Personalized Pancreatic Tumor Growth Prediction via Group Learning

Tumor growth prediction, a highly challenging task, has long been viewed as a mathematical modeling problem, where the tumor growth pattern is personalized based on imaging and clinical data of a target patient. Though mathematical models yield promising results, their prediction accuracy may be limited by the absence of population trend data and personalized clinical characteristics. In this paper, we propose a statistical group learning approach to predict the tumor growth pattern that incorporates both the population trend and personalized data, in order to discover high-level features from multimodal imaging data. A deep convolutional neural network approach is developed to model the voxel-wise spatio-temporal tumor progression. The deep features are combined with the time intervals and the clinical factors to feed a process of feature selection. Our predictive model is pretrained on a group data set and personalized on the target patient data to estimate the future spatio-temporal progression of the patient's tumor. Multimodal imaging data at multiple time points are used in the learning, personalization and inference stages. Our method achieves a Dice coefficient of 86.8% +- 3.6% and RVD of 7.9% +- 5.4% on a pancreatic tumor data set, outperforming the DSC of 84.4% +- 4.0% and RVD 13.9% +- 9.8% obtained by a previous state-of-the-art model-based method

Biomechanical Simulation of Electrode Migration for Deep Brain Stimulation

International audienceDeep Brain Stimulation is a modern surgical technique for treating patients who suffer from affective or motion disorders such as Parkinson's disease. The efficiency of the procedure relies heavily on the accuracy of the placement of a micro-electrode which sends electrical pulses to a specific part of the brain that controls motion and affective symptoms. However, targeting this small anatomical structure is rendered difficult due to a series of brain shifts that take place during and after the procedure. This paper introduces a biomechanical simulation of the intra and postoperative stages of the procedure in order to determine lead deformation and electrode migration due to brain shift. To achieve this goal, we propose a global approach, which accounts for brain deformation but also for the numerous interactions that take place during the procedure (contacts between the brain and the inner part of the skull and falx cerebri, effect of the cerebro-spinal fluid, and biomechanical interactions between the brain and the electrodes and cannula used during the procedure). Preliminary results show a good correlation between our simulations and various results reported in the literature

Predicting the Location of Glioma Recurrence After a Resection Surgery

International audienceWe propose a method for estimating the location of glioma recurrence after surgical resection. This method consists of a pipeline including the registration of images at different time points, the estimation of the tumor infiltration map, and the prediction of tumor regrowth using a reaction-diffusion model. A data set acquired on a patient with a low-grade glioma and post surgery MRIs is considered to evaluate the accuracy of the estimated recurrence locations found using our method. We observed good agreement in tumor volume prediction and qualitative matching in regrowth locations. Therefore, the proposed method seems adequate for modeling low-grade glioma recurrence. This tool could help clinicians anticipate tumor regrowth and better characterize the radiologically non-visible infiltrative extent of the tumor. Such information could pave the way for model-based personalization of treatment planning in a near future

A generative approach for image-based modeling of tumor growth

22nd International Conference, IPMI 2011, Kloster Irsee, Germany, July 3-8, 2011. ProceedingsExtensive imaging is routinely used in brain tumor patients to monitor the state of the disease and to evaluate therapeutic options. A large number of multi-modal and multi-temporal image volumes is acquired in standard clinical cases, requiring new approaches for comprehensive integration of information from different image sources and different time points. In this work we propose a joint generative model of tumor growth and of image observation that naturally handles multi-modal and longitudinal data. We use the model for analyzing imaging data in patients with glioma. The tumor growth model is based on a reaction-diffusion framework. Model personalization relies only on a forward model for the growth process and on image likelihood. We take advantage of an adaptive sparse grid approximation for efficient inference via Markov Chain Monte Carlo sampling. The approach can be used for integrating information from different multi-modal imaging protocols and can easily be adapted to other tumor growth models.German Academy of Sciences Leopoldina (Fellowship Programme LPDS 2009-10)Academy of Finland (133611)National Institutes of Health (U.S.) (NIBIB NAMIC U54-EB005149)National Institutes of Health (U.S.) (NCRR NAC P41- RR13218)National Institutes of Health (U.S.) (NINDS R01-NS051826)National Institutes of Health (U.S.) (NIH R01-NS052585)National Institutes of Health (U.S.) (NIH R01-EB006758)National Institutes of Health (U.S.) (NIH R01-EB009051)National Institutes of Health (U.S.) (NIH P41-RR014075)National Science Foundation (U.S.) (CAREER Award 0642971

