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ESHO

European Society of Hyperthermic
Oncology

ESHO Grand Challenge

ESHO grand challenge on hyperthermia computational modeling (ESHO-GC-HCP)

This document provides guidance for participation in the ESHO-GC-HCP. We welcome participants to apply their novel ideas on hyperthermia therapy (HT) technology following the standardized simulation benchmarks provided in the following sections.

Task/Aim

This challenge aims at invigorating and streamlining progress in hyperthermia device development and treatment planning research. To achieve this goal, we provide standardized simulation benchmarks to evaluate predicted clinical improvement. The simulation benchmarks are based on: 1) clinically derived applicator configurations; 2) traceable tissue properties; 3) robust and consistent numerical simulation techniques [2]; and 4) six open-source anatomical patient models. Four of these models are part of the new Erasmus Virtual Patient Repository (EVPR) [1], and two models were developed to expand the patient model database to other tumor site locations [2]. The ESHO-GC-HCP provides a forum to display the potential of new hyperthermia developments in a standardized framework. This challenge welcomes contributions on radiofrequency, microwave, and ultrasound hyperthermia technology.

Background

Hyperthermia treatment modelling and optimization (HTM&O) is the process in which the radiation oncology team defines the optimal treatment plan for a specific cancer patient using the available hyperthermia treatment resources. HTM&O includes computational modeling approaches for pre-treatment optimization and online treatment guidance. Pre-treatment HTM&O, also known as hyperthermia treatment planning (HTP), is used for (1) applicator type selection and arrangement, (2) analysis of the target heat-ability in non-standard clinical cases, (3) informing interdisciplinary discussions, and (4) investigation of the extent that potential contraindications (such as expected collateral toxicity) compromise treatment. During treatment, HTM&O is also known as online HTP and may be used for (5) adaptation of treatments based on measurements and/or feedback from the patient and/or clinical team. After treatment, HTM&O helps in (6) retrospective analyses to draw lessons regarding the suitability of the choices made during treatment application. HTM&O can also play an important role in (7) the education and training of hyperthermia technicians, physicists, and physicians. These clinical purposes require dedicated and validated computational models, which are not the main topic of this grand challenge. Still, the proposed guidelines should help promote standardized HTM&O and treatment delivery. Instead, the primary purpose of ESHO-GC-HCP stems from the fact that the HTM&O computational tools have gained a prominent role in the design and optimization of novel devices and treatment strategies. However, while HTM&O is gaining broader traction, there is limited convergence towards standardized computational practices, tissue properties, and verification/performance benchmarks. The ESHO-GC-HCP aims to bridge this gap.

In contrast to the readily available simulation tools and computational resources, our knowledge of tissue properties and their physiological dynamics is currently limited. As a consequence, any treatment planning approach carries uncertainties often leading to sub-optimal delivery of the HT treatment. The choices that have to be made in simulations are often unclear but strongly influence the temperature simulations. The enhanced availability of modeling tools with different numerical methods and automated parameter settings has led to a situation in which comparing the benefits of the various treatment planning strategies is nearly impossible; without a common ground, progress in the HT field is severely compromised. This challenge aims to provide the platform to directly compare various treatment strategies in order to improve the reliability and selectivity of the thermal dose delivery to the targeted region. An output of the challenge will be a ranking of techniques that achieves high and uniform SAR/temperature distributions in the target region while minimizing the energy deposition in healthy tissues. We welcome the contribution of novel radiofrequency (RF), microwave (MW) and focussed ultrasound (FUS) approaches for HTM&O, applicator design, dynamic treatment administration (e.g., focus scanning, temporal multiplexing, etc.), and closed-loop control techniques.

