ABSTRACT
Tumor treating fields (TTFields) is a novel therapeutic approach for the treatment of glioblastoma. The electric field intensity is a critical factor in the therapeutic efficacy of TTFields, as stronger electric field can more effectively impede the proliferation and survival of tumor cells. In this study, we aimed to improve the therapeutic effectiveness of TTFields by optimizing the position of electrode arrays, resulting in an increased electric field intensity at the tumor. Three representative head models of real glioblastoma patients were used as the research subjects in this study. The improved subtraction-average-based optimization (ISABO) algorithm based on circle chaos mapping, opposition-based learning and golden sine strategy, was employed to optimize the positions of the four sets of electrode arrays on the scalp. The electrode positions are dynamically adjusted through iterative search to maximize the electric field intensity at the tumor. The experimental results indicate that, in comparison to the conventional layout, the positions of the electrode arrays obtained by the ISABO algorithm can achieve average electric field intensity of 1.7887, 2.0058, and 1.3497 V/cm at the tumor of three glioblastoma patients, which are 23.6%, 29.4%, and 8.5% higher than the conventional layout, respectively. This study demonstrates that optimizing the location of the TTFields electrode array using the ISABO algorithm can effectively enhance the electric field intensity and treatment coverage in the tumor area, offering a more effective approach for personalized TTFields treatment.
ABSTRACT
Objective. To assist urologist and radiologist in the preoperative diagnosis of non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC), we proposed a combination models strategy (CMS) utilizing multiparametric magnetic resonance imaging.Approach. The CMS includes three components: image registration, image segmentation, and multisequence feature fusion. To ensure spatial structure consistency of T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE), a registration network based on patch sampling normalized mutual information was proposed to register DWI and DCE to T2WI. Moreover, to remove redundant information around the bladder, we employed a segmentation network to obtain the bladder and tumor regions from T2WI. Using the coordinate mapping from T2WI, we extracted these regions from DWI and DCE and integrated them into a three-branch dual-channel input. Finally, to fully fuse low-level and high-level features of T2WI, DWI, and DCE, we proposed a distributed multilayer fusion model for preoperative MIBC prediction with five-fold cross-validation.Main results. The study included 436 patients, of which 404 were for the internal cohort and 32 for external cohort. The MIBC was confirmed by pathological examination. In the internal cohort, the area under the curve, accuracy, sensitivity, and specificity achieved by our method were 0.928, 0.869, 0.753, and 0.929, respectively. For the urologist and radiologist, Vesical Imaging-Reporting and Data System score >3 was employed to determine MIBC. The urologist demonstrated an accuracy, sensitivity, and specificity of 0.842, 0.737, and 0.895, respectively, while the radiologist achieved 0.871, 0.803, and 0.906, respectively. In the external cohort, the accuracy of our method was 0.831, which was higher than that of the urologist (0.781) and the radiologist (0.813).Significance. Our proposed method achieved better diagnostic performance than urologist and was comparable to senior radiologist. These results indicate that CMS can effectively assist junior urologists and radiologists in diagnosing preoperative MIBC.