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Christenson C, Wu C, Hormuth DA, Huang S, Bao A, Brenner A, Yankeelov TE. Predicting the spatio-temporal response of recurrent glioblastoma treated with rhenium-186 labelled nanoliposomes. BRAIN MULTIPHYSICS 2023; 5:100084. [PMID: 38187909 PMCID: PMC10768931 DOI: 10.1016/j.brain.2023.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Rhenium-186 (186Re) labeled nanoliposome (RNL) therapy for recurrent glioblastoma patients has shown promise to improve outcomes by locally delivering radiation to affected areas. To optimize the delivery of RNL, we have developed a framework to predict patient-specific response to RNL using image-guided mathematical models. Methods We calibrated a family of reaction-diffusion type models with multi-modality imaging data from ten patients (NCR01906385) to predict the spatio-temporal dynamics of each patient's tumor. The data consisted of longitudinal magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) to estimate tumor burden and local RNL activity, respectively. The optimal model from the family was selected and used to predict future growth. A simplified version of the model was used in a leave-one-out analysis to predict the development of an individual patient's tumor, based on cohort parameters. Results Across the cohort, predictions using patient-specific parameters with the selected model were able to achieve Spearman correlation coefficients (SCC) of 0.98 and 0.93 for tumor volume and total cell number, respectively, when compared to the measured data. Predictions utilizing the leave-one-out method achieved SCCs of 0.89 and 0.88 for volume and total cell number across the population, respectively. Conclusion We have shown that patient-specific calibrations of a biology-based mathematical model can be used to make early predictions of response to RNL therapy. Furthermore, the leave-one-out framework indicates that radiation doses determined by SPECT can be used to assign model parameters to make predictions directly following the conclusion of RNL treatment. Statement of Significance This manuscript explores the application of computational models to predict response to radionuclide therapy in glioblastoma. There are few, to our knowledge, examples of mathematical models used in clinical radionuclide therapy. We have tested a family of models to determine the applicability of different radiation coupling terms for response to the localized radiation delivery. We show that with patient-specific parameter estimation, we can make accurate predictions of future glioblastoma response to the treatment. As a comparison, we have shown that population trends in response can be used to forecast growth from the moment the treatment has been delivered.In addition to the high simulation and prediction accuracy our modeling methods have achieved, the evaluation of a family of models has given insight into the response dynamics of radionuclide therapy. These dynamics, while different than we had initially hypothesized, should encourage future imaging studies involving high dosage radiation treatments, with specific emphasis on the local immune and vascular response.
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Affiliation(s)
| | - Chengyue Wu
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - David A. Hormuth
- Livestrong Cancer Institutes, USA
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Shiliang Huang
- Department of Oncology, The University of Texas Health Sciences Center at San Antonio, San Antonio, TX 78229, USA
| | - Ande Bao
- Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Andrew Brenner
- Department of Oncology, The University of Texas Health Sciences Center at San Antonio, San Antonio, TX 78229, USA
| | - Thomas E. Yankeelov
- Departments of Biomedical Engineering, USA
- Departments of Diagnostic Medicine, USA
- Departments of Oncology, USA
- Livestrong Cancer Institutes, USA
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
- The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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Wood KB, Comba A, Motsch S, Grigera TS, Lowenstein PR. Scale-free correlations and potential criticality in weakly ordered populations of brain cancer cells. SCIENCE ADVANCES 2023; 9:eadf7170. [PMID: 37379380 PMCID: PMC10306295 DOI: 10.1126/sciadv.adf7170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/24/2023] [Indexed: 06/30/2023]
Abstract
Collective behavior spans several orders of magnitude of biological organization, from cell colonies to flocks of birds. We used time-resolved tracking of individual glioblastoma cells to investigate collective motion in an ex vivo model of glioblastoma. At the population level, glioblastoma cells display weakly polarized motion in the (directional) velocities of single cells. Unexpectedly, fluctuations in velocities are correlated over distances many times the size of a cell. Correlation lengths scale linearly with the maximum end-to-end length of the population, indicating that they are scale-free and lack a characteristic decay scale other than the size of the system. Last, a data-driven maximum entropy model captures statistical features of the experimental data with only two free parameters: the effective length scale (nc) and strength (J) of local pairwise interactions between tumor cells. These results show that glioblastoma assemblies exhibit scale-free correlations in the absence of polarization, suggesting that they may be poised near a critical point.
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Affiliation(s)
- Kevin B. Wood
- Department of Biophysics, University of Michigan, Ann Arbor, MI, USA
- Department of Physics, University of Michigan, Ann Arbor, MI, USA
| | - Andrea Comba
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sebastien Motsch
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, USA
| | - Tomás S. Grigera
- Instituto de Física de Líquidos y Sistemas Biológicos (IFLySiB), Buenos Aires, Argentina
- Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
- CONICET, Godoy Cruz, Buenos Aires, Argentina
- Departamento de Física, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
- Istituto dei Sistemi Complessi, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Pedro R. Lowenstein
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Fritz M. Tumor Evolution Models of Phase-Field Type with Nonlocal Effects and Angiogenesis. Bull Math Biol 2023; 85:44. [PMID: 37081144 DOI: 10.1007/s11538-023-01151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/27/2023] [Indexed: 04/22/2023]
Abstract
In this survey article, a variety of systems modeling tumor growth are discussed. In accordance with the hallmarks of cancer, the described models incorporate the primary characteristics of cancer evolution. Specifically, we focus on diffusive interface models and follow the phase-field approach that describes the tumor as a collection of cells. Such systems are based on a multiphase approach that employs constitutive laws and balance laws for individual constituents. In mathematical oncology, numerous biological phenomena are involved, including temporal and spatial nonlocal effects, complex nonlinearities, stochasticity, and mixed-dimensional couplings. Using the models, for instance, we can express angiogenesis and cell-to-matrix adhesion effects. Finally, we offer some methods for numerically approximating the models and show simulations of the tumor's evolution in response to various biological effects.
