title: Towards the Personalized Treatment of Glioblastoma: Integrating Patient-Specific Clinical Data in a Continuous Mechanical Model.
abstract: Glioblastoma multiforme (GBM) is the most aggressive and malignant among brain tumors. In addition to uncontrolled proliferation and genetic instability, GBM is characterized by a diffuse infiltration, developing long protrusions that penetrate deeply along the fibers of the white matter. These features, combined with the underestimation of the invading GBM area by available imaging techniques, make a definitive treatment of GBM particularly difficult. A multidisciplinary approach combining mathematical, clinical and radiological data has the potential to foster our understanding of GBM evolution in every single patient throughout his/her oncological history, in order to target therapeutic weapons in a patient-specific manner. In this work, we propose a continuous mechanical model and we perform numerical simulations of GBM invasion combining the main mechano-biological characteristics of GBM with the micro-structural information extracted from radiological images, i.e. by elaborating patient-specific Diffusion Tensor Imaging (DTI) data. The numerical simulations highlight the influence of the different biological parameters on tumor progression and they demonstrate the fundamental importance of including anisotropic and heterogeneous patient-specific DTI data in order to obtain a more accurate prediction of GBM evolution. The results of the proposed mathematical model have the potential to provide a relevant benefit for clinicians involved in the treatment of this particularly aggressive disease and, more importantly, they might drive progress towards improving tumor control and patient's prognosis.
authors.affiliation: MOX-Department of Mathematics, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; Fondazione CEN, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Colombo
authors.affiliation: MOX-Department of Mathematics, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; Fondazione CEN, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Giverso
authors.affiliation: MOX-Department of Mathematics, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; Labs-Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Faggiano
authors.affiliation: Neuroradiology-Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Boffano
authors.affiliation: Department of Neurosurgery-Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Acerbi
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, CNRS, UMR 7190, Institut Jean Le Rond d'Alembert, F-75005 Paris, France.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ciarletta
mesh_terms: D016880:Anisotropy; D005909:Glioblastoma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009716:Numerical Analysis, Computer-Assisted; D066230:Patient-Specific Modeling; D057285:Precision Medicine; D047368:Tumor Burden