Tools

The purpose of the ESHO Grand challenge is to facilitate the direct evaluation of new optimization techniques or applicators for hyperthermia treatment delivery. The predicted performance of the novel technologies will be compared against benchmark results achieved in numerical setups that combine clinically-inspired applicator models and six HT patient models with tumors. Building on these models, standardized tissue properties and simulation approaches are described in reference [2]. The details on the numerical setup as well as the evaluation criteria are specified below. After registration for the challenge, the benchmark datasets will be provided upon request. These include the patient voxel models, tissue properties, pre-computed electric field distributions from the reference applicators, and pre-optimized antenna steering parameter amplitude/phase values.

Specific instructions depending on your technological approach are described below.

RF and MW HTM&O

  • We encourage to use all available benchmarks of anatomical models and applicators [2]. The applicators shall remain unaltered, unless applicator design is the topic of the submission (see below).

  • The results must be provided in terms of antenna steering parameters: amplitude, phase, and frequency, as well as time-course (if non-periodic).

  • The duration of the planning procedure must be provided, along with information about the employed computational hardware.

RF & MW Applicator development (potentially in combination with HTM&O), including ultra-wideband (UWB) techniques

New applicator proposals may be accompanied with new optimization approaches in this sub-challenge.

  • We encourage using the reference patient models along with the dielectric and thermal properties, as well as optimization metrics described in the guideline paper in appendices 1 and 2 [2].

  • If the investigated frequencies deviate from those in the benchmarks, the dielectric properties of healthy tissues and tumor must be calculated according to the approach detailed in reference [2] and reported accordingly.

  • The electrical fields of the antennas, temperature maps as well as the amplitude, phase, and frequency settings must be provided for evaluation at least for one operating frequency.The data format and structure must be submitted in the same format (mat) as in the provided datasets. The details about the format and structures are provided as a part of the benchmark datasets and are also available upon request.

  • For practical reasons, UWB HTM&O approaches are bundled in this sub-challenge. The applicators shall remain unaltered, but the antenna lengths can be changed to reflect the operating frequency. The dielectric properties of healthy tissues and tumor must be calculated according to the approach detailed in reference [2] and reported accordingly.

Ultrasound technology

  • Given the high focality of FUS, – which is a strength for targeting but also poses a challenge when treating larger tumors – we encourage participants to investigate/devise scanning strategies and/or corresponding phased-array applicators that maximize the thermal optimization metrics specified in reference [2].

  • We recommend using preferably the patient model Venus. Additional simulations with the other anatomical models are encouraged. The acoustic/thermal properties and optimization metrics described in the guideline paper [2] should be applied.

  • The results in terms of SAR (i.e.,normalized power deposition density) and temperature maps shall be provided. The data format and structure must be submitted in the same format as in the provided datasets.

How to proceed:

  • The participating team shall register following the ESHO website instructions.

  • The datasets will be provided upon request via email. Please send an email to ESHOgrandchallenge2021@conventus.de with the subject “ESHO-GC-setup + category”. The categories are 1) RF and MW HTM&O; 2) RF & MW Applicator development; and 3) Ultrasound technology.

  • When your results are ready for submission, inform as by an email sent to ESHOgrandchallenge2021@conventus.de with subject “ESHO-GC-results”. The email should contain 1-2 paragraphs explaining the applied method. A link for data upload will be provided afterwards.

Grand challenge setup

Teams participating in the ESHO Grand Challenge are encouraged to submit manuscripts to a Special issue of the International Journal of Hyperthermia that will launch in the Summer of 2021 and published in 2022. Authors should detail their methodology and obtained results. Furthermore, the authors of the best approaches will be publicly announced after the closure of the challenge and invited to submit a paper to the International Journal of Hyperthermia with the publication fee waived. A committee consisting of clinicians and physicists will rank the submission to find the challenge winner as described below. The winner(s) will be awared during ESHO 2022.

Timeline

  • Sept 15, 2021: Guideline paper published; webpage released; the challenge is open.