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Affiliation(s)
- Marvin Fritz
- Computational Methods for PDEs, Johann Radon Institute for Computational and Applied Mathematics, Linz, Austria.
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Subramanian S, Ghafouri A, Scheufele KM, Himthani N, Davatzikos C, Biros G. Ensemble Inversion for Brain Tumor Growth Models With Mass Effect. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:982-995. [PMID: 36378796 PMCID: PMC10201550 DOI: 10.1109/tmi.2022.3221913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We propose a method for extracting physics-based biomarkers from a single multiparametric Magnetic Resonance Imaging (mpMRI) scan bearing a glioma tumor. We account for mass effect, the deformation of brain parenchyma due to the growing tumor, which on its own is an important radiographic feature but its automatic quantification remains an open problem. In particular, we calibrate a partial differential equation (PDE) tumor growth model that captures mass effect, parameterized by a single scalar parameter, tumor proliferation, migration, while localizing the tumor initiation site. The single-scan calibration problem is severely ill-posed because the precancerous, healthy, brain anatomy is unknown. To address the ill-posedness, we introduce an ensemble inversion scheme that uses a number of normal subject brain templates as proxies for the healthy precancer subject anatomy. We verify our solver on a synthetic dataset and perform a retrospective analysis on a clinical dataset of 216 glioblastoma (GBM) patients. We analyze the reconstructions using our calibrated biophysical model and demonstrate that our solver provides both global and local quantitative measures of tumor biophysics and mass effect. We further highlight the improved performance in model calibration through the inclusion of mass effect in tumor growth models-including mass effect in the model leads to 10% increase in average dice coefficients for patients with significant mass effect. We further evaluate our model by introducing novel biophysics-based features and using them for survival analysis. Our preliminary analysis suggests that including such features can improve patient stratification and survival prediction.
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Wu C, Jarrett AM, Zhou Z, Elshafeey N, Adrada BE, Candelaria RP, Mohamed RM, Boge M, Huo L, White JB, Tripathy D, Valero V, Litton JK, Yam C, Son JB, Ma J, Rauch GM, Yankeelov TE. MRI-Based Digital Models Forecast Patient-Specific Treatment Responses to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer. Cancer Res 2022; 82:3394-3404. [PMID: 35914239 PMCID: PMC9481712 DOI: 10.1158/0008-5472.can-22-1329] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/14/2022] [Accepted: 07/26/2022] [Indexed: 02/07/2023]
Abstract
Triple-negative breast cancer (TNBC) is persistently refractory to therapy, and methods to improve targeting and evaluation of responses to therapy in this disease are needed. Here, we integrate quantitative MRI data with biologically based mathematical modeling to accurately predict the response of TNBC to neoadjuvant systemic therapy (NAST) on an individual basis. Specifically, 56 patients with TNBC enrolled in the ARTEMIS trial (NCT02276443) underwent standard-of-care doxorubicin/cyclophosphamide (A/C) and then paclitaxel for NAST, where dynamic contrast-enhanced MRI and diffusion-weighted MRI were acquired before treatment and after two and four cycles of A/C. A biologically based model was established to characterize tumor cell movement, proliferation, and treatment-induced cell death. Two evaluation frameworks were investigated using: (i) images acquired before and after two cycles of A/C for calibration and predicting tumor status after A/C, and (ii) images acquired before, after two cycles, and after four cycles of A/C for calibration and predicting response following NAST. For Framework 1, the concordance correlation coefficients between the predicted and measured patient-specific, post-A/C changes in tumor cellularity and volume were 0.95 and 0.94, respectively. For Framework 2, the biologically based model achieved an area under the receiver operator characteristic curve of 0.89 (sensitivity/specificity = 0.72/0.95) for differentiating pathological complete response (pCR) from non-pCR, which is statistically superior (P < 0.05) to the value of 0.78 (sensitivity/specificity = 0.72/0.79) achieved by tumor volume measured after four cycles of A/C. Overall, this model successfully captured patient-specific, spatiotemporal dynamics of TNBC response to NAST, providing highly accurate predictions of NAST response. SIGNIFICANCE Integrating MRI data with biologically based mathematical modeling successfully predicts breast cancer response to chemotherapy, suggesting digital twins could facilitate a paradigm shift from simply assessing response to predicting and optimizing therapeutic efficacy.
