title: Robustness of treatment planning for electrochemotherapy of deep-seated tumors.
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.
authors.affiliation: Faculty of Electrical Engineering, University of Ljubljana, Trzaska 25, 1000, Ljubljana, Slovenia.
authors.forename: Bor
authors.initials: B
authors.lastname: Kos
authors.forename: Anze
authors.initials: A
authors.lastname: Zupanic
authors.forename: Tadej
authors.initials: T
authors.lastname: Kotnik
authors.forename: Marko
authors.initials: M
authors.lastname: Snoj
authors.forename: Gregor
authors.initials: G
authors.lastname: Sersa
authors.forename: Damijan
authors.initials: D
authors.lastname: Miklavcic
mesh_terms: D002985:Clinical Protocols; D003198:Computer Simulation; D053672:Electrochemotherapy / Q000379:methods*; D006801:Humans; D008545:Melanoma / Q000473:pathology* / Q000628:therapy*; D008954:Models, Biological