Integration of Whole Brain Spectroscopic Imaging in Planning Workflow for Personalized Delivery of TTFields in Glioblastomas

Abstract

Motivation: Optimal treatment for GBM requires precise targeting of all viable tumor cells, many of which are not visible on conventional neuroimaging. Goal(s): We aimed to utilize WBSI to identify infiltrating tumor cells in GBM patients for selecting a precise target volume for personalized mapping of transducer arrays for enhanced delivery of TTFields. Approach: A mean value of choline/NAA was computed from normal mask, and all voxels that exceeded two-fold threshold value were included in a 3D-composite mask from the tumor region. Results: WBSI provided higher yield of voxels with good spectral quality, resulting in improved brain tumor coverage compared to anatomical MRI sequences. Impact: Alternative array configuration created from WBSI will allow precise delineation of tumor margins for enhanced delivery of TTFields dose to all proliferating regions of a GBM, decreasing the rate of local recurrence and ultimately improving overall survival.