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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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Meaney C, Das S, Colak E, Kohandel M. Deep learning characterization of brain tumours with diffusion weighted imaging. J Theor Biol 2023; 557:111342. [PMID: 36368560 DOI: 10.1016/j.jtbi.2022.111342] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/19/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
Glioblastoma multiforme (GBM) is one of the most deadly forms of cancer. Methods of characterizing these tumours are valuable for improving predictions of their progression and response to treatment. A mathematical model called the proliferation-invasion (PI) model has been used extensively in the literature to model the growth of these tumours, though it relies on known values of two key parameters: the tumour cell diffusivity and proliferation rate. Unfortunately, these parameters are difficult to estimate in a patient-specific manner, making personalized tumour forecasting challenging. In this paper, we develop and apply a deep learning model capable of making accurate estimates of these key GBM-characterizing parameters while simultaneously producing a full prediction of the tumour progression curve. Our method uses two sets of multi sequence MRI in order to produce estimations and relies on a preprocessing pipeline which includes brain tumour segmentation and conversion to tumour cellularity. We first apply our deep learning model to synthetic tumours to showcase the model's capabilities and identify situations where prediction errors are likely to occur. We then apply our model to a clinical dataset consisting of five patients diagnosed with GBM. For all patients, we derive evidence-based estimates for each of the PI model parameters and predictions for the future progression of the tumour, along with estimates of the parameter uncertainties. Our work provides a new, easily generalizable method for the estimation of patient-specific tumour parameters, which can be built upon to aid physicians in designing personalized treatments.
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Affiliation(s)
- Cameron Meaney
- Department of Applied Mathematics, University of Waterloo, Waterloo, Canada.
| | - Sunit Das
- Division of Neurosurgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Errol Colak
- Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Medical Imaging and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Odette Professorship in Artificial Intelligence for Medical Imaging, St. Michael's Hospital, Toronto, Canada
| | - Mohammad Kohandel
- Department of Applied Mathematics, University of Waterloo, Waterloo, Canada
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3
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Dynamic characterization of breast cancer response to neoadjuvant therapy using biophysical metrics of spatial proliferation. Sci Rep 2022; 12:11718. [PMID: 35810187 PMCID: PMC9271064 DOI: 10.1038/s41598-022-15801-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/29/2022] [Indexed: 11/08/2022] Open
Abstract
Current tools to assess breast cancer response to neoadjuvant chemotherapy cannot reliably predict disease eradication, which if possible, could allow early cessation of therapy. In this work, we assessed the ability of an image data-driven mathematical modeling approach for dynamic characterization of breast cancer response to neoadjuvant therapy. We retrospectively analyzed patients enrolled in the I-SPY 2 TRIAL at the Atrium Health Wake Forest Baptist Comprehensive Cancer Center. Patients enrolled on the study received four MR imaging examinations during neoadjuvant therapy with acquisitions at baseline (T0), 3-weeks/early-treatment (T1), 12-weeks/mid-treatment (T2), and completion of therapy prior to surgery (T3). We use a biophysical mathematical model of tumor growth to generate spatial estimates of tumor proliferation to characterize the dynamics of treatment response. Using histogram summary metrics to quantify estimated tumor proliferation maps, we found strong correlation of mathematical model-estimated tumor proliferation with residual cancer burden, with Pearson correlation coefficients ranging from 0.88 and 0.97 between T0 and T2, representing a significant improvement from conventional assessment methods of change in mean apparent diffusion coefficient and functional tumor volume. This data shows the significant promise of imaging-based biophysical mathematical modeling methods for dynamic characterization of patient-specific response to neoadjuvant therapy with correlation to residual disease outcomes.
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4
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Martens C, Rovai A, Bonatto D, Metens T, Debeir O, Decaestecker C, Goldman S, Van Simaeys G. Deep Learning for Reaction-Diffusion Glioma Growth Modeling: Towards a Fully Personalized Model? Cancers (Basel) 2022; 14:cancers14102530. [PMID: 35626134 PMCID: PMC9139770 DOI: 10.3390/cancers14102530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Mathematical tumor growth models have been proposed for decades to capture the growth of gliomas, an aggressive form of brain tumor. However, the estimation of the tumor cell-density distribution at diagnosis and model parameters from partial observations provided by magnetic resonance imaging are ill-posed problems. In this work, we propose a deep learning-based approach to address these problems. 1200 synthetic tumors are first generated using the mathematical model over brain geometries of 6 volunteers. Two deep convolutional neural networks are then trained to (i) reconstruct a whole tumor cell-density distribution and (ii) evaluate the model parameters from partial observations provided in the form of threshold-like imaging contours, with state-of-the-art results. From the estimated cell-density distribution and parameter values, the spatio-temporal evolution of the tumor can ultimately be accurately captured by the mathematical model. Such an approach could be of great interest for glioma characterization and therapy planning. Abstract Reaction-diffusion models have been proposed for decades to capture the growth of gliomas, the most common primary brain tumors. However, ill-posedness of the initialization at diagnosis time and parameter estimation of such models have restrained their clinical use as a personalized predictive tool. In this work, we investigate the ability of deep convolutional neural networks (DCNNs) to address commonly encountered pitfalls in the field. Based on 1200 synthetic tumors grown over real brain geometries derived from magnetic resonance (MR) data of six healthy subjects, we demonstrate the ability of DCNNs to reconstruct a whole tumor cell-density distribution from only two imaging contours at a single time point. With an additional imaging contour extracted at a prior time point, we also demonstrate the ability of DCNNs to accurately estimate the individual diffusivity and proliferation parameters of the model. From this knowledge, the spatio-temporal evolution of the tumor cell-density distribution at later time points can ultimately be precisely captured using the model. We finally show the applicability of our approach to MR data of a real glioblastoma patient. This approach may open the perspective of a clinical application of reaction-diffusion growth models for tumor prognosis and treatment planning.