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Affiliation(s)
- Chengyue Wu
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin. Austin, Texas 78712
| | - Angela M. Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin. Austin, Texas 78712
- Livestrong Cancer Institutes, The University of Texas at Austin. Austin, Texas 78712
| | - Zijian Zhou
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Nabil Elshafeey
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Beatriz E. Adrada
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Rosalind P. Candelaria
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Rania M.M. Mohamed
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Medine Boge
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Lei Huo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Jason B. White
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Debu Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Vicente Valero
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Jennifer K. Litton
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Clinton Yam
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Jong Bum Son
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Jingfei Ma
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Gaiane M. Rauch
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Thomas E. Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin. Austin, Texas 78712
- Livestrong Cancer Institutes, The University of Texas at Austin. Austin, Texas 78712
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
- Department of Biomedical Engineering, The University of Texas at Austin. Austin, Texas 78712
- Department of Diagnostic Medicine, The University of Texas at Austin. Austin, Texas 78712
- Department of Oncology, The University of Texas at Austin. Austin, Texas 78712
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Wu C, Lorenzo G, Hormuth DA, Lima EABF, Slavkova KP, DiCarlo JC, Virostko J, Phillips CM, Patt D, Chung C, Yankeelov TE. Integrating mechanism-based modeling with biomedical imaging to build practical digital twins for clinical oncology. BIOPHYSICS REVIEWS 2022; 3:021304. [PMID: 35602761 PMCID: PMC9119003 DOI: 10.1063/5.0086789] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/29/2022] [Indexed: 12/11/2022]
Abstract
Digital twins employ mathematical and computational models to virtually represent a physical object (e.g., planes and human organs), predict the behavior of the object, and enable decision-making to optimize the future behavior of the object. While digital twins have been widely used in engineering for decades, their applications to oncology are only just emerging. Due to advances in experimental techniques quantitatively characterizing cancer, as well as advances in the mathematical and computational sciences, the notion of building and applying digital twins to understand tumor dynamics and personalize the care of cancer patients has been increasingly appreciated. In this review, we present the opportunities and challenges of applying digital twins in clinical oncology, with a particular focus on integrating medical imaging with mechanism-based, tissue-scale mathematical modeling. Specifically, we first introduce the general digital twin framework and then illustrate existing applications of image-guided digital twins in healthcare. Next, we detail both the imaging and modeling techniques that provide practical opportunities to build patient-specific digital twins for oncology. We then describe the current challenges and limitations in developing image-guided, mechanism-based digital twins for oncology along with potential solutions. We conclude by outlining five fundamental questions that can serve as a roadmap when designing and building a practical digital twin for oncology and attempt to provide answers for a specific application to brain cancer. We hope that this contribution provides motivation for the imaging science, oncology, and computational communities to develop practical digital twin technologies to improve the care of patients battling cancer.
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Affiliation(s)
- Chengyue Wu
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
| | | | | | | | - Kalina P. Slavkova
- Department of Physics, The University of Texas at Austin, Austin, Texas 78712, USA
| | | | | | - Caleb M. Phillips
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
| | - Debra Patt
- Texas Oncology, Austin, Texas 78731, USA
| | - Caroline Chung
- Department of Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, Texas 77030, USA
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Ji H, Lafata K, Mowery Y, Brizel D, Bertozzi AL, Yin FF, Wang C. Post-Radiotherapy PET Image Outcome Prediction by Deep Learning Under Biological Model Guidance: A Feasibility Study of Oropharyngeal Cancer Application. Front Oncol 2022; 12:895544. [PMID: 35646643 PMCID: PMC9135979 DOI: 10.3389/fonc.2022.895544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 01/03/2023] Open
Abstract
PurposeTo develop a method of biologically guided deep learning for post-radiation 18FDG-PET image outcome prediction based on pre-radiation images and radiotherapy dose information.MethodsBased on the classic reaction–diffusion mechanism, a novel biological model was proposed using a partial differential equation that incorporates spatial radiation dose distribution as a patient-specific treatment information variable. A 7-layer encoder–decoder-based convolutional neural network (CNN) was designed and trained to learn the proposed biological model. As such, the model could generate post-radiation 18FDG-PET image outcome predictions with breakdown biological components for enhanced explainability. The proposed method was developed using 64 oropharyngeal patients with paired 18FDG-PET studies before and after 20-Gy delivery (2 Gy/day fraction) by intensity-modulated radiotherapy (IMRT). In a two-branch deep learning execution, the proposed CNN learns specific terms in the biological model from paired 18FDG-PET images and spatial dose distribution in one branch, and the biological model generates post-20-Gy 18FDG-PET image prediction in the other branch. As in 2D execution, 718/233/230 axial slices from 38/13/13 patients were used for training/validation/independent test. The prediction image results in test cases were compared with the ground-truth results quantitatively.ResultsThe proposed method successfully generated post-20-Gy 18FDG-PET image outcome prediction with breakdown illustrations of biological model components. Standardized uptake value (SUV) mean values in 18FDG high-uptake regions of predicted images (2.45 ± 0.25) were similar to ground-truth results (2.51 ± 0.33). In 2D-based Gamma analysis, the median/mean Gamma Index (<1) passing rate of test images was 96.5%/92.8% using the 5%/5 mm criterion; such result was improved to 99.9%/99.6% when 10%/10 mm was adopted.ConclusionThe developed biologically guided deep learning method achieved post-20-Gy 18FDG-PET image outcome predictions in good agreement with ground-truth results. With the breakdown biological modeling components, the outcome image predictions could be used in adaptive radiotherapy decision-making to optimize personalized plans for the best outcome in the future.
