Abstract #0399

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

Laiz Laura de Godoy¹, Arthich Rajan¹, Brian Berger², Sulaiman Sheriff³, Atom Sarkar⁴, Rinku Shah⁴, Dawit Aregawi⁵, Tara Morrison⁶, Srilatha Hosur⁷, Sunjay Shah⁸, Gaurav Shukla⁸, Rachelle Lanciano⁹, Varsha Jain¹⁰, Scott Herbert¹⁰, Nduka Amankulor¹¹, Stephanie Weiss¹², Anshu Giri¹³, Aruna Padmanabhan¹², Stephen Bagley¹, Kheng Choon Lim¹⁴, Demetrius Ribeiro de Paula¹⁵, Demetrius Lee¹, Kristina Vineis¹, Lisa Desiderio¹, MacLean Nasrallah¹, Suyash Mohan¹, and Sanjeev Chawla¹

¹Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States, ²Novocure, Portsmouth, NH, United States, ³University of Miami, Miami, FL, United States, ⁴St Mary Medical Center, Langhorne, PA, United States, ⁵Hershey Medical Center, Hershey, PA, United States, ⁶Lehigh Valley Hospital-Cedar Crest, Allentown, PA, United States, ⁷Lancaster General Hospital, Lancaster, PA, United States, ⁸Christiana Care Heath System, Wilmington, DE, United States, ⁹Crozer-Chester Medical Center, Upland, PA, United States, ¹⁰Jefferson Abington Hospital, Abington, PA, United States, ¹¹Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Philadelphia, PA, United States, ¹²Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States, ¹³Fox Chase Cancer Center, Philadelphia, PA, United States, ¹⁴Singapore General Hospital, Singapore, Singapore, ¹⁵Radboud University Medical Centre, Nijmegen, Netherlands

Synopsis

Keywords: Tumors (Post-Treatment), Spectroscopy, glioblastoma; TTFields; WBSI; MRI

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.

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