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Affiliation(s)
- Corentin Martens
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
- Correspondence:
| | - Antonin Rovai
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
| | - Daniele Bonatto
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
| | - Thierry Metens
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
- Department of Radiology, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Olivier Debeir
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
| | - Christine Decaestecker
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (D.B.); (T.M.)
| | - Serge Goldman
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
| | - Gaetan Van Simaeys
- Department of Nuclear Medicine, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (O.D.); (C.D.)
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Harris DC, Mignucci-Jiménez G, Xu Y, Eikenberry SE, Quarles CC, Preul MC, Kuang Y, Kostelich EJ. Tracking glioblastoma progression after initial resection with minimal reaction-diffusion models. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:5446-5481. [PMID: 35603364 DOI: 10.3934/mbe.2022256] [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: 06/15/2023]
Abstract
We describe a preliminary effort to model the growth and progression of glioblastoma multiforme, an aggressive form of primary brain cancer, in patients undergoing treatment for recurrence of tumor following initial surgery and chemoradiation. Two reaction-diffusion models are used: the Fisher-Kolmogorov equation and a 2-population model, developed by the authors, that divides the tumor into actively proliferating and quiescent (or necrotic) cells. The models are simulated on 3-dimensional brain geometries derived from magnetic resonance imaging (MRI) scans provided by the Barrow Neurological Institute. The study consists of 17 clinical time intervals across 10 patients that have been followed in detail, each of whom shows significant progression of tumor over a period of 1 to 3 months on sequential follow up scans. A Taguchi sampling design is implemented to estimate the variability of the predicted tumors to using 144 different choices of model parameters. In 9 cases, model parameters can be identified such that the simulated tumor, using both models, contains at least 40 percent of the volume of the observed tumor. We discuss some potential improvements that can be made to the parameterizations of the models and their initialization.
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Affiliation(s)
- Duane C Harris
- School of Mathematical & Statistical Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Giancarlo Mignucci-Jiménez
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Yuan Xu
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Steffen E Eikenberry
- School of Mathematical & Statistical Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - C Chad Quarles
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Mark C Preul
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Yang Kuang
- School of Mathematical & Statistical Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Eric J Kostelich
- School of Mathematical & Statistical Sciences, Arizona State University, Tempe, AZ 85281, USA
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6
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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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7
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Martens C, Lebrun L, Decaestecker C, Vandamme T, Van Eycke YR, Rovai A, Metens T, Debeir O, Goldman S, Salmon I, Van Simaeys G. Initial Condition Assessment for Reaction-Diffusion Glioma Growth Models: A Translational MRI-Histology (In)Validation Study. Tomography 2021; 7:650-674. [PMID: 34842805 PMCID: PMC8628987 DOI: 10.3390/tomography7040055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 01/21/2023] Open
Abstract
Reaction-diffusion models have been proposed for decades to capture the growth of gliomas. Nevertheless, these models require an initial condition: the tumor cell density distribution over the whole brain at diagnosis time. Several works have proposed to relate this distribution to abnormalities visible on magnetic resonance imaging (MRI). In this work, we verify these hypotheses by stereotactic histological analysis of a non-operated brain with glioblastoma using a 3D-printed slicer. Cell density maps are computed from histological slides using a deep learning approach. The density maps are then registered to a postmortem MR image and related to an MR-derived geodesic distance map to the tumor core. The relation between the edema outlines visible on T2-FLAIR MRI and the distance to the core is also investigated. Our results suggest that (i) the previously proposed exponential decrease of the tumor cell density with the distance to the core is reasonable but (ii) the edema outlines would not correspond to a cell density iso-contour and (iii) the suggested tumor cell density at these outlines is likely overestimated. These findings highlight the limitations of conventional MRI to derive glioma cell density maps and the need for other initialization methods for reaction-diffusion models to be used in clinical practice.
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Affiliation(s)
- Corentin Martens
- Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (C.D.); (Y.-R.V.E.); (O.D.); (I.S.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (T.V.); (T.M.)
| | - Laetitia Lebrun
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium;
| | - Christine Decaestecker
- Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (C.D.); (Y.-R.V.E.); (O.D.); (I.S.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (T.V.); (T.M.)
| | - Thomas Vandamme
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (T.V.); (T.M.)
| | - Yves-Rémi Van Eycke
- Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (C.D.); (Y.-R.V.E.); (O.D.); (I.S.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (T.V.); (T.M.)
| | - Antonin Rovai
- Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
| | - Thierry Metens
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (T.V.); (T.M.)
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Olivier Debeir
- Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (C.D.); (Y.-R.V.E.); (O.D.); (I.S.)
- Laboratory of Image Synthesis and Analysis (LISA), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue Franklin Roosevelt 50, 1050 Brussels, Belgium; (T.V.); (T.M.)
| | - Serge Goldman
- Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (C.D.); (Y.-R.V.E.); (O.D.); (I.S.)
| | - Isabelle Salmon
- Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (C.D.); (Y.-R.V.E.); (O.D.); (I.S.)
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium;
| | - Gaetan Van Simaeys
- Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium; (A.R.); (S.G.); (G.V.S.)
- Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles, Rue Adrienne Bolland 8, 6041 Charleroi, Belgium; (C.D.); (Y.-R.V.E.); (O.D.); (I.S.)
