JP7383679B2 - Mriによる導電率測定値に基づいて頭部上の電極位置を最適化したttfield治療 - Google Patents
Mriによる導電率測定値に基づいて頭部上の電極位置を最適化したttfield治療 Download PDFInfo
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Description
本出願は、米国仮特許出願第62/247,314号(2015年10月28日出願)および第62/294,372号(2016年2月12日出願)の利益を主張し、それら各々の全体を参照により本明細書に援用する。
正確な計算ファントムの作成は、好ましくは、計算ファントム内の各地点における電気的性質(例えば、導電率、抵抗率)を正確にマッピングすることを伴う。計算ファントムを作成する1つの従来的な方法は、頭部を個別の等方性の電気的性質を備えた異なる組織タイプにセグメント化することを伴う。この方法を使用してモデルを構築する際、各組織タイプの電気的性質がモデルへと正確にマッピングされるように、3D空間における各組織タイプの境界を正確に特定することが重要である。
アレイレイアウトの最適化は、患者の脳の患部領域(腫瘍)内の電場を最適化するアレイレイアウトを見つけることを意味する。この最適化は、以下の4つのステップを実施することによって実現されてもよい。(S21)現実的な頭部モデル内における治療の標的とされる体積(標的体積)を特定するステップ、(S22)変換器アレイを自動的に配置し、現実的な頭部モデルにおいて境界条件を設定するステップ、(S23)アレイが現実的な頭部モデルに配置され、境界条件が適用されると、現実的な頭部モデル内で展開する電場を計算するステップ、ならびに、(S24)最適化アルゴリズムを稼働して、標的体積内の最適な電場分布をもたらすレイアウトを見つけるステップ。これら4つのステップを実現するための詳細な例を以下に提供する。
a. 変換器アレイの中央点がモデル頭部上に配置される位置を規定する。位置は、ユーザが、またはステップS24で考察した電場最適化アルゴリズムのステップの1つとして規定することができる。
b. ステップ(a)からの入力を、ディスクの幾何学形状に関する知識、およびディスクを整列して配列する方法の知識と併せて使用して、モデル内の変換器アレイにおける全てのディスクの中心の近似位置を計算する。
c. ディスクが配置される位置における、現実的なモデルの表面の配向を計算する。計算は、指定のディスク中心からディスク半径1つ分の距離以内にある、計算ファントムの皮膚上の全ての地点を見出すことによって実施される。これらの地点の座標が行列の列状に配列され、特異値分解が行列に対して実施される。そこで、モデルの皮膚に対する法線は、見出される最小固有値に対応する固有ベクトルである。
d. 変換器アレイの各ディスクに関して、ディスクと患者の身体との間の良好な接触を担保するのに要する、医療用ゲルの厚さを計算する。これは、皮膚表面の法線に対して平行にその高さが配向された円筒のパラメータを見出すことによって行われる。円筒は、ディスクの半径に等しい半径を有して規定され、その高さは、法線を見つけるのに使用される皮膚上の点を越えて所定の量(所定の定数)延在するように設定される。これによって、ファントム表面から少なくとも所定の量が延在する円筒がもたらされる。
e. モデル上に、(d)で説明した円筒を作成する。
f. 二値論理演算(例えば、頭部を円筒から減算する)を通して、患者の現実的なモデル内へと突出する円筒の領域をモデルから除去する。結果として得られる「切頭円筒」は、変換器アレイと関連付けられた医療用ゲルを表す。
g. 「切頭円筒」の外側に、変換器アレイのセラミックディスクを表すディスクを配置する。
概念の証明は、皮質組織の異方性導電率値を組み込んだ、前に展開した現実的なヒトの頭部モデルに対する修正に基づくものであった。このモデルは健康な被験者から生じたものなので、腫瘍を仮想病変によって表さなければならなかった。ファントムは、TTFields印加後の電場分布を計算するのに既に使用されている。