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Affiliation(s)
- Hangjie Ji
- Department of Mathematics, North Carolina State University, Raleigh, NC, United States
| | - Kyle Lafata
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
- Department of Radiology, Duke University Medical Center, Durham, NC, United States
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, United States
| | - Yvonne Mowery
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
| | - David Brizel
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
| | - Andrea L. Bertozzi
- Mechanical and Aerospace Engineering Department, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Mathematics, University of California, Los Angeles, Los Angeles, CA, United States
| | - Fang-Fang Yin
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
| | - Chunhao Wang
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States
- *Correspondence: Chunhao Wang,
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Lipková J, Menze B, Wiestler B, Koumoutsakos P, Lowengrub JS. Modelling glioma progression, mass effect and intracranial pressure in patient anatomy. J R Soc Interface 2022; 19:20210922. [PMID: 35317645 PMCID: PMC8941421 DOI: 10.1098/rsif.2021.0922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 02/06/2023] Open
Abstract
Increased intracranial pressure is the source of most critical symptoms in patients with glioma, and often the main cause of death. Clinical interventions could benefit from non-invasive estimates of the pressure distribution in the patient's parenchyma provided by computational models. However, existing glioma models do not simulate the pressure distribution and they rely on a large number of model parameters, which complicates their calibration from available patient data. Here we present a novel model for glioma growth, pressure distribution and corresponding brain deformation. The distinct feature of our approach is that the pressure is directly derived from tumour dynamics and patient-specific anatomy, providing non-invasive insights into the patient's state. The model predictions allow estimation of critical conditions such as intracranial hypertension, brain midline shift or neurological and cognitive impairments. A diffuse-domain formalism is employed to allow for efficient numerical implementation of the model in the patient-specific brain anatomy. The model is tested on synthetic and clinical cases. To facilitate clinical deployment, a high-performance computing implementation of the model has been publicly released.
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Affiliation(s)
- Jana Lipková
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Bjoern Menze
- Department of Informatics, Technical University of Munich, Munich, Germany
- Department of Quantitative Biomedicine, University of Zürich, Zürich, Switzerland
- Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Benedikt Wiestler
- Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Petros Koumoutsakos
- Computational Science and Engineering Lab, ETH Zürich, Zürich, Switzerland
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - John S. Lowengrub
- Department of Mathematics, University of California, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, CA, USA
- Center for Complex Biological Systems, Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
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Jarrett AM, Kazerouni AS, Wu C, Virostko J, Sorace AG, DiCarlo JC, Hormuth DA, Ekrut DA, Patt D, Goodgame B, Avery S, Yankeelov TE. Quantitative magnetic resonance imaging and tumor forecasting of breast cancer patients in the community setting. Nat Protoc 2021; 16:5309-5338. [PMID: 34552262 PMCID: PMC9753909 DOI: 10.1038/s41596-021-00617-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/12/2021] [Indexed: 02/07/2023]
Abstract
This protocol describes a complete data acquisition, analysis and computational forecasting pipeline for employing quantitative MRI data to predict the response of locally advanced breast cancer to neoadjuvant therapy in a community-based care setting. The methodology has previously been successfully applied to a heterogeneous patient population. The protocol details how to acquire the necessary images followed by registration, segmentation, quantitative perfusion and diffusion analysis, model calibration, and prediction. The data collection portion of the protocol requires ~25 min of scanning, postprocessing requires 2-3 h, and the model calibration and prediction components require ~10 h per patient depending on tumor size. The response of individual breast cancer patients to neoadjuvant therapy is forecast by application of a biophysical, reaction-diffusion mathematical model to these data. Successful application of the protocol results in coregistered MRI data from at least two scan visits that quantifies an individual tumor's size, cellularity and vascular properties. This enables a spatially resolved prediction of how a particular patient's tumor will respond to therapy. Expertise in image acquisition and analysis, as well as the numerical solution of partial differential equations, is required to carry out this protocol.
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Affiliation(s)
- Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
- Livestrong Cancer Institutes, Austin, TX, USA
| | - Anum S Kazerouni
- Departments of Biomedical Engineering, Austin, TX, USA
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Chengyue Wu
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | - John Virostko
- Livestrong Cancer Institutes, Austin, TX, USA
- Departments of Diagnostic Medicine, Austin, TX, USA
- Departments of Oncology, Austin, TX, USA
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Julie C DiCarlo
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
- Livestrong Cancer Institutes, Austin, TX, USA
| | - David A Hormuth
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
- Livestrong Cancer Institutes, Austin, TX, USA
| | - David A Ekrut
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | | | - Boone Goodgame
- Departments of Oncology, Austin, TX, USA
- Departments of Internal Medicine, The University of Texas at Austin, Austin, Texas, USA
- Seton Hospital, Austin, TX, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, TX, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA.
- Livestrong Cancer Institutes, Austin, TX, USA.
- Departments of Biomedical Engineering, Austin, TX, USA.
- Departments of Diagnostic Medicine, Austin, TX, USA.
- Departments of Oncology, Austin, TX, USA.
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Wang X, Yang W. The effects of detailed nursing interventions on the safety and stress responses of tumor patients. Am J Transl Res 2021; 13:11375-11383. [PMID: 34786065 PMCID: PMC8581874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The overall aim is to study the effect of detailed nursing interventions on the safety and stress responses of tumor patients. METHODS A total of 100 patients who underwent tumor surgery between August 2017 and August 2019 were included and randomized into an experimental group (n=50) and a control group (n=50). Both groups were administered conventional nursing, and based on that, the experimental group was treated with detailed nursing. The two groups were compared in terms of their blood pressure changes, serum norepinephrine (NE), epinephrine (E), cortisol, nursing quality, and Self-Rating Depression/Anxiety Scale (SDS/SAS) scores. The incidences of adverse reactions and the nursing satisfaction were also compared. RESULTS After the nursing, the experimental group had better results in their blood pressure levels, stress indexes, nutritional status, and nursing quality (P<0.05). Compared with the control group, lower SDS/SAS scores, fewer accidents, and higher nursing satisfaction were observed in the experimental group (P<0.05). The progression-free survival rates at 6 and 12 months after the operations were significantly higher in the experimental group than that in the control group (P<0.05). CONCLUSION Detailed nursing interventions can substantially improve the psychological conditions of patients with tumors and diminish their adverse stress responses with a high safety profile, so it is worthy of clinical promotion and application.
