Virtual brain tumours (gliomas) enhance the reality of medical imaging and highlight inadequacies of current therapy

Abstract

Gliomas are brain tumours that differ from most other cancers by their diffuse invasion of the surrounding normal tissue and their notorious recurrence following all forms of therapy. We have developed a mathematical model to quantify the spatio-temporal growth and invasion of gliomas in three dimensions throughout a virtual human brain. The model quantifies the extent of tumorous invasion of individual gliomas in three-dimensions to a degree beyond the limits of present medical imaging, including even microscopy, and makes clear why current therapies based on existing imaging techniques are inadequate and cannot be otherwise without other methods for detecting tumour cells in the brain. The model's estimate of the extent of tumourous invasion beyond that defined by standard medical imaging can be useful in more accurately planning therapy regimes as well as predicting sites of potential recurrence without waiting for reemergence on follow-up imaging.

Figure 1

Sections of the virtual human brain in sagittal, coronal and horizontal planes that intersect at the site of the glioma originating in the superior frontal region denoted by an asterisk (*). The left column of brain sections corresponds to the tumour at diagnosis whereas the right column represents the same tumour at death. Red denotes a high density of tumour cells while blue denotes a low density. A thick black contour defines the edge of the tumour detectable by enhanced CT. Cell migration was allowed to occur in a truly three-dimensional solid representation of the brain. The elapsed time between diagnosis and death for this virtual glioma is approximately 158 days.

Figure 2

Sections of the virtual human brain in sagittal, coronal and horizontal planes that intersect at the site of the glioma originating in the thalamus denoted by an asterisk (*). The left column of brain sections corresponds to the tumour at diagnosis whereas the right column represents the same tumour at death. Red denotes a high density of tumour cells while blue denotes a low density. A thick black contour defines the edge of the tumour detectable by enhanced CT. Cell migration was allowed to occur in a truly three-dimensional solid representation of the brain. The elapsed time between diagnosis and death for this virtual gliomas is approximately 256 days.

Figure 3

The effects of on survival times of five-fold variations of the ratio of motility in grey matter to that in white matter (γ=D_w/D_g) for virtual gliomas in frontal white matter or in thalamus.