Robustness of Treatment Planning for Electrochemotherapy of Deep-Seated Tumors |
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Authors: | Bor Kos Anze Zupanic Tadej Kotnik Marko Snoj Gregor Sersa Damijan Miklavcic |
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Institution: | (1) Faculty of Electrical Engineering, University of Ljubljana, Trzaska 25, 1000 Ljubljana, Slovenia;(2) Institute of Oncology, Zaloska 2, 1000 Ljubljana, Slovenia;(3) Laboratory of Biocybernetics, Trzaska 25, 1000 Ljubljana, Slovenia; |
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Abstract: | Treatment of cutaneous and subcutaneous tumors with electrochemotherapy has become a regular clinical method, while treatment
of deep-seated tumors is still at an early stage of development. We present a method for preparing a dedicated patient-specific,
computer-optimized treatment plan for electrochemotherapy of deep-seated tumors based on medical images. The treatment plan
takes into account the patient’s anatomy, tissue conductivity changes during electroporation and the constraints of the pulse
generator. Analysis of the robustness of a treatment plan made with this method shows that the effectiveness of the treatment
is not affected significantly by small single errors in electrode positioning. However, when many errors occur simultaneously,
the resulting drop in effectiveness is larger, which means that it is necessary to be as accurate as possible in electrode
positioning. The largest effect on treatment effectiveness stems from uncertainties in dielectric properties and electroporation
thresholds of treated tumors and surrounding tissues, which emphasizes the need for more accurate measurements and more research.
The presented methods for treatment planning and robustness analysis allow quantification of the treatment reproducibility
and enable the setting of suitable safety margins to improve the likelihood of successful treatment of deep-seated tumors
by electrochemotherapy. |
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