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Affiliation(s)
- Xi Wang
- Department of Gynaecology, China-Japan Union Hospital of Jilin UniversityJilin, China
| | - Wei Yang
- Department of Hepatopancreatobiliary Surgery, China-Japan Union Hospital of Jilin UniversityJilin, China
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Hormuth DA, Jarrett AM, Davis T, Yankeelov TE. Towards an Image-Informed Mathematical Model of In Vivo Response to Fractionated Radiation Therapy. Cancers (Basel) 2021; 13:cancers13081765. [PMID: 33917080 PMCID: PMC8067722 DOI: 10.3390/cancers13081765] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/01/2021] [Accepted: 04/04/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Using medical imaging data and computational models, we develop a modeling framework to provide personalized treatment response forecasts to fractionated radiation therapy for individual tumors. We evaluate this approach in an animal model of brain cancer and forecast changes in tumor cellularity and vasculature. Abstract Fractionated radiation therapy is central to the treatment of numerous malignancies, including high-grade gliomas where complete surgical resection is often impractical due to its highly invasive nature. Development of approaches to forecast response to fractionated radiation therapy may provide the ability to optimize or adapt treatment plans for radiotherapy. Towards this end, we have developed a family of 18 biologically-based mathematical models describing the response of both tumor and vasculature to fractionated radiation therapy. Importantly, these models can be personalized for individual tumors via quantitative imaging measurements. To evaluate this family of models, rats (n = 7) with U-87 glioblastomas were imaged with magnetic resonance imaging (MRI) before, during, and after treatment with fractionated radiotherapy (with doses of either 2 Gy/day or 4 Gy/day for up to 10 days). Estimates of tumor and blood volume fractions, provided by diffusion-weighted MRI and dynamic contrast-enhanced MRI, respectively, were used to calibrate tumor-specific model parameters. The Akaike Information Criterion was employed to select the most parsimonious model and determine an ensemble averaged model, and the resulting forecasts were evaluated at the global and local level. At the global level, the selected model’s forecast resulted in less than 16.2% error in tumor volume estimates. At the local (voxel) level, the median Pearson correlation coefficient across all prediction time points ranged from 0.57 to 0.87 for all animals. While the ensemble average forecast resulted in increased error (ranging from 4.0% to 1063%) in tumor volume predictions over the selected model, it increased the voxel wise correlation (by greater than 12.3%) for three of the animals. This study demonstrates the feasibility of calibrating a model of response by serial quantitative MRI data collected during fractionated radiotherapy to predict response at the conclusion of treatment.
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Affiliation(s)
- David A. Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; (A.M.J.); (T.E.Y.)
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
- Correspondence:
| | - Angela M. Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; (A.M.J.); (T.E.Y.)
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
| | - Tessa Davis
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Thomas E. Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA; (A.M.J.); (T.E.Y.)
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA;
- Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX 78712, USA
- Department of Oncology, The University of Texas at Austin, Austin, TX 78712, USA
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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12
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Jarrett AM, Hormuth DA, Wu C, Kazerouni AS, Ekrut DA, Virostko J, Sorace AG, DiCarlo JC, Kowalski J, Patt D, Goodgame B, Avery S, Yankeelov TE. Evaluating patient-specific neoadjuvant regimens for breast cancer via a mathematical model constrained by quantitative magnetic resonance imaging data. Neoplasia 2020; 22:820-830. [PMID: 33197744 PMCID: PMC7677708 DOI: 10.1016/j.neo.2020.10.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
The ability to accurately predict response and then rigorously optimize a therapeutic regimen on a patient-specific basis, would transform oncology. Toward this end, we have developed an experimental-mathematical framework that integrates quantitative magnetic resonance imaging (MRI) data into a biophysical model to predict patient-specific treatment response of locally advanced breast cancer to neoadjuvant therapy. Diffusion-weighted and dynamic contrast-enhanced MRI data is collected prior to therapy, after 1 cycle of therapy, and at the completion of the first therapeutic regimen. The model is initialized and calibrated with the first 2 patient-specific MRI data sets to predict response at the third, which is then compared to patient outcomes (N = 18). The model's predictions for total cellularity, total volume, and the longest axis at the completion of the regimen are significant within expected measurement precision (P< 0.05) and strongly correlated with measured response (P < 0.01). Further, we use the model to investigate, in silico, a range of (practical) alternative treatment plans to achieve the greatest possible tumor control for each individual in a subgroup of patients (N = 13). The model identifies alternative dosing strategies predicted to achieve greater tumor control compared to the standard of care for 12 of 13 patients (P < 0.01). In summary, a predictive, mechanism-based mathematical model has demonstrated the ability to identify alternative treatment regimens that are forecasted to outperform the therapeutic regimens the patients clinically. This has important implications for clinical trial design with the opportunity to alter oncology care in the future.
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Affiliation(s)
- Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA; Livestrong Cancer Institutes, Austin, TX, USA
| | - David A Hormuth
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA; Livestrong Cancer Institutes, Austin, TX, USA
| | - Chengyue Wu
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Anum S Kazerouni
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - David A Ekrut
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | - John Virostko
- Livestrong Cancer Institutes, Austin, TX, USA; Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA; Department of Oncology, The University of Texas at Austin, Austin, TX, USA
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Julie C DiCarlo
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA
| | - Jeanne Kowalski
- Livestrong Cancer Institutes, Austin, TX, USA; Department of Oncology, The University of Texas at Austin, Austin, TX, USA
| | | | - Boone Goodgame
- Department of Oncology, The University of Texas at Austin, Austin, TX, USA; Department of Internal Medicine, The University of Texas at Austin, Austin, TX, USA; Seton Hospital, Austin, TX, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, TX, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, Austin, TX, USA; Livestrong Cancer Institutes, Austin, TX, USA; Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA; Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA; Department of Oncology, The University of Texas at Austin, Austin, TX, USA; Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA.
