N. Gentilal , A. Naveh , T. Marciano , P.C. Miranda
{"title":"头皮温度对TTFields治疗最佳布局选择的影响","authors":"N. Gentilal , A. Naveh , T. Marciano , P.C. Miranda","doi":"10.1016/j.irbm.2023.100768","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Objectives</h3><p><span><span>Tumor Treating Fields<span> (TTFields) is an FDA-approved technique used in the treatment of </span></span>glioblastoma<span>. It consists in applying an electric field (EF) with a frequency of 200 kHz using two pairs of transducer arrays. During treatment planning, the NovoTAL system is used to strategically place the arrays on the head in regions that maximize the EF at the tumor. Current should be injected at least 18 hours/day and induce a minimum EF of 1 V/cm at the tumor. To avoid any thermal harm to the patient, the temperature of the scalp is kept around 39.5</span></span> <!-->°C by changing the injected current. The goal of this study was to investigate how accounting for the temperature of the scalp during treatment planning might affect the choice of the best layout suggested by NovoTAL. Furthermore, we also studied the sensitivity of the results to the metric used to evaluate the layouts.</p></div><div><h3>Methods</h3><p>We used a realistic head model with a virtual glioblastoma in our studies. Through the NovoTAL system we obtained five realistic array layouts and we predicted the best one for our model based on the approach currently implemented in this system. We then repeated the same type of analysis, but also accounting for the temperature during planning. In both cases we ranked the layouts based on three different criteria: the LMiPD and the LAPD (local minimum and local average power densities, respectively) in the tumor and the SAR (specific absorption rate) in the head</p></div><div><h3>Results</h3><p>Accounting for the temperature does not significantly affect the choice of the best layout provided that the arrays are at least 1 cm apart from each other. Otherwise, a common temperature hotspot occurs in the scalp between the closest transducers of the adjacent arrays, which limits how much current can be injected and consequently treatment effectiveness. Also, the choice of the best layout depends on the criterion used.</p></div><div><h3>Conclusions</h3><p>Accounting for the temperature might led to significant variations in the current injected. The LMiPD might be used as a first criterion to choose the best treatment layout, followed by the LAPD and then the SAR.</p></div>","PeriodicalId":14605,"journal":{"name":"Irbm","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"The Impact of Scalp's Temperature on the Choice of the Best Layout for TTFields Treatment\",\"authors\":\"N. Gentilal , A. Naveh , T. Marciano , P.C. Miranda\",\"doi\":\"10.1016/j.irbm.2023.100768\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and Objectives</h3><p><span><span>Tumor Treating Fields<span> (TTFields) is an FDA-approved technique used in the treatment of </span></span>glioblastoma<span>. It consists in applying an electric field (EF) with a frequency of 200 kHz using two pairs of transducer arrays. During treatment planning, the NovoTAL system is used to strategically place the arrays on the head in regions that maximize the EF at the tumor. Current should be injected at least 18 hours/day and induce a minimum EF of 1 V/cm at the tumor. To avoid any thermal harm to the patient, the temperature of the scalp is kept around 39.5</span></span> <!-->°C by changing the injected current. The goal of this study was to investigate how accounting for the temperature of the scalp during treatment planning might affect the choice of the best layout suggested by NovoTAL. Furthermore, we also studied the sensitivity of the results to the metric used to evaluate the layouts.</p></div><div><h3>Methods</h3><p>We used a realistic head model with a virtual glioblastoma in our studies. Through the NovoTAL system we obtained five realistic array layouts and we predicted the best one for our model based on the approach currently implemented in this system. We then repeated the same type of analysis, but also accounting for the temperature during planning. In both cases we ranked the layouts based on three different criteria: the LMiPD and the LAPD (local minimum and local average power densities, respectively) in the tumor and the SAR (specific absorption rate) in the head</p></div><div><h3>Results</h3><p>Accounting for the temperature does not significantly affect the choice of the best layout provided that the arrays are at least 1 cm apart from each other. Otherwise, a common temperature hotspot occurs in the scalp between the closest transducers of the adjacent arrays, which limits how much current can be injected and consequently treatment effectiveness. Also, the choice of the best layout depends on the criterion used.</p></div><div><h3>Conclusions</h3><p>Accounting for the temperature might led to significant variations in the current injected. The LMiPD might be used as a first criterion to choose the best treatment layout, followed by the LAPD and then the SAR.</p></div>\",\"PeriodicalId\":14605,\"journal\":{\"name\":\"Irbm\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Irbm\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1959031823000179\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Irbm","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1959031823000179","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
The Impact of Scalp's Temperature on the Choice of the Best Layout for TTFields Treatment
Background and Objectives
Tumor Treating Fields (TTFields) is an FDA-approved technique used in the treatment of glioblastoma. It consists in applying an electric field (EF) with a frequency of 200 kHz using two pairs of transducer arrays. During treatment planning, the NovoTAL system is used to strategically place the arrays on the head in regions that maximize the EF at the tumor. Current should be injected at least 18 hours/day and induce a minimum EF of 1 V/cm at the tumor. To avoid any thermal harm to the patient, the temperature of the scalp is kept around 39.5 °C by changing the injected current. The goal of this study was to investigate how accounting for the temperature of the scalp during treatment planning might affect the choice of the best layout suggested by NovoTAL. Furthermore, we also studied the sensitivity of the results to the metric used to evaluate the layouts.
Methods
We used a realistic head model with a virtual glioblastoma in our studies. Through the NovoTAL system we obtained five realistic array layouts and we predicted the best one for our model based on the approach currently implemented in this system. We then repeated the same type of analysis, but also accounting for the temperature during planning. In both cases we ranked the layouts based on three different criteria: the LMiPD and the LAPD (local minimum and local average power densities, respectively) in the tumor and the SAR (specific absorption rate) in the head
Results
Accounting for the temperature does not significantly affect the choice of the best layout provided that the arrays are at least 1 cm apart from each other. Otherwise, a common temperature hotspot occurs in the scalp between the closest transducers of the adjacent arrays, which limits how much current can be injected and consequently treatment effectiveness. Also, the choice of the best layout depends on the criterion used.
Conclusions
Accounting for the temperature might led to significant variations in the current injected. The LMiPD might be used as a first criterion to choose the best treatment layout, followed by the LAPD and then the SAR.
期刊介绍:
IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux).
As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in:
-Physiological and Biological Signal processing (EEG, MEG, ECG…)-
Medical Image processing-
Biomechanics-
Biomaterials-
Medical Physics-
Biophysics-
Physiological and Biological Sensors-
Information technologies in healthcare-
Disability research-
Computational physiology-
…