Predicting brain tumour growth patterns using a novel MRI‐based tumour spread map: application to radiotherapy planning
Bibliographic record
Abstract
BACKGROUND: The treatment of glioblastomas (GBM) with radiation therapy is extremely challenging due to their invasive nature and high recurrence rate within normal brain tissue. PURPOSE: In this work, we present a new metric called the tumour spread (TS) map, which utilizes diffusion tensor imaging (DTI) to predict the probable direction of tumour cells spread along fiber tracts. We hypothesized that the TS map could serve as a predictive tool for identifying patterns of likely recurrence in patients with GBM and, therefore, be used to modify the delivery of radiation treatment to pre-emptively target regions at high risk of tumour spread. METHODS: In this proof-of-concept study, we visualized the white matter fiber tract pathways within the brain using diffusion tensor tractography and developed an algorithm which mathematically calculates a relative probability index in each voxel, resulting in the generation of the TS map. Based on the information provided by the TS map, the original radiotherapy target volume was then modified to include areas with a higher probability of tumour spread and exclude other areas with a lower probability of spread. A volumetric modulated arc therapy (VMAT) treatment plan was then developed utilizing the modified target volumes and subsequently compared to that using the original target volumes. Follow-up anatomical imaging obtained 8 months post-surgery was assessed to validate our findings. RESULTS: A TS map was generated on a glioblastoma patient demonstrating a relative probability of tumour spread along fiber tracts throughout the brain. The modified planning target volume better covered brain regions with a higher risk of tumour spread while still demonstrating a 21% reduction in volume compared to the original planning target volume, resulting in greater preservation of normal tissue. The modified VMAT plan resulted in an average mean dose to four identified recurrences of 80% of the prescription dose, while the original VMAT plan delivered only 63% of the prescription dose as the average mean dose to the recurrences. CONCLUSION: The utilization of tractography and the generation of corresponding TS maps offer a promising approach to predicting patterns of tumour recurrence and optimizing treatment delivery. Further research is needed to validate the predictive value of the TS map on a larger cohort of patients and explore its potential in personalized treatment strategies for GBM patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".