The mathematical model continues to be based purely on the classical definition of cancer as uncontrolled proliferation of cells with the potential for invasion and metastasis, simplified for gliomas, which practically do not metastasise. Thus, the model defines the behaviour of gliomas in words and mathematics as follows:
This is a classical conservation–diffusion equation (Murray, 2003 ), in which
c(
x,
t) defines the concentration of malignant cells at location
x and time
t,
D (mm
2 day
−1) is the random motility (dispersal) coefficient defining the net rate of migration of the tumour cells,
ρ (per day) represents the net proliferation rate of the tumour cells (including mitosis and cell loss),
K is the limiting concentration of cells that a volume of tissue can hold (i.e., the carrying capacity of the tissue) and ∇
2 represents the dispersal operator, the Laplacian, expressed mathematically as the sum of three second derivatives in space (Strang, 1991 ). The model has been adapted to use the BrainWeb Atlas (Collins
et al, 1998 (
link)) to accommodate an irregularly shaped tumour located anywhere within 3-dimensionally continuous heterogeneous tissue with differences in grey and white matter, anatomically accurate to 1 mm
3 (Swanson, 1999 ; Swanson
et al, 2003a ). The model can accommodate different velocities of glioma cell motility in grey and white matter (Swanson, 1999 ) but, since the original MRIs were not available, this feature was not used in the present analysis.
Equation (1) implies mathematically that the ‘edge’ of the visible tumour advances asymptotically as a ‘traveling wave,’ (Swanson, 1999 ) which expands radially and linearly, according to Fisher's approximation or Skellam's model (Shigesada and Kawasaki, 1997 ): . Although there is no true edge to an infiltrating tumour, such as a glioma, any point on the ‘gradient’ between the T1-Gd and T2 circumferences (
Figure 3) moves as part of the ‘traveling wave.’ In general, as shown schematically in
Figure 3, proliferation (
ρ) tends to drive the wave up (but not above the carrying capacity
K) and dispersal (
D) tends to drive the gradient centrifugally.
The ‘gradient’ between the T1-Gd and T2 images can be expressed in a different way, involving the ratio
D/
ρ. This ‘gradient’ has not been quantitatively defined but can be approximated from the observations of Kelly
et al (1987) (
link), Kelly (1993) (
link) and Dalrymple
et al (1994) (
link), who reported that the T1-Gd circumference approximates the edge of the ‘solid tumour’ and that the T2 circumference represents not only the extent of oedema but also a zone of a low concentration of ‘isolated tumour cells.’ We hypothesised that these circumferences might represent concentrations of tumour cells equal to 80 and 16%, respectively, of the maximum concentration (
Figure 3). That tumour cells extend much farther then even the imageable abnormality is evidenced by malignant cells being cultured by Silbergeld and Chicoine (1997) (
link) from as far away as 4 cm. A close study of other solutions of the model
Eq. (1) finds a highly non-linear relationship between the ratio
D/
ρ and the average radii of spheres equivalent to the volumes defined by T1-Gd and T2,
rT1 and
rT2, respectively (Harpold
et al, 2007 (
link)). The equation by no means is a simple ratio of any part(s) of the MR images, but includes fractional exponents of ratios of differences that make it highly non-linear.
Our model consists of the following two parts: (1)
Eq. 1, the spatio-temporal bio-mathematical formulation of the proliferation and dispersal of the tumour cells, both visible (detectable by scans) and invisible (diffusing into the surrounding normal-appearing tissue), and (2) the use of Fisher's approximation ( ) to estimate the time required for the tumour to expand from its detectable actual size at diagnosis to its size at death (Woodward
et al, 1996 (
link)).
Swanson K.R., Rostomily R.C, & Alvord EC J.r. (2007). A mathematical modelling tool for predicting survival of individual patients following resection of glioblastoma: a proof of principle. British Journal of Cancer, 98(1), 113-119.