{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T02:29:33Z","timestamp":1783391373174,"version":"3.54.6"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T00:00:00Z","timestamp":1580083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T00:00:00Z","timestamp":1580083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"A Reason To Ride"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Tumor Treating Fields (TTFields) are alternating electric fields at 200\u00a0kHz 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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>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 (E<jats:sub>AUC<\/jats:sub>). Hotspots, or regions of interest with the highest 5% of TTFields intensity (E<jats:sub>5%<\/jats:sub>), had an average increase of 95.6%. Of the 6 posterior fossa configurations modeled, the PA<jats:sub>Horizontal<\/jats:sub> arrangement provided the greatest field coverage at the GTV when the posteroanterior array was placed centrally along the patient\u2019s posterior neck and horizontally parallel, along the longer axis, to the coronal plane of the patient\u2019s head. Varying the arrays also produced hotspots proportional to TTFields coverage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11060-020-03406-x","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T11:03:11Z","timestamp":1580122991000},"page":"125-133","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Finite element analysis of Tumor Treating Fields in a patient with posterior fossa glioblastoma"],"prefix":"10.1007","volume":"147","author":[{"given":"Edwin","family":"Lok","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pyay","family":"San","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7112-6207","authenticated-orcid":false,"given":"Eric T.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,27]]},"reference":[{"issue":"11","key":"3406_CR1","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1002\/cam4.519","volume":"4","author":"E Lok","year":"2015","unstructured":"Lok E, Hua V, Wong ET (2015) Computed modeling of alternating electric fields therapy for recurrent glioblastoma. Cancer Med 4(11):1697\u20131699","journal-title":"Cancer Med"},{"issue":"5","key":"3406_CR2","doi-asserted-by":"publisher","first-page":"e0125269","DOI":"10.1371\/journal.pone.0125269","volume":"10","author":"N Gera","year":"2016","unstructured":"Gera N, Yang A, Holtzman TS, Lee SX, Wong ET, Swanson KD (2016) Tumor treating fields perturb the localization of septins and cause aberrant mitotic exit. PLoS ONE 10(5):e0125269","journal-title":"PLoS ONE"},{"issue":"23","key":"3406_CR3","doi-asserted-by":"publisher","first-page":"2306","DOI":"10.1001\/jama.2017.18718","volume":"318","author":"R Stupp","year":"2017","unstructured":"Stupp R, Taillibert S, Kanner A, Read W, Steinberg D, Lhermitte B et al (2017) Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: a randomized clinical trial. JAMA 318(23):2306\u20132316","journal-title":"JAMA"},{"issue":"4","key":"3406_CR4","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1053\/j.seminoncol.2014.03.011","volume":"41","author":"ME Lacouture","year":"2014","unstructured":"Lacouture ME, David ME, Elzinga G, Butowski N, Tran D, Villano JL et al (2014) Characterization and management of dermatologic adverse events with the NovoTTF-100A system, a novel anti-mitotic electric field device for the treatment of recurrent glioblastoma. Semin Oncol 41(4):S1\u2013S14","journal-title":"Semin Oncol"},{"issue":"8","key":"3406_CR5","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s11864-015-0353-5","volume":"16","author":"ET Wong","year":"2015","unstructured":"Wong ET, Lok E, Swanson KD (2015) An Evidence-based review of alternating electric fields therapy for malignant gliomas. Curr Treat Options Oncol 16(8):40","journal-title":"Curr Treat Options Oncol"},{"key":"3406_CR6","first-page":"e58937","volume":"146","author":"MM Riley","year":"2019","unstructured":"Riley MM, San P, Lok E, Swanson KD, Wong ET (2019) The clinical application of tumor treating fields therapy in glioblastoma. J Vis Exp 146:e58937","journal-title":"J Vis Exp"},{"issue":"8","key":"3406_CR7","doi-asserted-by":"publisher","first-page":"e0201957","DOI":"10.1371\/journal.pone.0201957","volume":"13","author":"AR Korshoej","year":"2018","unstructured":"Korshoej AR, Hansen FL, Mikic N, von Oettingen G, Sorensen JCH, Thielscher A (2018) Importance of electrode position for the distribution of Tumor Treating Fields (TTFields) in a human brain, identification of effective layouts through systematic analysis of array positions for multiple tumor locations. PLoS ONE 13(8):e0201957","journal-title":"PLoS ONE"},{"issue":"13","key":"3406_CR8","first-page":"4871","volume":"79","author":"E Lok","year":"2019","unstructured":"Lok E, San P, White