A Feature-Driven Active Framework for Ultrasound-Based Brain Shift Compensation

A reliable Ultrasound (US)-to-US registration method to compensate for brain shift would substantially improve Image-Guided Neurological Surgery. Developing such a registration method is very challenging, due to factors such as missing correspondence in images, the complexity of brain pathology and the demand for fast computation. We propose a novel feature-driven active framework. Here, landmarks and their displacement are first estimated from a pair of US images using corresponding local image features. Subsequently, a Gaussian Process (GP) model is used to interpolate a dense deformation field from the sparse landmarks. Kernels of the GP are estimated by using variograms and a discrete grid search method. If necessary, the user can actively add new landmarks based on the image context and visualization of the uncertainty measure provided by the GP to further improve the result. We retrospectively demonstrate our registration framework as a robust and accurate brain shift compensation solution on clinical data acquired during neurosurgery

Classification Forests for Semantic Segmentation of Brain Lesions in Multi-channel MRI

International audienceClassification forests, as discussed in Chapter 2, have a series of advantageous properties which make them a very good choice for applications in medical image analysis. Classification forests are inherent multi-label classifiers (which allows for the simultaneous segmentation of different tissues), have good generalization properties (which is important as training data is often scarce in medical applications), and are able to deal with very high-dimensional feature spaces (which allows the use of non-local and context-aware features to describe the input data). In this chapter we demonstrate how classification forests can be used as a basic building block to develop state of the art systems for medical image analysis in two challenging applications. These applications perform the segmentation of two different types of brain lesions based on 3D multi-channel magnetic resonance images (MRI) as input. More specifically, we discuss (1) the segmentation of the individual tissues of high-grade brain tumor lesions, and (2) the segmentation of multiple-sclerosis lesions

Source localization of reaction-diffusion models for brain tumors

We propose a mathematically well-founded approach for locating the source (initial state) of density functions evolved within a nonlinear reaction-diffusion model. The reconstruction of the initial source is an ill-posed inverse problem since the solution is highly unstable with respect to measurement noise. To address this instability problem, we introduce a regularization procedure based on the nonlinear Landweber method for the stable determination of the source location. This amounts to solving a sequence of well-posed forward reaction-diffusion problems. The developed framework is general, and as a special instance we consider the problem of source localization of brain tumors. We show numerically that the source of the initial densities of tumor cells are reconstructed well on both imaging data consisting of simple and complex geometric structures

Evaluating the Effect of Tissue Anisotropy on Brain Tumor Growth using a Mechanically-coupled Reaction-Diffusion Model

Glioblastoma (GBM), the most frequent malignant brain tumor in adults, is char- acterized by rapid growth and healthy tissue invasion. Long-term prognosis for GBM remains poor with median overall survival between 1 y to 2 y [15]. GBM presents with different growth phenotypes, ranging from invasive tumors without notable mass-effect to strongly displacing lesions. Biomechanical forces, such as those resulting from displacive tumor growth, shape the tumor environment and contribute to tumor progression [9]. We present an extended version of a mechanically–coupled reaction-diffusion model of brain tu- mor growth [1] that simulates tumor evolution over time and across different brain regions using literature-based parameter estimates for tumor cell proliferation, as well as isotropic motility, and mechanical tissue properties. This model yielded realistic estimates of the mechanical impact of a growing tumor on intra-cranial pressure. However, comparison to imaging data showed that asymmetric shapes could not be reproduced by isotropic growth assumptions. We modified this model to account for structural tissue anisotropy which is known to affect the directionality of tumor cell migration and may influence the mechanical behavior of brain tissue. Tumors were seeded at multiple locations in a human MR-DTI brain atlas and their spatio-temporal evolution was simulated using the Finite-Element Method. We evaluated the impact of tissue anisotropy on the model’s ability to reproduce the aspherical shapes of real pathologies by comparing predicted lesions to publicly available GBM imaging data. We found the impact on tumor shape to be strongly location dependent and highest for tumors located in brain regions that are characterized by a single dominant white matter direction, such as the corpus callosum. However, despite strongly anisotropic growth assumptions, all simulated tumors remained more spherical than real lesions at the corresponding location and similar volume. This finding is in agreement with previous studies [17, 6] suggesting that anisotropic cell migration along white matter fiber tracks is not a major determinant of tumor shape in the setting of reaction-diffusion based tumor growth models and for most locations across the brain

Model for in vivo progression of tumors based on co-evolving cell population and vasculature

With countless biological details emerging from cancer experiments, there is a growing need for minimal mathematical models which simultaneously advance our understanding of single tumors and metastasis, provide patient-personalized predictions, whilst avoiding excessive hard-to-measure input parameters which complicate simulation, analysis and interpretation. Here we present a model built around a co-evolving resource network and cell population, yielding good agreement with primary tumors in a murine mammary cell line EMT6-HER2 model in BALB/c mice and with clinical metastasis data. Seeding data about the tumor and its vasculature from in vivo images, our model predicts corridors of future tumor growth behavior and intervention response. A scaling relation enables the estimation of a tumor's most likely evolution and pinpoints specific target sites to control growth. Our findings suggest that the clinically separate phenomena of individual tumor growth and metastasis can be viewed as mathematical copies of each other differentiated only by network structure