22 単純化した等方性モデル、頭部の左右(LR)アレイ
23 単純化した異方性モデル、頭部の左右(LR)アレイ
24 現実的な等方性モデル、前後(AP)部分のアレイ
25 単純化した等方性モデル、前後(AP)部分のアレイ
26 単純化した異方性モデル、前後(AP)部分のアレイ
31 原型モデル
32 simple1モデル
33 simple2モデル
40 頭皮
42 変換器アレイ
44 変換器アレイ
51 SHM1
52 SHM2
54 頭骨
55 CSF
56 灰白質
58 白質
62 凸包
64 脳室
66 腫瘍
71 RHM等方性モデル
72 SHM2等方性モデル
73 RHM異方性モデル
74 SHM2異方性モデル
75 SHM4異方性モデル
Claims (15)
- 被験者の身体上に配置された複数の電極の位置を最適化するためにプロセッサが実行する方法であって、前記電極が、解剖学的体積内の標的組織に電場を与えるのに電極が使用され、前記方法が、
前記解剖学的体積における導電率または電気抵抗率測定値を取得するステップと、
前記解剖学的体積を組織タイプにセグメント化せずに、前記取得した導電率または電気抵抗率測定値から直接、前記解剖学的体積の導電率または電気抵抗率の3Dマップを生成するステップと、
前記解剖学的体積内における標的体積の場所を特定するステップと、
前記生成するステップで生成された導電率または電気抵抗率の前記3Dマップ、および前記標的体積の前記場所に基づいて、前記電極の位置を決定するステップとを含み、
前記解剖学的体積が脳であり、
前記電極の位置の決定が、前記脳の導電率または電気抵抗率の前記3Dマップが第1の一定の導電率を有する第1のシェルのモデルに取り囲まれている複合モデルに基づく、方法。 - 前記取得するステップで取得した前記測定値が分子の拡散を表す、請求項1に記載の方法。
- 前記取得するステップが、拡散強調画像法を使用してMRIデータを獲得するステップを含む、請求項1に記載の方法。
- 前記取得するステップが、カスタマイズした多重エコー勾配シーケンスを使用してMRIデータを獲得するステップを含む、請求項1に記載の方法。
- 前記取得するステップが、拡散テンソル画像法を使用してMRIデータを獲得するステップを含む、請求項1に記載の方法。
- 前記解剖学的体積が脳の白質および灰白質を含む、請求項1に記載の方法。
- 前記第1のシェルの前記モデルが、頭皮、頭骨、およびCSFを総合したものを表す、請求項1に記載の方法。
- 前記第1のシェルの前記モデルがCSFを表し、
前記複合モデルが頭骨を表す第2のシェルを更に含み、前記第2のシェルが第2の一定の導電率を有し、
前記複合モデルが頭皮を表す第3のシェルを更に含み、前記第3のシェルが第3の一定の導電率を有する、請求項1に記載の方法。 - 前記生成するステップにおいて、導電率または電気抵抗率の前記3Dマップが1mm×1mm×1mmよりも高い解像度を有する、請求項1に記載の方法。
- 導電率または電気抵抗率の3Dマップを生成する前記ステップが、前記解剖学的体積を表す単純な幾何オブジェクトを生成するステップを含む、請求項1に記載の方法。
- 導電率または電気抵抗率の3Dマップを生成する前記ステップが、異方性比率に基づいて各体積要素の組織タイプを分類するステップを含む、請求項1に記載の方法。
- 導電率または電気抵抗率の3Dマップを生成する前記ステップが、平均導電率に基づいて各体積要素の組織タイプを分類するステップを含む、請求項1に記載の方法。
- 導電率または電気抵抗率の3Dマップを生成する前記ステップが、導電率テンソルの固有値の幾何平均を特定の等方性基準値に対して整合させるステップを含む、請求項1に記載の方法。
- 前記解剖学的体積が前記被験者の胸部を含む、請求項1に記載の方法。
- 前記解剖学的体積が前記被験者の腹部を含む、請求項1に記載の方法。
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