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13
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Jarrett AM, Hormuth DA, Adhikarla V, Sahoo P, Abler D, Tumyan L, Schmolze D, Mortimer J, Rockne RC, Yankeelov TE. Towards integration of 64Cu-DOTA-trastuzumab PET-CT and MRI with mathematical modeling to predict response to neoadjuvant therapy in HER2 + breast cancer. Sci Rep 2020; 10:20518. [PMID: 33239688 PMCID: PMC7688955 DOI: 10.1038/s41598-020-77397-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
While targeted therapies exist for human epidermal growth factor receptor 2 positive (HER2 +) breast cancer, HER2 + patients do not always respond to therapy. We present the results of utilizing a biophysical mathematical model to predict tumor response for two HER2 + breast cancer patients treated with the same therapeutic regimen but who achieved different treatment outcomes. Quantitative data from magnetic resonance imaging (MRI) and 64Cu-DOTA-trastuzumab positron emission tomography (PET) are used to estimate tumor density, perfusion, and distribution of HER2-targeted antibodies for each individual patient. MRI and PET data are collected prior to therapy, and follow-up MRI scans are acquired at a midpoint in therapy. Given these data types, we align the data sets to a common image space to enable model calibration. Once the model is parameterized with these data, we forecast treatment response with and without HER2-targeted therapy. By incorporating targeted therapy into the model, the resulting predictions are able to distinguish between the two different patient responses, increasing the difference in tumor volume change between the two patients by > 40%. This work provides a proof-of-concept strategy for processing and integrating PET and MRI modalities into a predictive, clinical-mathematical framework to provide patient-specific predictions of HER2 + treatment response.
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Affiliation(s)
- Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
| | - David A Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
| | - Vikram Adhikarla
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA
| | - Prativa Sahoo
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA
| | - Daniel Abler
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Lusine Tumyan
- Department of Radiology, City of Hope National Medical Center, Duarte, CA, USA
| | - Daniel Schmolze
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Joanne Mortimer
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Russell C Rockne
- Division of Mathematical Oncology, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, 1500 E Duarte Rd, Bldg. 74, Duarte, CA, 91010, USA.
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, USA.
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA.
- Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA.
- Department of Oncology, The University of Texas at Austin, Austin, TX, USA.
- Department of Biomedical Engineering, The University of Texas at Austin, 107 W Dean Keeton Street Stop C0800, Austin, TX, 78712, USA.
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Elazab A, Wang C, Safdar Gardezi SJ, Bai H, Wang T, Lei B, Chang C. Glioma Growth Prediction via Generative Adversarial Learning from Multi-Time Points Magnetic Resonance Images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:1750-1753. [PMID: 33018336 DOI: 10.1109/embc44109.2020.9175817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gliomas are the most dominant and lethal type of brain tumors. Growth prediction is significant to quantify tumor aggressiveness, improve therapy planning, and estimate patients' survival time. This is commonly addressed in literature using mathematical models guided by multi-time point scans of multi/single-modal data for the same subject. However, these models are mechanism-based and heavily rely on complicated mathematical formulations of partial differential equations with few parameters that are insufficient to capture different patterns and other characteristics of gliomas. In this paper, we propose a 3D generative adversarial networks (GANs) for glioma growth prediction. Specifically, we stack 2 GANs with conditional initialization of segmented feature maps. Furthermore, we employ Dice loss in our objective function and devised 3D U-Net architecture for better image generation. The proposed method is trained and validated using 3D patch-based strategy on real magnetic resonance images of 9 subjects with 3 time points. Experimental results show that the proposed method can be successfully used for glioma growth prediction with satisfactory performance.
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Multiatlas Calibration of Biophysical Brain Tumor Growth Models with Mass Effect. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2020; 12262:551-560. [PMID: 34704089 DOI: 10.1007/978-3-030-59713-9_53] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We present a 3D fully-automatic method for the calibration of partial differential equation (PDE) models of glioblastoma (GBM) growth with "mass effect", the deformation of brain tissue due to the tumor. We quantify the mass effect, tumor proliferation, tumor migration, and the localized tumor initial condition from a single multiparameteric Magnetic Resonance Imaging (mpMRI) patient scan. The PDE is a reaction-advection-diffusion partial differential equation coupled with linear elasticity equations to capture mass effect. The single-scan calibration model is notoriously difficult because the precancerous (healthy) brain anatomy is unknown. To solve this inherently ill-posed and illconditioned optimization problem, we introduce a novel inversion scheme that uses multiple brain atlases as proxies for the healthy precancer patient brain resulting in robust and reliable parameter estimation. We apply our method on both synthetic and clinical datasets representative of the heterogeneous spatial landscape typically observed in glioblastomas to demonstrate the validity and performance of our methods. In the synthetic data, we report calibration errors (due to the ill-posedness and our solution scheme) in the 10%-20% range. In the clinical data, we report good quantitative agreement with the observed tumor and qualitative agreement with the mass effect (for which we do not have a ground truth). Our method uses a minimal set of parameters and provides both global and local quantitative measures of tumor infiltration and mass effect.
