Image to physical space registration of supine breast MRI for image guided breast surgery

Conley, Rebekah H.; Meszoely, Ingrid M.; Pheiffer, Thomas S.; Weis, Jared A.; Yankeelov, Thomas E.; Miga, Michael I.

doi:10.1117/12.2043817

Cited by 6 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This analysis was then used as a guideline to develop the phantom and fine tune its material properties. It should be noted that supine MR imaging was used for its more accurate representation of the breast during the lumpectomy procedure [1]. As noted earlier, the deformation apparatus applies compressional forces on the phantom.…”

Section: Discussionmentioning

confidence: 99%

“…BCT has the risk of reoperation due to difficulty in determining tumor borders intraoperatively. A comprehensive framework for imageguided breast surgery using supine magnetic resonance (MR) images, patient specific biomechanical models, and intraoperative ultrasound has been proposed [1,2] as a superior intraoperative tumor localization strategy. A mock surgical setup that could be used to evaluate data acquisition and registration methods for such surgical systems would be of great value.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characterization of a phantom setup for breast conserving cancer surgery

Chadwell

Conley

Collins

et al. 2016

Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling

Self Cite

View full text Add to dashboard Cite

The purpose of this work is to develop an anatomically and mechanically representative breast phantom for the validation of breast conserving surgical therapies, specifically, in this case, image guided surgeries. Using three patients scheduled for lumpectomy and four healthy volunteers in mock surgical presentations, the magnitude, direction, and location of breast deformations was analyzed. A phantom setup was then designed to approximate such deformations in a mock surgical environment. Specifically, commercially available and custom-built polyvinyl alcohol (PVA) phantoms were used to mimic breast tissue during surgery. A custom designed deformation apparatus was then created to reproduce deformations seen in typical clinical setups of the preand intra-operative breast geometry. Quantitative analysis of the human subjects yielded a positive correlation between breast volume and amount of breast deformation. Phantom results reflected similar behavior with the custom-built PVA phantom outperforming the commercial phantom.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characterization of a phantom setup for breast conserving cancer surgery

Chadwell

Conley

Collins

et al. 2016

Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling

Self Cite

View full text Add to dashboard Cite

show abstract

“…The use of supine breast MRI in the context of image-guided breast surgery (IGBS) has been suggested in several frameworks. 22,[28][29][30] Image-guided surgery, or frameless stereotaxy, relates the location of surgical instruments in the operating room to preoperative imaging data. These systems are the clinical gold standard for performing neurosurgery and have been adapted for use in the liver, 31 kidney, 32 and lungs.…”

Section: Introductionmentioning

confidence: 99%

Toward quantitative quasistatic elastography with a gravity-induced deformation source for image-guided breast surgery

et al. 2018

View full text Add to dashboard Cite

Biomechanical breast models have been employed for applications in image registration and diagnostic analysis, breast augmentation simulation, and for surgical and biopsy guidance. Accurate applications of stress-strain relationships of tissue within the breast can improve the accuracy of biomechanical models that attempt to simulate breast deformations. Reported stiffness values for adipose, glandular, and cancerous tissue types vary greatly. Variations in reported stiffness properties have been attributed to differences in testing methodologies and assumptions, measurement errors, and natural interpatient differences in tissue elasticity. Therefore, the ability to determine patient-specific breast tissue properties would be advantageous for these procedural applications. While some elastography methods are not quantitative and others do not measure material properties under deformation conditions that are appropriate to the application of concern, in this study, we developed an elasticity estimation method that is performed using deformations representative of supine therapeutic procedures. More specifically, reconstruction of mechanical properties appropriate for the standard-of-care supine lumpectomy was performed by iteratively fitting two anatomical images before and after deformations taking place in the supine breast configuration. The method proposed is workflow-friendly, quantitative, and uses a noncontact, gravity-induced deformation source.

show abstract

“…To achieve this, methods using bio-mechanical models for prone-to-supine registration of MR images have been suggested [7,14]. Recently, utilization of supine MR images for surgical guidance has been considered in frameworks for image-guided breast surgery [2,8,25]. Alignment of presurgical supine MR images to surgically oriented MR images using surface markers has also been shown to be feasible [10].…”

Section: Introductionmentioning

confidence: 99%

Realization of a biomechanical model-assisted image guidance system for breast cancer surgery using supine MRI

et al. 2015

Self Cite

View full text Add to dashboard Cite

Purpose Unfortunately, the current re-excision rates for breast conserving surgeries due to positive margins average 20–40%. The high re-excision rates arise from difficulty in localizing tumor boundaries intraoperatively and lack of real-time information on the presence of residual disease. The work presented here introduces the use of supine magnetic resonance (MR) images, digitization technology, and bio-mechanical models to investigate the capability of using an image guidance system to localize tumors intraoperatively. Methods Preoperative supine MR images were used to create patient-specific biomechanical models of the breast tissue, chest wall, and tumor. In a mock intraoperative setup, a laser range scanner was used to digitize the breast surface and tracked ultrasound was used to digitize the chest wall and tumor. Rigid registration combined with a novel non-rigid registration routine was used to align the preoperative and intraoperative patient breast and tumor. The registra tion framework is driven by breast surface data (laser range scan of visible surface), ultrasound chest wall surface, and MR-visible fiducials. Tumor localizations by tracked ultra-sound were only used to evaluate the fidelity of aligning preoperative MR tumor contours to physical patient space. The use of tracked ultrasound to digitize subsurface features to constrain our nonrigid registration approach and to assess the fidelity of our framework makes this work unique. Two patient subjects were analyzed as a preliminary investigation toward the realization of this supine image-guided approach. Results An initial rigid registration was performed using adhesive MR-visible fiducial markers for two patients scheduled for a lumpectomy. For patient 1, the rigid registration resulted in a root-mean-square fiducial registration error (FRE) of 7.5 mm and the difference between the intraoperative tumor centroid as visualized with tracked ultrasound imaging and the registered preoperative MR counterpart was 6.5 mm. Nonrigid correction resulted in a decrease in FRE to 2.9 mm and tumor centroid difference to 5.5 mm. For patient 2, rigid registration resulted in a FRE of 8.8 mm and a 3D tumor centroid difference of 12.5 mm. Following nonrigid correction for patient 2, the FRE was reduced to 7.4 mm and the 3D tumor centroid difference was reduced to 5.3 mm. Conclusion Using our prototype image-guided surgery platform, we were able to align intraoperative data with preoperative patient-specific models with clinically relevant accuracy; i.e., tumor centroid localizations of approximately 5.3–5.5 mm.

show abstract

Image to physical space registration of supine breast MRI for image guided breast surgery

Cited by 6 publications

References 18 publications

Characterization of a phantom setup for breast conserving cancer surgery

Characterization of a phantom setup for breast conserving cancer surgery

Toward quantitative quasistatic elastography with a gravity-induced deformation source for image-guided breast surgery

Realization of a biomechanical model-assisted image guidance system for breast cancer surgery using supine MRI

Contact Info

Product

Resources

About