Imaging properties of 3D printed breast phantoms for lesion localization and Core needle biopsy training

Abstract

Background: Breast cancer is the most commonly diagnosed malignancy in females and frequently requires core needle biopsy (CNB) to guide management. Adequate training resources for CNB suffer tremendous limitations in reusability, accurate simulation of breast tissue, and cost. The relatively recent advent of 3D printing offers an alternative for the development of breast phantoms for training purposes. However, the feasibility of this technology for the purpose of ultrasound (US) guided breast intervention has not been thoroughly studied. Methods: We designed three breast phantom models that were printed in multiple resins available through Stratasys, including VeroClear, TangoPlus and Tissue Matrix. We also constructed several traditional breast phantoms using chicken breast and Knox gelatin for comparison. These phantoms were compared side-by-side for ultrasound penetrance, simulation of breast tissue integrity, anatomic accuracy, reusability, and cost. Results: 3D printed breast phantoms were more anatomically accurate models than traditional breast phantoms. The chicken breast phantom provided acceptable US beam penetration and material hardness for simulation of human breast tissue integrity. Sonographic image quality of the chicken breast phantom was the most accurate overall. The gelatin-based phantom also had acceptable US beam penetration and image quality; however, this material was too soft and poorly simulated breast tissue integrity. 3D printed phantoms were not visible under US. Conclusions: There is a large unmet need for a printable material that is truly compatible with multimodality imaging for breast and other soft tissue intervention. Further research is warranted to create a realistic, reusable and affordable material to 3D print phantoms for US-guided intervention training.

Projection-based stereolithography for direct 3D printing of heterogeneous ultrasound phantoms

“…Other groups have used inkjet technology to generate regions of binary hyperechogenicity at the imaging voxel level; however, the need for a support material during the fabrication process ultimately limits control over the phantoms’ contrast and spatial resolution [ 29 , 30 ]. Additionally, several tested materials do not provide adequate US image quality to qualify as potential tissue-mimicking phantoms [ 31 , 32 ]. Therefore, challenges remain with respect to 3D printing phantoms using soft materials with varying levels of backscatter or stiffness in a single fabrication session.…”

Applications of 3D printing in breast cancer management

“…Similarly, 3D printed breast phantoms aid in the teaching and training of ultrasound-guided core needle biopsy techniques [ 47 ]. Although chicken breast has been traditionally used for training of ultrasound guided needle biopsy techniques, it is non-reusable, environmentally unfriendly, and unsanitary risking contamination of biopsy instruments which leads to increased waste and cost.…”

Development of a novel framework to evaluate the localization accuracy of tomosynthesis‐guided breast biopsy units

“…Efforts have been made to propose alternative phantoms for lesion localization in breast biopsy (mainly for training purposes) such as using turkey meat, eggplant or pastry as medium and sea salt or sand as targets or a 3D printed breast biopsy phantoms 9,10 . However, to the best of our knowledge, this is the first study to propose a phantom and a novel error analysis approach to evaluate the localization accuracy of the tomosynthesis‐guided breast biopsy units.…”