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8
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Hormuth DA, Al Feghali KA, Elliott AM, Yankeelov TE, Chung C. Image-based personalization of computational models for predicting response of high-grade glioma to chemoradiation. Sci Rep 2021; 11:8520. [PMID: 33875739 PMCID: PMC8055874 DOI: 10.1038/s41598-021-87887-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/30/2021] [Indexed: 12/16/2022] Open
Abstract
High-grade gliomas are an aggressive and invasive malignancy which are susceptible to treatment resistance due to heterogeneity in intratumoral properties such as cell proliferation and density and perfusion. Non-invasive imaging approaches can measure these properties, which can then be used to calibrate patient-specific mathematical models of tumor growth and response. We employed multiparametric magnetic resonance imaging (MRI) to identify tumor extent (via contrast-enhanced T1-weighted, and T2-FLAIR) and capture intratumoral heterogeneity in cell density (via diffusion-weighted imaging) to calibrate a family of mathematical models of chemoradiation response in nine patients with unresected or partially resected disease. The calibrated model parameters were used to forecast spatially-mapped individual tumor response at future imaging visits. We then employed the Akaike information criteria to select the most parsimonious member from the family, a novel two-species model describing the enhancing and non-enhancing components of the tumor. Using this model, we achieved low error in predictions of the enhancing volume (median: - 2.5%, interquartile range: 10.0%) and a strong correlation in total cell count (Kendall correlation coefficient 0.79) at 3-months post-treatment. These preliminary results demonstrate the plausibility of using multiparametric MRI data to inform spatially-informative, biologically-based predictive models of tumor response in the setting of clinical high-grade gliomas.
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Affiliation(s)
- David A Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 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, Austin, TX, USA.
| | - Karine A Al Feghali
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew M Elliott
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Thomas E Yankeelov
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, 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, Austin, TX, USA
- Department of Diagnostic Medicine, The University of Texas at Austin, Austin, Austin, TX, USA
- Department of Oncology, The University of Texas at Austin, Austin, Austin, TX, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, Austin, TX, USA
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA
| | - Caroline Chung
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
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9
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Kazerouni AS, Gadde M, Gardner A, Hormuth DA, Jarrett AM, Johnson KE, Lima EAF, Lorenzo G, Phillips C, Brock A, Yankeelov TE. Integrating Quantitative Assays with Biologically Based Mathematical Modeling for Predictive Oncology. iScience 2020; 23:101807. [PMID: 33299976 PMCID: PMC7704401 DOI: 10.1016/j.isci.2020.101807] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
We provide an overview on the use of biological assays to calibrate and initialize mechanism-based models of cancer phenomena. Although artificial intelligence methods currently dominate the landscape in computational oncology, mathematical models that seek to explicitly incorporate biological mechanisms into their formalism are of increasing interest. These models can guide experimental design and provide insights into the underlying mechanisms of cancer progression. Historically, these models have included a myriad of parameters that have been difficult to quantify in biologically relevant systems, limiting their practical insights. Recently, however, there has been much interest calibrating biologically based models with the quantitative measurements available from (for example) RNA sequencing, time-resolved microscopy, and in vivo imaging. In this contribution, we summarize how a variety of experimental methods quantify tumor characteristics from the molecular to tissue scales and describe how such data can be directly integrated with mechanism-based models to improve predictions of tumor growth and treatment response.
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Affiliation(s)
- Anum S. Kazerouni
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
| | - Manasa Gadde
- 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
| | - Andrea Gardner
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
| | - David A. Hormuth
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
| | - Angela M. Jarrett
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
| | - Kaitlyn E. Johnson
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
| | - Ernesto A.B. F. Lima
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
- Texas Advanced Computing Center, The University of Texas at Austin, Austin, TX 78712, USA
| | - Guillermo Lorenzo
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Caleb Phillips
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Amy Brock
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
- Livestrong Cancer Institutes, The University of Texas at Austin, Austin, TX 78712, USA
| | - Thomas E. Yankeelov
- 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
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712, USA
- Livestrong Cancer Institutes, 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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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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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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Mang A, Bakas S, Subramanian S, Davatzikos C, Biros G. Integrated Biophysical Modeling and Image Analysis: Application to Neuro-Oncology. Annu Rev Biomed Eng 2020; 22:309-341. [PMID: 32501772 PMCID: PMC7520881 DOI: 10.1146/annurev-bioeng-062117-121105] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Central nervous system (CNS) tumors come with vastly heterogeneous histologic, molecular, and radiographic landscapes, rendering their precise characterization challenging. The rapidly growing fields of biophysical modeling and radiomics have shown promise in better characterizing the molecular, spatial, and temporal heterogeneity of tumors. Integrative analysis of CNS tumors, including clinically acquired multi-parametric magnetic resonance imaging (mpMRI) and the inverse problem of calibrating biophysical models to mpMRI data, assists in identifying macroscopic quantifiable tumor patterns of invasion and proliferation, potentially leading to improved (a) detection/segmentation of tumor subregions and (b) computer-aided diagnostic/prognostic/predictive modeling. This article presents a summary of (a) biophysical growth modeling and simulation,(b) inverse problems for model calibration, (c) these models' integration with imaging workflows, and (d) their application to clinically relevant studies. We anticipate that such quantitative integrative analysis may even be beneficial in a future revision of the World Health Organization (WHO) classification for CNS tumors, ultimately improving patient survival prospects.
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Affiliation(s)
- Andreas Mang
- Department of Mathematics, University of Houston, Houston, Texas 77204, USA;
| | - Spyridon Bakas
- Department of Mathematics, University of Houston, Houston, Texas 77204, USA;
| | - Shashank Subramanian
- Oden Institute of Computational Engineering and Sciences, The University of Texas at Austin, Austin, Texas 78712, USA; ,
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA); Department of Radiology; and Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; ,
| | - George Biros
- Oden Institute of Computational Engineering and Sciences, The University of Texas at Austin, Austin, Texas 78712, 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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Narasimhan S, Johnson HB, Nickles TM, Miga MI, Rana N, Attia A, Weis JA. Biophysical model-based parameters to classify tumor recurrence from radiation-induced necrosis for brain metastases. Med Phys 2019; 46:2487-2496. [PMID: 30816555 DOI: 10.1002/mp.13461] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/30/2019] [Accepted: 02/20/2019] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Stereotactic radiosurgery (SRS) is used for local control treatment of patients with intracranial metastases. As a result of SRS, some patients develop radiation-induced necrosis. Radiographically, radiation-induced necrosis can appear similar to tumor recurrence in magnetic resonance (MR) T1 -weighted contrast-enhanced imaging, T2 -weighted MR imaging, and Fluid-Attenuated Inversion Recovery (FLAIR) MR imaging. Radiographic ambiguities often necessitate invasive brain biopsies to determine lesion etiology or cause delayed subsequent therapy initiation. We use a biomechanically coupled tumor growth model to estimate patient-specific model parameters and model-derived measures to noninvasively classify etiology of enhancing lesions in this patient population. METHODS In this initial, preliminary retrospective study, we evaluated five patients with tumor recurrence and five with radiation-induced necrosis. Longitudinal patient-specific MR imaging data were used in conjunction with the model to parameterize tumor cell proliferation rate and tumor cell diffusion coefficient, and Dice correlation coefficients were used to quantify degree of correlation between model-estimated mechanical stress fields and edema visualized from MR imaging. RESULTS Results found four statistically relevant parameters which can differentiate tumor recurrence and radiation-induced necrosis. CONCLUSIONS This preliminary investigation suggests potential of this framework to noninvasively determine the etiology of enhancing lesions in patients who previously underwent SRS for intracranial metastases.
