Figure 1.
Growth of an untreated virtual control (UVC) tumor for a 57 year-old patient with a left fronto-parietal lobe glioblastoma.
a: Volumetric images of the untreated virtual control at six time points where Day 0 is the time of the patient's first pre-treatment MRI scan. Pseudocoloring indicates the tumor cell density, normalized to the maximum cell density of the tissue. b: T1Gd spherically-equivalent radius time curve from same simulation showing how the Days Gained score is computed. c: Post-treatment T1Gd MRI slice showing actual tumor (red outline) and perimeter of the simulated tumor's T1Gd-enhancing region at the same time point (cyan outline). Image oriented according to radiological convention: patient left is on the right.
Figure 2.
Comparisons between T1Gd MRI data and untreated virtual control (UVC) prediction at post-treatment time point.
Patient was 58 years old and underwent biopsy followed by conformal radiation therapy with concurrent temozolomide chemotherapy. Top row: MRI data. Middle row: Actual tumor perimeter (red) with superimposed UVC-predicted tumor perimeter (cyan). Bottom row: full distribution of UVC cell densities showing invasion peripheral to abnormality. Outermost blue cell density profile represents a very low, but non-zero, threshold. Perimeter of actual tumor outlined in white.
Table 1.
Clinical characteristics of patients.
Figure 3.
Spatial comparisons between baseline pre-treatment MRI (red outline) and simulation results (cyan outline) seeded with our initial condition. a: large tumor on T1Gd MRI.
b: smaller tumor on FLAIR MRI. c: Highly anisotropic tumor growth on T2-weighted MRI. Our simulations produce tight spatial matches to a range of tumors (a and b), but decrease in accuracy for tumors with high anisotropy (c).
Figure 4.
Kaplan-Meier analyses on progression-free and overall survival.
a: Analysis on progression-free survival data revealed a significant difference between the patients with Days Gained scores greater than or equal to 100 and those with lower scores. b: Overall survival analysis also revealed a significant difference between the patients with Days Gained scores greater than or equal to 117 and those with lower scores.