INTRODUCTION Tumor Treating Fields (TTFields) are alternating electric fields at 200 kHz that disrupt tumor cells as they undergo mitosis. Patient survival benefit has been demonstrated in randomized clinical trials but much of the data are available only for supratentorial glioblastomas. We investigated a series of alternative array configurations for the posterior fossa to determine the electric field coverage of a cerebellar glioblastoma. METHODS Semi-automated segmentation of neuro-anatomical structures was performed while the gross tumor volume (GTV) was manually delineated. A three-dimensional finite-element mesh was generated and then solved for field distribution. RESULTS Compared to the supratentorial array configuration, the alternative array configurations consist of posterior displacement the 2 lateral opposing arrays and inferior displacement of the posteroanterior array, resulting in an average increase of 46.6% electric field coverage of the GTV as measured by the area under the curve of the electric field-volume histogram (EAUC). Hotspots, or regions of interest with the highest 5% of TTFields intensity (E5%), had an average increase of 95.6%. Of the 6 posterior fossa configurations modeled, the PAHorizontal arrangement provided the greatest field coverage at the GTV when the posteroanterior array was placed centrally along the patient's posterior neck and horizontally parallel, along the longer axis, to the coronal plane of the patient's head. Varying the arrays also produced hotspots proportional to TTFields coverage. CONCLUSIONS Our finite element modeling showed that the alternative array configurations offer an improved TTFields coverage to the cerebellar tumor compared to the conventional supratentorial configuration.

中文翻译：

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后颅窝成胶质细胞瘤患者肿瘤治疗区域的有限元分析。

引言肿瘤治疗场（TTFields）是200 kHz的交变电场，在发生有丝分裂时会破坏肿瘤细胞。患者的生存获益已在随机临床试验中得到证实，但许多数据仅适用于幕上胶质母细胞瘤。我们研究了后颅窝的一系列替代阵列配置，以确定小脑胶质母细胞瘤的电场覆盖范围。方法进行神经解剖结构的半自动分割，而总肿瘤体积（GTV）手动描绘。生成三维有限元网格，然后求解其场分布。结果与幕上阵列配置相比，可选的阵列配置包括后移位，两个侧向相对阵列和后前阵列的下移位，通过电场-体积直方图曲线下的面积测量，GTV的电场覆盖平均增加46.6％ （EAUC）。热点或TTFields强度最高（E5％）5％的感兴趣区域的平均增长率为95.6％。在模型化的6种后颅窝构型中，当将后前部阵列沿患者后颈部居中放置并沿较长轴水平平行于患者头部冠状平面时，PAHorizo​​ntal排列在GTV上提供了最大的视野覆盖范围。改变阵列还会产生与TTFields覆盖范围成比例的热点。