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Affiliation(s)
- Saramati Narasimhan
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN, 37235, USA
| | - Haley B Johnson
- Department of Biomedical Engineering, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Tanner M Nickles
- Department of Biomedical Engineering, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Michael I Miga
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN, 37235, USA
- Vanderbilt Institute for Surgery and Engineering (VISE), Nashville, TN, USA
| | - Nitesh Rana
- Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Albert Attia
- Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jared A Weis
- Department of Biomedical Engineering, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
- Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
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Feng X, Hormuth DA, Yankeelov TE. An adjoint-based method for a linear mechanically-coupled tumor model: Application to estimate the spatial variation of murine glioma growth based on diffusion weighted magnetic resonance imaging. COMPUTATIONAL MECHANICS 2019; 63:159-180. [PMID: 30880856 PMCID: PMC6415692 DOI: 10.1007/s00466-018-1589-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/25/2018] [Indexed: 05/02/2023]
Abstract
We present an efficient numerical method to quantify the spatial variation of glioma growth based on subject-specific medical images using a mechanically-coupled tumor model. The method is illustrated in a murine model of glioma in which we consider the tumor as a growing elastic mass that continuously deforms the surrounding healthy-appearing brain tissue. As an inverse parameter identification problem, we quantify the volumetric growth of glioma and the growth component of deformation by fitting the model predicted cell density to the cell density estimated using the diffusion-weighted magnetic resonance imaging (DW-MRI) data. Numerically, we developed an adjoint-based approach to solve the optimization problem. Results on a set of experimentally measured, in vivo rat glioma data indicate good agreement between the fitted and measured tumor area and suggest a wide variation of in-plane glioma growth with the growth-induced Jacobian ranging from 1.0 to 6.0.
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Affiliation(s)
- Xinzeng Feng
- Institute for Computational Engineering and Sciences, The University of Texas at Austin
| | - David A. Hormuth
- Institute for Computational Engineering and Sciences, The University of Texas at Austin
| | - Thomas E. Yankeelov
- Institute for Computational Engineering and Sciences, The University of Texas at Austin
- Department of Biomedical Engineering, The University of Texas at Austin
- Department of Diagnostic Medicine, The University of Texas at Austin
- Livestrong Cancer Institutes, The University of Texas at Austin
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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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Nilsson M, Englund E, Szczepankiewicz F, van Westen D, Sundgren PC. Imaging brain tumour microstructure. Neuroimage 2018; 182:232-250. [DOI: 10.1016/j.neuroimage.2018.04.075] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 04/27/2018] [Accepted: 04/30/2018] [Indexed: 01/18/2023] Open
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Hormuth DA, Weis JA, Barnes SL, Miga MI, Quaranta V, Yankeelov TE. Biophysical Modeling of In Vivo Glioma Response After Whole-Brain Radiation Therapy in a Murine Model of Brain Cancer. Int J Radiat Oncol Biol Phys 2018; 100:1270-1279. [PMID: 29398129 PMCID: PMC5934308 DOI: 10.1016/j.ijrobp.2017.12.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/17/2017] [Accepted: 12/03/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE To develop and investigate a set of biophysical models based on a mechanically coupled reaction-diffusion model of the spatiotemporal evolution of tumor growth after radiation therapy. METHODS AND MATERIALS Post-radiation therapy response is modeled using a cell death model (Md), a reduced proliferation rate model (Mp), and cell death and reduced proliferation model (Mdp). To evaluate each model, rats (n = 12) with C6 gliomas were imaged with diffusion-weighted magnetic resonance imaging (MRI) and contrast-enhanced MRI at 7 time points over 2 weeks. Rats received either 20 or 40 Gy between the third and fourth imaging time point. Diffusion-weighted MRI was used to estimate tumor cell number within enhancing regions in contrast-enhanced MRI data. Each model was fit to the spatiotemporal evolution of tumor cell number from time point 1 to time point 5 to estimate model parameters. The estimated model parameters were then used to predict tumor growth at the final 2 imaging time points. The model prediction was evaluated by calculating the error in tumor volume estimates, average surface distance, and voxel-based cell number. RESULTS For both the rats treated with either 20 or 40 Gy, significantly lower error in tumor volume, average surface distance, and voxel-based cell number was observed for the Mdp and Mp models compared with the Md model. The Mdp model fit, however, had significantly lower sum squared error compared with the Mp and Md models. CONCLUSIONS The results of this study indicate that for both doses, the Mp and Mdp models result in accurate predictions of tumor growth, whereas the Md model poorly describes response to radiation therapy.
