Department of Human Structure and Repair, Ghent University, Ghent, Belgium; IBiTech-BioMMedA, Ghent University, Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
Department of Radiology, University Hospital Ghent, Ghent, Belgium; Ghent Institute of Functional and Metabolic Imaging (GIFMI), Ghent University, Ghent, Belgium; IBitech-Medisip, Ghent University, Ghent, Belgium.
Comput Biol Med. 2023 Sep;163:107190. doi: 10.1016/j.compbiomed.2023.107190. Epub 2023 Jun 22.
Inadequate uptake of therapeutic agents by tumor cells is still a major barrier in clinical cancer therapy. Mathematical modeling is a powerful tool to describe and investigate the transport phenomena involved. However, current models for interstitial flow and drug delivery in solid tumors have not yet embedded the existing heterogeneity of tumor biomechanical properties. The purpose of this study is to introduce a novel and more realistic methodology for computational models of solid tumor perfusion and drug delivery accounting for these regional heterogeneities as well as lymphatic drainage effects. Several tumor geometries were studied using an advanced computational fluid dynamics (CFD) modeling approach of intratumor interstitial fluid flow and drug transport. Hereby, the following novelties were implemented: (i) the heterogeneity of tumor-specific hydraulic conductivity and capillary permeability; (ii) the effect of lymphatic drainage on interstitial fluid flow and drug penetration. Tumor size and shape both have a crucial role on the interstitial fluid flow regime as well as drug transport illustrating a direct correlation with interstitial fluid pressure (IFP) and an inverse correlation with drug penetration, except for large tumors having a diameter larger than 50 mm. The results also suggest that the interstitial fluid flow and drug penetration in small tumors depend on tumor shape. A parameter study on the necrotic core size illustrated that the core effect (i.e. fluid flow and drug penetration alteration) was only profound in small tumors. Interestingly, the impact of a necrotic core on drug penetration differs depending on the tumor shape from having no effect in ideally spherical tumors to a clear effect in elliptical tumors with a necrotic core. A realistic presence of lymphatic vessels only slightly affected tumor perfusion, having no substantial effect on drug delivery. In conclusion, our findings illustrated that our novel parametric CFD modeling strategy in combination with accurate profiling of heterogeneous tumor biophysical properties can provide a powerful tool for better insights into tumor perfusion and drug transport, enabling effective therapy planning.
肿瘤细胞对治疗药物的摄取不足仍然是临床癌症治疗的主要障碍。数学建模是描述和研究所涉及的传输现象的有力工具。然而,目前用于实体瘤间质流动和药物输送的模型尚未嵌入肿瘤生物力学特性的现有异质性。本研究的目的是引入一种新的、更现实的方法,用于计算实体瘤灌注和药物输送模型,以考虑这些区域异质性和淋巴引流效应。使用先进的计算流体动力学 (CFD) 肿瘤内间质流体流动和药物输送的建模方法研究了几种肿瘤几何形状。在此,实施了以下创新:(i)肿瘤特异性水力传导率和毛细血管通透性的异质性;(ii)淋巴引流对间质流体流动和药物渗透的影响。肿瘤大小和形状对间质流体流动状态以及药物输送都有至关重要的作用,表明与间质流体压力 (IFP) 呈直接相关,与药物渗透呈反比,除了直径大于 50 毫米的大肿瘤外。结果还表明,小肿瘤的间质流体流动和药物渗透取决于肿瘤形状。坏死核心大小的参数研究表明,核心效应(即流体流动和药物渗透改变)仅在小肿瘤中非常显著。有趣的是,坏死核心对药物渗透的影响取决于肿瘤形状,从理想球形肿瘤中没有影响到椭圆形肿瘤中具有坏死核心的明显影响。真实存在的淋巴管仅对肿瘤灌注产生轻微影响,对药物输送没有实质性影响。总之,我们的研究结果表明,我们的新型参数 CFD 建模策略与对异质肿瘤生物物理特性的精确分析相结合,可以为更好地了解肿瘤灌注和药物输送提供有力工具,从而实现有效的治疗计划。