Miranda Pedro C, Mekonnen Abeye, Salvador Ricardo, Basser Peter J
IBEB, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal.
Phys Med Biol. 2014 Aug 7;59(15):4137-47. doi: 10.1088/0031-9155/59/15/4137. Epub 2014 Jul 8.
The use of alternating electric fields has been recently proposed for the treatment of recurrent glioblastoma. In order to predict the electric field distribution in the brain during the application of such tumor treating fields (TTF), we constructed a realistic head model from MRI data and placed transducer arrays on the scalp to mimic an FDA-approved medical device. Values for the tissue dielectric properties were taken from the literature; values for the device parameters were obtained from the manufacturer. The finite element method was used to calculate the electric field distribution in the brain. We also included a 'virtual lesion' in the model to simulate the presence of an idealized tumor. The calculated electric field in the brain varied mostly between 0.5 and 2.0 V cm( - 1) and exceeded 1.0 V cm( - 1) in 60% of the total brain volume. Regions of local field enhancement occurred near interfaces between tissues with different conductivities wherever the electric field was perpendicular to those interfaces. These increases were strongest near the ventricles but were also present outside the tumor's necrotic core and in some parts of the gray matter-white matter interface. The electric field values predicted in this model brain are in reasonably good agreement with those that have been shown to reduce cancer cell proliferation in vitro. The electric field distribution is highly non-uniform and depends on tissue geometry and dielectric properties. This could explain some of the variability in treatment outcomes. The proposed modeling framework could be used to better understand the physical basis of TTF efficacy through retrospective analysis and to improve TTF treatment planning.
最近有人提出使用交变电场来治疗复发性胶质母细胞瘤。为了预测在应用这种肿瘤治疗电场(TTF)期间大脑中的电场分布,我们根据MRI数据构建了一个逼真的头部模型,并在头皮上放置换能器阵列以模拟一种经美国食品药品监督管理局(FDA)批准的医疗设备。组织介电特性的值取自文献;设备参数的值从制造商处获得。使用有限元方法计算大脑中的电场分布。我们还在模型中加入了一个“虚拟病变”来模拟理想化肿瘤的存在。大脑中计算出 的电场大多在0.5至2.0 V/cm之间变化,并且在整个大脑体积的60%中超过1.0 V/cm。在电场垂直于不同电导率组织之间界面的任何地方,局部场增强区域都会出现。这些增强在脑室附近最强,但也存在于肿瘤坏死核心之外以及灰质 - 白质界面的某些部分。该模型大脑中预测的电场值与那些已被证明能在体外减少癌细胞增殖的电场值相当吻合。电场分布高度不均匀,并且取决于组织几何形状和介电特性。这可以解释治疗结果中的一些变异性。所提出的建模框架可用于通过回顾性分析更好地理解TTF疗效的物理基础,并改进TTF治疗计划。