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Affiliation(s)
- David A Hormuth
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, Texas.
| | - Jared A Weis
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina; Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Stephanie L Barnes
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, Texas
| | - Michael I Miga
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee; Department of Neurological Surgery, Vanderbilt University, Nashville, Tennessee
| | - Vito Quaranta
- Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee
| | - Thomas E Yankeelov
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, Texas; Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas; Department of Internal Medicine, The University of Texas at Austin, Austin, Texas
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Hormuth DA, Eldridge SL, Weis JA, Miga MI, Yankeelov TE. Mechanically Coupled Reaction-Diffusion Model to Predict Glioma Growth: Methodological Details. Methods Mol Biol 2018; 1711:225-241. [PMID: 29344892 DOI: 10.1007/978-1-4939-7493-1_11] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Biophysical models designed to predict the growth and response of tumors to treatment have the potential to become a valuable tool for clinicians in care of cancer patients. Specifically, individualized tumor forecasts could be used to predict response or resistance early in the course of treatment, thereby providing an opportunity for treatment selection or adaption. This chapter discusses an experimental and modeling framework in which noninvasive imaging data is used to initialize and parameterize a subject-specific model of tumor growth. This modeling approach is applied to an analysis of murine models of glioma growth.
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Affiliation(s)
- David A Hormuth
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, TX, USA.
| | - Stephanie L Eldridge
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, TX, USA.,Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Jared A Weis
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Michael I Miga
- Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.,Department of Radiology, Vanderbilt University, Nashville, TN, USA.,Department of Radiological Sciences, Vanderbilt University, Nashville, TN, USA.,Diagnostic Medicine, The University of Texas at Austin, Austin, TX, USA
| | - Thomas E Yankeelov
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, TX, USA. .,Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA. .,Diagnostic Medicine, 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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20
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Yin Y, Sedlaczek O, Muller B, Warth A, Gonzalez-Vallinas M, Lahrmann B, Grabe N, Kauczor HU, Breuhahn K, Vignon-Clementel IE, Drasdo D. Tumor Cell Load and Heterogeneity Estimation From Diffusion-Weighted MRI Calibrated With Histological Data: an Example From Lung Cancer. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:35-46. [PMID: 28463188 DOI: 10.1109/tmi.2017.2698525] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Diffusion-weighted magnetic resonance imaging (DWI) is a key non-invasive imaging technique for cancer diagnosis and tumor treatment assessment, reflecting Brownian movement of water molecules in tissues. Since densely packed cells restrict molecule mobility, tumor tissues produce usually higher signal (a.k.a. less attenuated signal) on isotropic maps compared with normal tissues. However, no general quantitative relation between DWI data and the cell density has been established. In order to link low-resolution clinical cross-sectional data with high-resolution histological information, we developed an image processing and analysis chain, which was used to study the correlation between the diffusion coefficient (D value) estimated from DWI and tumor cellularity from serial histological slides of a resected non-small cell lung cancer tumor. Color deconvolution followed by cell nuclei segmentation was performed on digitized histological images to determine local and cell-type specific 2d (two-dimensional) densities. From these, the 3d cell density was inferred by a model-based sampling technique, which is necessary for the calculation of local and global 3d tumor cell count. Next, DWI sequence information was overlaid with high-resolution CT data and the resected histology using prominent anatomical hallmarks for co-registration of histology tissue blocks and non-invasive imaging modalities' data. The integration of cell numbers information and DWI data derived from different tumor areas revealed a clear negative correlation between cell density and D value. Importantly, spatial tumor cell density can be calculated based on DWI data. In summary, our results demonstrate that tumor cell count and heterogeneity can be predicted from DWI data, which may open new opportunities for personalized diagnosis and therapy optimization.
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21
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Hormuth DA, Weis JA, Barnes SL, Miga MI, Rericha EC, Quaranta V, Yankeelov TE. A mechanically coupled reaction-diffusion model that incorporates intra-tumoural heterogeneity to predict in vivo glioma growth. J R Soc Interface 2017; 14:rsif.2016.1010. [PMID: 28330985 DOI: 10.1098/rsif.2016.1010] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/24/2017] [Indexed: 12/18/2022] Open
Abstract
While gliomas have been extensively modelled with a reaction-diffusion (RD) type equation it is most likely an oversimplification. In this study, three mathematical models of glioma growth are developed and systematically investigated to establish a framework for accurate prediction of changes in tumour volume as well as intra-tumoural heterogeneity. Tumour cell movement was described by coupling movement to tissue stress, leading to a mechanically coupled (MC) RD model. Intra-tumour heterogeneity was described by including a voxel-specific carrying capacity (CC) to the RD model. The MC and CC models were also combined in a third model. To evaluate these models, rats (n = 14) with C6 gliomas were imaged with diffusion-weighted magnetic resonance imaging over 10 days to estimate tumour cellularity. Model parameters were estimated from the first three imaging time points and then used to predict tumour growth at the remaining time points which were then directly compared to experimental data. The results in this work demonstrate that mechanical-biological effects are a necessary component of brain tissue tumour modelling efforts. The results are suggestive that a variable tissue carrying capacity is a needed model component to capture tumour heterogeneity. Lastly, the results advocate the need for additional effort towards capturing tumour-to-tissue infiltration.
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Affiliation(s)
- David A Hormuth
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Jared A Weis
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Stephanie L Barnes
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Michael I Miga
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA.,Department of Neurological Surgery, Vanderbilt University, Nashville, TN, USA
| | - Erin C Rericha
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, USA
| | - Vito Quaranta
- Department of Cancer Biology, Vanderbilt University, Nashville, TN, USA
| | - Thomas E Yankeelov
- Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, TX, USA .,Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.,Internal Medicine, The University of Texas at Austin, Austin, TX, USA
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22
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Weis JA, Miga MI, Yankeelov TE. Three-dimensional Image-based Mechanical Modeling for Predicting the Response of Breast Cancer to Neoadjuvant Therapy. COMPUTER METHODS IN APPLIED MECHANICS AND ENGINEERING 2017; 314:494-512. [PMID: 28042181 PMCID: PMC5193147 DOI: 10.1016/j.cma.2016.08.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The use of quantitative medical imaging data to initialize and constrain mechanistic mathematical models of tumor growth has demonstrated a compelling strategy for predicting therapeutic response. More specifically, we have demonstrated a data-driven framework for prediction of residual tumor burden following neoadjuvant therapy in breast cancer that uses a biophysical mathematical model combining reaction-diffusion growth/therapy dynamics and biomechanical effects driven by early time point imaging data. Whereas early work had been based on a limited dimensionality reduction (two-dimensional planar modeling analysis) to simplify the numerical implementation, in this work, we extend our framework to a fully volumetric, three-dimensional biophysical mathematical modeling approach in which parameter estimates are generated by an inverse problem based on the adjoint state method for numerical efficiency. In an in silico performance study, we show accurate parameter estimation with error less than 3% as compared to ground truth. We apply the approach to patient data from a patient with pathological complete response and a patient with residual tumor burden and demonstrate technical feasibility and predictive potential with direct comparisons between imaging data observation and model predictions of tumor cellularity and volume. Comparisons to our previous two-dimensional modeling framework reflect enhanced model prediction of residual tumor burden through the inclusion of additional imaging slices of patient-specific data.