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Subramanian S, Scheufele K, Mehl M, Biros G. WHERE DID THE TUMOR START? AN INVERSE SOLVER WITH SPARSE LOCALIZATION FOR TUMOR GROWTH MODELS. INVERSE PROBLEMS 2020; 36:045006. [PMID: 33746330 PMCID: PMC7971430 DOI: 10.1088/1361-6420/ab649c] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We present a numerical scheme for solving an inverse problem for parameter estimation in tumor growth models for glioblastomas, a form of aggressive primary brain tumor. The growth model is a reaction-diffusion partial differential equation (PDE) for the tumor concentration. We use a PDE-constrained optimization formulation for the inverse problem. The unknown parameters are the reaction coefficient (proliferation), the diffusion coefficient (infiltration), and the initial condition field for the tumor PDE. Segmentation of Magnetic Resonance Imaging (MRI) scans drive the inverse problem where segmented tumor regions serve as partial observations of the tumor concentration. Like most cases in clinical practice, we use data from a single time snapshot. Moreover, the precise time relative to the initiation of the tumor is unknown, which poses an additional difficulty for inversion. We perform a frozen-coefficient spectral analysis and show that the inverse problem is severely ill-posed. We introduce a biophysically motivated regularization on the structure and magnitude of the tumor initial condition. In particular, we assume that the tumor starts at a few locations (enforced with a sparsity constraint on the initial condition of the tumor) and that the initial condition magnitude in the maximum norm is equal to one. We solve the resulting optimization problem using an inexact quasi-Newton method combined with a compressive sampling algorithm for the sparsity constraint. Our implementation uses PETSc and AccFFT libraries. We conduct numerical experiments on synthetic and clinical images to highlight the improved performance of our solver over a previously existing solver that uses standard two-norm regularization for the calibration parameters. The existing solver is unable to localize the initial condition. Our new solver can localize the initial condition and recover infiltration and proliferation. In clinical datasets (for which the ground truth is unknown), our solver results in qualitatively different solutions compared to the two-norm regularized solver.
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Affiliation(s)
- Shashank Subramanian
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, 201 E. 24th Street, Austin, Texas, USA
| | - Klaudius Scheufele
- Institute for Parallel and Distributed Systems, Universität Stuttgart, Universitatsstraßë38, Stuttgart, Germany
| | - Miriam Mehl
- Institute for Parallel and Distributed Systems, Universität Stuttgart, Universitatsstraßë38, Stuttgart, Germany
| | - George Biros
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, 201 E. 24th Street, Austin, Texas, USA
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Hormuth DA, Jarrett AM, Yankeelov TE. Forecasting tumor and vasculature response dynamics to radiation therapy via image based mathematical modeling. Radiat Oncol 2020; 15:4. [PMID: 31898514 PMCID: PMC6941255 DOI: 10.1186/s13014-019-1446-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/12/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Intra-and inter-tumoral heterogeneity in growth dynamics and vascularity influence tumor response to radiation therapy. Quantitative imaging techniques capture these dynamics non-invasively, and these data can initialize and constrain predictive models of response on an individual basis. METHODS We have developed a family of 10 biologically-based mathematical models describing the spatiotemporal dynamics of tumor volume fraction, blood volume fraction, and response to radiation therapy. To evaluate this family of models, rats (n = 13) with C6 gliomas were imaged with magnetic resonance imaging (MRI) three times before, and four times following a single fraction of 20 Gy or 40 Gy whole brain irradiation. The first five 3D time series data of tumor volume fraction, estimated from diffusion-weighted (DW-) MRI, and blood volume fraction, estimated from dynamic contrast-enhanced (DCE-) MRI, were used to calibrate tumor-specific model parameters. The most parsimonious and well calibrated of the 10 models, selected using the Akaike information criterion, was then utilized to predict future growth and response at the final two imaging time points. Model predictions were compared at the global level (percent error in tumor volume, and Dice coefficient) as well as at the local or voxel level (concordance correlation coefficient). RESULT The selected model resulted in < 12% error in tumor volume predictions, strong spatial agreement between predicted and observed tumor volumes (Dice coefficient > 0.74), and high level of agreement at the voxel level between the predicted and observed tumor volume fraction and blood volume fraction (concordance correlation coefficient > 0.77 and > 0.65, respectively). CONCLUSIONS This study demonstrates that serial quantitative MRI data collected before and following radiation therapy can be used to accurately predict tumor and vasculature response with a biologically-based mathematical model that is calibrated on an individual basis. To the best of our knowledge, this is the first effort to characterize the tumor and vasculature response to radiation therapy temporally and spatially using imaging-driven mathematical models.
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Affiliation(s)
- David A Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, USA.
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA.
| | - Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
- Departments of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
- Departments of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA
- Departments of Oncology, The University of Texas at Austin, Austin, TX, USA
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Hormuth DA, Jarrett AM, Feng X, Yankeelov TE. Calibrating a Predictive Model of Tumor Growth and Angiogenesis with Quantitative MRI. Ann Biomed Eng 2019; 47:1539-1551. [PMID: 30963385 PMCID: PMC6544501 DOI: 10.1007/s10439-019-02262-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/30/2019] [Indexed: 02/05/2023]
Abstract
The spatiotemporal variations in tumor vasculature inevitably alters cell proliferation and treatment efficacy. Thus, rigorous characterization of tumor dynamics must include a description of this phenomenon. We have developed a family of biophysical models of tumor growth and angiogenesis that are calibrated with diffusion-weighted magnetic resonance imaging (DW-MRI) and dynamic contrast-enhanced (DCE-) MRI data to provide individualized tumor growth forecasts. Tumor and blood volume fractions were evolved using two, coupled partial differential equations consisting of proliferation, diffusion, and death terms. To evaluate these models, rats (n = 8) with C6 gliomas were imaged seven times. The tumor volume fraction was estimated using DW-MRI, while DCE-MRI provided estimates of the blood volume fraction. The first three time points were used to calibrate model parameters, which were then used to predict growth at the remaining four time points and compared directly to the measurements. The best performing model predicted tumor growth with less than 10.3% error in tumor volume and with less than 9.4% error at the voxel-level at all prediction time points. The best performing model resulted in less than 9.3% error in blood volume at the voxel-level. This pre-clinical study demonstrates the potential for image-based, mechanistic modeling of tumor growth and angiogenesis.