  • Jan 15, 2022: Submit preliminary results

  • Mar 15, 2022: Drafts detailing the Materials and Methods + Results

  • Aug 31, 2022: The results of Grand challenge ranked

  • ESHO 2022: Award section to announce the winner and top three approaches from specific ranking criteria

Review criteria

A committee consisting of clinicians and physicists will rank the papers to find the challenge winner according to the following ranking criteria:

  • Clinical value:

    • What are the odds that the proposed solution will make it into the clinic, i.e., is the procedure easy to implement under clinical constraints?

    • What is the potential for such a solution to improve the delivery/monitoring of thermal dose to tumors while reducing the thermal dose to healthy tissues?

    • The quantitative evaluation will be in terms of THQ, TCxx and temperature coverage [2] as well as the achievable computational speed.

  • Innovation/Insights:

    • What novel possibilities/scientific understanding does the investigation/proposed approach offer.

  • Disruptive value:

    • Does the proposed solution have the potential to significantly alter the way hyperthermia is delivered to patients, or to significantly alter hyperthermia treatment planning?

  • Promotion of hyperthermia:

    • Does the suggested approach have the potential to promote the wider use of hyperthermia therapy in the oncology field?

The challenge will be closed after the deadline. However, a new challenge with updated settings or patient models will be eventually open. Results of the Grand challenge 2021 will be presented at ESHO 2022. The main organizers agree to commit themselves to (future) support of this challenge with the updated setup in due time.

Organizers

Hana Dobsicek Trefna
Maarten Paulides
Dario Rodrigues
Petra Kok
Sergio Curto
Kemal Sumser
Esra Neufeld

Terms of participation

The Grand Challenge on HTM&O is organized in the spirit of cooperative scientific progress. We do not claim any ownership or rights to the methods, but we require anyone to respect the rules below. The following rules apply to those who register as team and/or download the data.

The datasets provided in this Grand Challenge, or any data derived from these datasets, may not be forwarded or redistributed under any circumstances to persons not belonging to the registered team.

All information entered when registering a team, including the name of the contact person, the affiliation (institute, organization or company the team’s contact person works for) and the email address must be complete and correct. Anonymous or incomplete registration is not allowed. If you wish to submit anonymously, e.g. if you want to submit your results to a journal or conference that requires anonymous submission, please contact the organizers first.

The data provided may only be used for preparing an entry to be submitted to this challenge. Without prior participation in the challenge and approval by the organizers, the data cannot be used for other purposes, such as scientific studies or to train/develop algorithms, including, but not limited to, algorithms used in commercial products.

If a commercial system is evaluated, no method description is necessary, but the system has to be publicly available and the exact applicator name and version (or model) number must be provided.

If the results of algorithms in this challenge are to be used in scientific publications (e.g., journal publications, conference papers, technical reports, presentations at conferences and meetings) you must include an appropriate citation of the guideline [2] and EVPR [1] papers.

Evaluation of the results will involve a ranking process by the jury and the ranking results will be announced at ESHO 2022. By submitting results, you grant us permission to publish our evaluation in the Editorial paper of the Special Issue of the International Journal of Hyperthermia. The authors of the emerging methods and technologies will be invited to submit their work to this Special Issue. Participating teams maintain full ownership and rights to their method.

Teams must notify via email (ESHOgrandchallenge2021@conventus.de) the organizers of this challenge about any publication that is based, in part or in total, on the data published on this website (https://www.esho.info/ESHOGrandChallenge), to enable the organizers to maintain a list of publications associated with the challenge.

References

[1] G. G. Bellizzi et al., "Standardization of patient modeling in hyperthermia simulation studies: introducing the Erasmus Virtual Patient Repository," International Journal of Hyperthermia, vol. 37, no. 1, pp. 608-616, 2020/01/01 2020.

[2] M. M. Paulides et al., "ESHO benchmarks for computational modeling and optimization in hyperthermia therapy", International Journal of Hyperthermia, early access, 2021.

Teams are welcome to register and submit their methods to the online challenge!