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Affiliation(s)
- Jared A. Weis
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Michael I. Miga
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Neurosurgery, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Thomas E. Yankeelov
- Institute for Computational Engineering and Sciences, and Departments of Biomedical Engineering and Internal Medicine, The University of Texas, Austin, TX, USA
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23
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Abstract
Mathematical modelling approaches have become increasingly abundant in cancer research. The complexity of cancer is well suited to quantitative approaches as it provides challenges and opportunities for new developments. In turn, mathematical modelling contributes to cancer research by helping to elucidate mechanisms and by providing quantitative predictions that can be validated. The recent expansion of quantitative models addresses many questions regarding tumour initiation, progression and metastases as well as intra-tumour heterogeneity, treatment responses and resistance. Mathematical models can complement experimental and clinical studies, but also challenge current paradigms, redefine our understanding of mechanisms driving tumorigenesis and shape future research in cancer biology.
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Affiliation(s)
- Philipp M Altrock
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Department of Biostatistics, Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, Boston, Massachusetts 02115, USA
- Program for Evolutionary Dynamics, Harvard University, 1 Brattle Square, Suite 6, Cambridge, Massachusetts 02138, USA
| | - Lin L Liu
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Department of Biostatistics, Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, Boston, Massachusetts 02115, USA
| | - Franziska Michor
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Department of Biostatistics, Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, Boston, Massachusetts 02115, USA
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24
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Weis JA, Miga MI, Arlinghaus LR, Li X, Abramson V, Chakravarthy AB, Pendyala P, Yankeelov TE. Predicting the Response of Breast Cancer to Neoadjuvant Therapy Using a Mechanically Coupled Reaction-Diffusion Model. Cancer Res 2015; 75:4697-707. [PMID: 26333809 DOI: 10.1158/0008-5472.can-14-2945] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 07/29/2015] [Indexed: 12/21/2022]
Abstract
Although there are considerable data on the use of mathematical modeling to describe tumor growth and response to therapy, previous approaches are often not of the form that can be easily applied to clinical data to generate testable predictions in individual patients. Thus, there is a clear need to develop and apply clinically relevant oncologic models that are amenable to available patient data and yet retain the most salient features of response prediction. In this study we show how a biomechanical model of tumor growth can be initialized and constrained by serial patient-specific magnetic resonance imaging data, obtained at two time points early in the course of therapy (before initiation and following one cycle of therapy), to predict the response for individual patients with breast cancer undergoing neoadjuvant therapy. Using our mechanics coupled modeling approach, we are able to predict, after the first cycle of therapy, breast cancer patients that would eventually achieve a complete pathologic response and those who would not, with receiver operating characteristic area under the curve (AUC) of 0.87, sensitivity of 92%, and specificity of 84%. Our approach significantly outperformed the AUCs achieved by standard (i.e., not mechanically coupled) reaction-diffusion predictive modeling (0.75), simple analysis of the tumor cellularity estimated from imaging data (0.73), and the Response Evaluation Criteria in Solid Tumors (0.71). Thus, we show the potential for mathematical model prediction for use as a prognostic indicator of response to therapy. The work indicates the considerable promise of image-driven biophysical modeling for predictive frameworks within therapeutic applications.
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Affiliation(s)
- Jared A Weis
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee. Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee. Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.
| | - Michael I Miga
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee. Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee. Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee. Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee
| | - Lori R Arlinghaus
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee
| | - Xia Li
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee
| | - Vandana Abramson
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee. Department of Medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, Tennessee
| | - A Bapsi Chakravarthy
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee. Department of Radiation Oncology, Vanderbilt University, Nashville, Tennessee
| | - Praveen Pendyala
- Department of Radiation Oncology, Vanderbilt University, Nashville, Tennessee
| | - Thomas E Yankeelov
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee. Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee. Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee. Department of Physics, Vanderbilt University, Nashville, Tennessee. Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee.
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25
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Hormuth DA, Weis JA, Barnes SL, Miga MI, Rericha EC, Quaranta V, Yankeelov TE. Predicting in vivo glioma growth with the reaction diffusion equation constrained by quantitative magnetic resonance imaging data. Phys Biol 2015; 12:046006. [PMID: 26040472 DOI: 10.1088/1478-3975/12/4/046006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Reaction-diffusion models have been widely used to model glioma growth. However, it has not been shown how accurately this model can predict future tumor status using model parameters (i.e., tumor cell diffusion and proliferation) estimated from quantitative in vivo imaging data. To this end, we used in silico studies to develop the methods needed to accurately estimate tumor specific reaction-diffusion model parameters, and then tested the accuracy with which these parameters can predict future growth. The analogous study was then performed in a murine model of glioma growth. The parameter estimation approach was tested using an in silico tumor 'grown' for ten days as dictated by the reaction-diffusion equation. Parameters were estimated from early time points and used to predict subsequent growth. Prediction accuracy was assessed at global (total volume and Dice value) and local (concordance correlation coefficient, CCC) levels. Guided by the in silico study, rats (n = 9) with C6 gliomas, imaged with diffusion weighted magnetic resonance imaging, were used to evaluate the model's accuracy for predicting in vivo tumor growth. The in silico study resulted in low global (tumor volume error <8.8%, Dice >0.92) and local (CCC values >0.80) level errors for predictions up to six days into the future. The in vivo study showed higher global (tumor volume error >11.7%, Dice <0.81) and higher local (CCC <0.33) level errors over the same time period. The in silico study shows that model parameters can be accurately estimated and used to accurately predict future tumor growth at both the global and local scale. However, the poor predictive accuracy in the experimental study suggests the reaction-diffusion equation is an incomplete description of in vivo C6 glioma biology and may require further modeling of intra-tumor interactions including segmentation of (for example) proliferative and necrotic regions.