V, Wong ET (2019) Comparative analysis of Tumor Treating Fields using conventional versus alternative array placement for posterior fossa glioblastoma. Proc 2019 AACR Ann Meet 79(Suppl 13):4871","journal-title":"Proc 2019 AACR Ann Meet"},{"issue":"21","key":"3406_CR9","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1088\/1361-6560\/aa87f3","volume":"62","author":"JJ Timmons","year":"2017","unstructured":"Timmons JJ, Lok E, San P, Bui K, Wong ET (2017) End-to-end workflow for finite element analysis of Tumor Treating Fields in glioblastomas. Phys Med Biol 62(21):264\u20138282","journal-title":"Phys Med Biol"},{"issue":"3","key":"3406_CR10","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1007\/s11060-013-1231-2","volume":"115","author":"I Strauss","year":"2013","unstructured":"Strauss I, Jonas-Kimchi T, Bokstein F, Blumenthal D, Roth J, Sitt R et al (2013) Gliomas of the posterior fossa in adults. J Neurooncol 115(3):401\u2013409","journal-title":"J Neurooncol"},{"issue":"9","key":"3406_CR11","doi-asserted-by":"publisher","first-page":"3288","DOI":"10.1158\/0008-5472.CAN-04-0083","volume":"64","author":"ED Kirson","year":"2004","unstructured":"Kirson ED, Gurvich Z, Schneiderman R, Dekel E, Itzhaki A, Wasserman Y et al (2004) Disruption of cancer cell replication by alternating electric fields. Cancer Res 64(9):3288\u20133295","journal-title":"Cancer Res"},{"issue":"6","key":"3406_CR12","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1002\/cam4.1095","volume":"6","author":"E Lok","year":"2017","unstructured":"Lok E, San P, Hua V, Phung M, Wong ET (2017) Analysis of physical characteristics of Tumor Treating Fields for human glioblastoma. Cancer Med 6(6):1286\u20131300","journal-title":"Cancer Med"},{"issue":"1","key":"3406_CR13","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/0360-3016(91)90171-Y","volume":"21","author":"B Emani","year":"1991","unstructured":"Emani B, Lyman J, Brown A, Cola L, Goitein M, Munzenrider JE et al (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21(1):109\u2013122","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"3406_CR14","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.ijrobp.2009.09.040","volume":"76","author":"SM Bentzen","year":"2010","unstructured":"Bentzen SM, Constine LS, Deasy JO, Eisbruch A, Jackson A, Marks LB et al (2010) Quantitative analyses of normal tissue effects in the clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys 76(3):S3\u2013S9","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"3406_CR15","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/j.ijrobp.2019.04.008","volume":"104","author":"MT Ballo","year":"2019","unstructured":"Ballo MT, Urman N, Lavy-Shahaf G, Grewal J, Bomzon Z, Toms S (2019) Correlation of Tumor Treating Fields dosimetry to survival outcomes in newly diagnosed glioblastoma: a large-scale numerical simulation-based analysis of data from the phase 3 EF-14 randomized trial. Int J Radiat Oncol Biol Phys 104(5):1106\u20131113","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"pii","key":"3406_CR16","doi-asserted-by":"publisher","first-page":"e35178","DOI":"10.7554\/eLife.35178","volume":"7","author":"Y Huang","year":"2018","unstructured":"Huang Y, Liu AA, Lafon B, Friedman D, Dayan M, Wang X et al (2018) Measurements and models of electric fields in the in vivo human brain during transcranial electric stimulation. eLife 7(pii):e35178","journal-title":"eLife"}],"container-title":["Journal of Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-020-03406-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s11060-020-03406-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-020-03406-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T00:15:10Z","timestamp":1611620110000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s11060-020-03406-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,27]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["3406"],"URL":"https:\/\/doi.org\/10.1007\/s11060-020-03406-x","relation":{},"ISSN":["0167-594X","1573-7373"],"issn-type":[{"value":"0167-594X","type":"print"},{"value":"1573-7373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,27]]},"assertion":[{"value":"19 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Eric T Wong has received research funding for clinical trials and a laboratory project investigating the basic mechanisms of alternating electric fields on dividing tumor cells from Novocure, the company that makes the patient treatment device that emits Tumor Treating Fields. Edwin Lok, Pyay San, Olivia Liang and Victoria White have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained from the human participant in this study. This research was performed according to an IRB-approved protocol at Dana Farber Cancer Institute.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}