating-field", "reader_count"=>10, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>2, "Student > Doctoral Student"=>1, "Researcher"=>2, "Student > Ph. D. Student"=>2, "Student > Master"=>1, "Student > Bachelor"=>1, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>2, "Student > Doctoral Student"=>1, "Researcher"=>2, "Student > Ph. D. Student"=>2, "Student > Master"=>1, "Student > Bachelor"=>1, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Engineering"=>1, "Biochemistry, Genetics and Molecular Biology"=>4, "Medicine and Dentistry"=>3, "Agricultural and Biological Sciences"=>1, "Physics and Astronomy"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>4}}, "group_count"=>2}

Scopus | Further Information

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