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Affiliation(s)
- David A Hormuth
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA. Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
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26
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Yankeelov TE, Atuegwu N, Hormuth D, Weis JA, Barnes SL, Miga MI, Rericha EC, Quaranta V. Clinically relevant modeling of tumor growth and treatment response. Sci Transl Med 2013; 5:187ps9. [PMID: 23720579 DOI: 10.1126/scitranslmed.3005686] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Current mathematical models of tumor growth are limited in their clinical application because they require input data that are nearly impossible to obtain with sufficient spatial resolution in patients even at a single time point--for example, extent of vascularization, immune infiltrate, ratio of tumor-to-normal cells, or extracellular matrix status. Here we propose the use of emerging, quantitative tumor imaging methods to initialize a new generation of predictive models. In the near future, these models could be able to forecast clinical outputs, such as overall response to treatment and time to progression, which will provide opportunities for guided intervention and improved patient care.
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Affiliation(s)
- Thomas E Yankeelov
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37212, USA.
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27
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Weis JA, Miga MI, Arlinghaus LR, Li X, Chakravarthy AB, Abramson V, Farley J, Yankeelov TE. A mechanically coupled reaction-diffusion model for predicting the response of breast tumors to neoadjuvant chemotherapy. Phys Med Biol 2013; 58:5851-66. [PMID: 23920113 PMCID: PMC3791925 DOI: 10.1088/0031-9155/58/17/5851] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There is currently a paucity of reliable techniques for predicting the response of breast tumors to neoadjuvant chemotherapy. The standard approach is to monitor gross changes in tumor size as measured by physical exam and/or conventional imaging, but these methods generally do not show whether a tumor is responding until the patient has received many treatment cycles. One promising approach to address this clinical need is to integrate quantitative in vivo imaging data into biomathematical models of tumor growth in order to predict eventual response based on early measurements during therapy. In this work, we illustrate a novel biomechanical mathematical modeling approach in which contrast enhanced and diffusion weighted magnetic resonance imaging data acquired before and after the first cycle of neoadjuvant therapy are used to calibrate a patient-specific response model which subsequently is used to predict patient outcome at the conclusion of therapy. We present a modification of the reaction-diffusion tumor growth model whereby mechanical coupling to the surrounding tissue stiffness is incorporated via restricted cell diffusion. We use simulations and experimental data to illustrate how incorporating tissue mechanical properties leads to qualitatively and quantitatively different tumor growth patterns than when such properties are ignored. We apply the approach to patient data in a preliminary dataset of eight patients exhibiting a varying degree of responsiveness to neoadjuvant therapy, and we show that the mechanically coupled reaction-diffusion tumor growth model, when projected forward, more accurately predicts residual tumor burden at the conclusion of therapy than the non-mechanically coupled model. The mechanically coupled model predictions exhibit a significant correlation with data observations (PCC = 0.84, p < 0.01), and show a statistically significant >4 fold reduction in model/data error (p = 0.02) as compared to the non-mechanically coupled model.
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Affiliation(s)
- Jared A Weis
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Departments of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Michael I Miga
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Departments of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA
| | - Lori R Arlinghaus
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Xia Li
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
| | - A Bapsi Chakravarthy
- Radiation Oncology, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Vandana Abramson
- Medical Oncology, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Jaime Farley
- Medical Oncology, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Thomas E Yankeelov
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Departments of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA
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28
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Parameterizing the Logistic Model of Tumor Growth by DW-MRI and DCE-MRI Data to Predict Treatment Response and Changes in Breast Cancer Cellularity during Neoadjuvant Chemotherapy. Transl Oncol 2013; 6:256-64. [PMID: 23730404 DOI: 10.1593/tlo.13130] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/12/2013] [Accepted: 03/18/2013] [Indexed: 12/26/2022] Open
Abstract
Diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging (MRI) data of 28 patients were obtained pretreatment, after one cycle, and after completion of all cycles of neoadjuvant chemotherapy (NAC). For each patient at each time point, the tumor cell number was estimated using the apparent diffusion coefficient and the extravascular extracellular (v e) and plasma volume (v p) fractions. The proliferation/death rate was obtained using the number of tumor cells from the first two time points in conjunction with the logistic model of tumor growth, which was then used to predict tumor cellularity at the conclusion of NAC. The Pearson correlation coefficient between the predicted and the experimental number of tumor cells measured at the end of NAC was 0.81 (P = .0043). The proliferation rate estimated after the first cycle of therapy was able to separate patients who went on to achieve pathologic complete response from those who did not (P = .021) with a sensitivity and specificity of 82.4% and 72.7%, respectively. These data provide preliminary results indicating that incorporating readily available quantitative MRI data into a simple model of tumor growth can lead to potentially clinically relevant information for predicting an individual patient's response to NAC.