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Affiliation(s)
- David A Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, 78712-1229, USA.
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA.
| | - Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, 78712-1229, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
| | - Xinzeng Feng
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, 78712-1229, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 201 E. 24th Street, POB 4.102, 1 University Station (C0200), Austin, TX, 78712-1229, USA
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
- Department of Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA
- Department of Oncology, The University of Texas at Austin, Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX, USA
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Subramanian S, Gholami A, Biros G. Simulation of glioblastoma growth using a 3D multispecies tumor model with mass effect. J Math Biol 2019; 79:941-967. [PMID: 31127329 DOI: 10.1007/s00285-019-01383-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/26/2019] [Indexed: 02/02/2023]
Abstract
In this article, we present a multispecies reaction-advection-diffusion partial differential equation coupled with linear elasticity for modeling tumor growth. The model aims to capture the phenomenological features of glioblastoma multiforme observed in magnetic resonance imaging (MRI) scans. These include enhancing and necrotic tumor structures, brain edema and the so-called "mass effect", a term-of-art that refers to the deformation of brain tissue due to the presence of the tumor. The multispecies model accounts for proliferating, invasive and necrotic tumor cells as well as a simple model for nutrition consumption and tumor-induced brain edema. The coupling of the model with linear elasticity equations with variable coefficients allows us to capture the mechanical deformations due to the tumor growth on surrounding tissues. We present the overall formulation along with a novel operator-splitting scheme with components that include linearly-implicit preconditioned elliptic solvers, and a semi-Lagrangian method for advection. We also present results showing simulated MRI images which highlight the capability of our method to capture the overall structure of glioblastomas in MRIs.
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Affiliation(s)
- Shashank Subramanian
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
| | - Amir Gholami
- Department of Electrical Engineering and Computer Sciences, UC Berkeley, Berkeley, CA, 94720, USA
| | - George Biros
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, 78712, USA
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Jarrett AM, Lima EABF, Hormuth DA, McKenna MT, Feng X, Ekrut DA, Resende ACM, Brock A, Yankeelov TE. Mathematical models of tumor cell proliferation: A review of the literature. Expert Rev Anticancer Ther 2018; 18:1271-1286. [PMID: 30252552 PMCID: PMC6295418 DOI: 10.1080/14737140.2018.1527689] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION A defining hallmark of cancer is aberrant cell proliferation. Efforts to understand the generative properties of cancer cells span all biological scales: from genetic deviations and alterations of metabolic pathways to physical stresses due to overcrowding, as well as the effects of therapeutics and the immune system. While these factors have long been studied in the laboratory, mathematical and computational techniques are being increasingly applied to help understand and forecast tumor growth and treatment response. Advantages of mathematical modeling of proliferation include the ability to simulate and predict the spatiotemporal development of tumors across multiple experimental scales. Central to proliferation modeling is the incorporation of available biological data and validation with experimental data. Areas covered: We present an overview of past and current mathematical strategies directed at understanding tumor cell proliferation. We identify areas for mathematical development as motivated by available experimental and clinical evidence, with a particular emphasis on emerging, non-invasive imaging technologies. Expert commentary: The data required to legitimize mathematical models are often difficult or (currently) impossible to obtain. We suggest areas for further investigation to establish mathematical models that more effectively utilize available data to make informed predictions on tumor cell proliferation.
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Affiliation(s)
- Angela M Jarrett
- a Institute for Computational Engineering and Sciences , The University of Texas at Austin , Austin , USA
- b Livestrong Cancer Institutes , The University of Texas at Austin , Austin , USA
| | - Ernesto A B F Lima
- a Institute for Computational Engineering and Sciences , The University of Texas at Austin , Austin , USA
| | - David A Hormuth
- a Institute for Computational Engineering and Sciences , The University of Texas at Austin , Austin , USA
- b Livestrong Cancer Institutes , The University of Texas at Austin , Austin , USA
| | - Matthew T McKenna
- c Department of Biomedical Engineering , Vanderbilt University , Nashville , USA
| | - Xinzeng Feng
- a Institute for Computational Engineering and Sciences , The University of Texas at Austin , Austin , USA
| | - David A Ekrut
- a Institute for Computational Engineering and Sciences , The University of Texas at Austin , Austin , USA
| | - Anna Claudia M Resende
- a Institute for Computational Engineering and Sciences , The University of Texas at Austin , Austin , USA
- d Department of Computational Modeling , National Laboratory for Scientific Computing , Petrópolis , Brazil
| | - Amy Brock
- b Livestrong Cancer Institutes , The University of Texas at Austin , Austin , USA
- e Department of Biomedical Engineering , The University of Texas at Austin , Austin , USA
| | - Thomas E Yankeelov
- a Institute for Computational Engineering and Sciences , The University of Texas at Austin , Austin , USA
- b Livestrong Cancer Institutes , The University of Texas at Austin , Austin , USA
- e Department of Biomedical Engineering , The University of Texas at Austin , Austin , USA
- f Department of Diagnostic Medicine , The University of Texas at Austin , Austin , USA
- g Department of Oncology , The University of Texas at Austin , Austin , USA
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