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29
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Tyson DR, Quaranta V. Beyond genetics in personalized cancer treatment: assessing dynamics and heterogeneity of tumor responses. Per Med 2013; 10:221-225. [PMID: 24696699 PMCID: PMC3970774 DOI: 10.2217/pme.13.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Darren R. Tyson
- Department of Cancer Biology, Vanderbilt University School of Medicine, Nashville, TN 37232
| | - Vito Quaranta
- Department of Cancer Biology, Vanderbilt University School of Medicine, Nashville, TN 37232
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30
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Ng TSC, Wert D, Sohi H, Procissi D, Colcher D, Raubitschek AA, Jacobs RE. Serial diffusion MRI to monitor and model treatment response of the targeted nanotherapy CRLX101. Clin Cancer Res 2013; 19:2518-27. [PMID: 23532891 DOI: 10.1158/1078-0432.ccr-12-2738] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE Targeted nanotherapies are being developed to improve tumor drug delivery and enhance therapeutic response. Techniques that can predict response will facilitate clinical translation and may help define optimal treatment strategies. We evaluated the efficacy of diffusion-weighted magnetic resonance imaging to monitor early response to CRLX101 (a cyclodextrin-based polymer particle containing the DNA topoisomerase I inhibitor camptothecin) nanotherapy (formerly IT-101), and explored its potential as a therapeutic response predictor using a mechanistic model of tumor cell proliferation. EXPERIMENTAL DESIGN Diffusion MRI was serially conducted following CRLX101 administration in a mouse lymphoma model. Apparent diffusion coefficients (ADCs) extracted from the data were used as treatment response biomarkers. Animals treated with irinotecan (CPT-11) and saline were imaged for comparison. ADC data were also input into a mathematical model of tumor growth. Histological analysis using cleaved-caspase 3, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, Ki-67, and hematoxylin and eosin (H&E) were conducted on tumor samples for correlation with imaging results. RESULTS CRLX101-treated tumors at day 2, 4, and 7 posttreatment exhibited changes in mean ADC = 16 ± 9%, 24 ± 10%, 49 ± 17%, and size (TV) = -5 ± 3%, -30 ± 4%, and -45 ± 13%, respectively. Both parameters were statistically greater than controls [p(ADC) ≤ 0.02, and p(TV) ≤ 0.01 at day 4 and 7], and noticeably greater than CPT-11-treated tumors (ADC = 5 ± 5%, 14 ± 7%, and 18 ± 6%; TV = -15 ± 5%, -22 ± 13%, and -26 ± 8%). Model-derived parameters for cell proliferation obtained using ADC data distinguished CRLX101-treated tumors from controls (P = 0.02). CONCLUSIONS Temporal changes in ADC specified early CRLX101 treatment response and could be used to model image-derived cell proliferation rates following treatment. Comparisons of targeted and nontargeted treatments highlight the utility of noninvasive imaging and modeling to evaluate, monitor, and predict responses to targeted nanotherapeutics.
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Affiliation(s)
- Thomas S C Ng
- Biological Imaging Center, Beckman Institute, California Institute of Technology, Pasadena, California, USA.
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31
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Abramson RG, Arlinghaus LR, Weis JA, Li X, Dula AN, Chekmenev EY, Smith SA, Miga MI, Abramson VG, Yankeelov TE. Current and emerging quantitative magnetic resonance imaging methods for assessing and predicting the response of breast cancer to neoadjuvant therapy. BREAST CANCER-TARGETS AND THERAPY 2012; 2012:139-154. [PMID: 23154619 DOI: 10.2147/bctt.s35882] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Reliable early assessment of breast cancer response to neoadjuvant therapy (NAT) would provide considerable benefit to patient care and ongoing research efforts, and demand for accurate and noninvasive early-response biomarkers is likely to increase. Response assessment techniques derived from quantitative magnetic resonance imaging (MRI) hold great potential for integration into treatment algorithms and clinical trials. Quantitative MRI techniques already available for assessing breast cancer response to neoadjuvant therapy include lesion size measurement, dynamic contrast-enhanced MRI, diffusion-weighted MRI, and proton magnetic resonance spectroscopy. Emerging yet promising techniques include magnetization transfer MRI, chemical exchange saturation transfer MRI, magnetic resonance elastography, and hyperpolarized MR. Translating and incorporating these techniques into the clinical setting will require close attention to statistical validation methods, standardization and reproducibility of technique, and scanning protocol design.
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Affiliation(s)
- Richard G Abramson
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA ; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA ; Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
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32
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Yankeelov TE. Integrating Imaging Data into Predictive Biomathematical and Biophysical Models of Cancer. ISRN BIOMATHEMATICS 2012; 2012:287394. [PMID: 23914302 PMCID: PMC3729405 DOI: 10.5402/2012/287394] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
While there is a mature literature on biomathematical and biophysical modeling in cancer, many of the existing approaches are not of clinical utility, as they require input data that are extremely difficult to obtain in an intact organism, and/or require a large number of assumptions on the free parameters included in the models. Thus, there has only been very limited application of such models to solve problems of clinical import. More recently, however, there has been increased activity at the interface of quantitative, noninvasive imaging data, and tumor mathematical modeling. In addition to reporting on bulk tumor morphology and volume, emerging imaging techniques can quantitatively report on for example tumor vascularity, glucose metabolism, cell density and proliferation, and hypoxia. In this paper, we first motivate the problem of predicting therapy response by highlighting some (acknowledged) shortcomings in existing methods. We then provide introductions to a number of representative quantitative imaging methods and describe how they are currently (and potentially can be) used to initialize and constrain patient specific mathematical and biophysical models of tumor growth and treatment response, thereby increasing the clinical utility of such approaches. We conclude by highlighting some of the exciting research directions when one integrates quantitative imaging and tumor modeling.
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Affiliation(s)
- Thomas E. Yankeelov
- Institute of Imaging Science, Vanderbilt University, AA-1105 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2310, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, AA-1105 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2310, USA
- Department of Biomedical Engineering, Vanderbilt University, AA-1105 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2310, USA
- Department of Physics, Vanderbilt University, AA-1105 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2310, USA
- Department of Cancer Biology, Vanderbilt University, AA-1105 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2310, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University, 1161 21st Avenue South, Nashville, TN 37232-2310, USA
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