Initial study of breast tissue retraction toward image guided breast surgery

Shannon, Michael J.; Meszoely, Ingrid M.; Ondrake, Janet E.; Pheiffer, Thomas S.; Simpson, Amber L.; Sun, Kay; Miga, Michael I.

doi:10.1117/12.912860

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…This work presents a silicone breast retraction phantom for BCS procedures to model and quantify deformations from retraction. It extends our previous work by creating a phantom that includes a realistic mock clinical retractor and a more realistic phantom with CT-visible markers 12 . In a previous BCS retraction phantom implementation, common eating utensils were used to simulate a tissue hook retractor, the phantom itself was made from a common bowl, and surface points were digitized by ink markings 12 .…”

Section: Discussionmentioning

confidence: 70%

“…It extends our previous work by creating a phantom that includes a realistic mock clinical retractor and a more realistic phantom with CT-visible markers 12 . In a previous BCS retraction phantom implementation, common eating utensils were used to simulate a tissue hook retractor, the phantom itself was made from a common bowl, and surface points were digitized by ink markings 12 . The BCS retraction phantom presented here is more realistic in terms of breast size and shape, tissue mimicking material, and surgical retraction instrumentation.…”

Section: Discussionmentioning

confidence: 70%

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Modeling retraction for breast conserving surgery guidance

Espinosa

Ringel

Heiselman

et al. 2023

Medical Imaging 2023: Image-Guided Procedures, Robotic Interventions, and Modeling

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Breast conserving surgery is a common treatment option for early-stage breast cancer, and it relies on complete tumor excision such that no residual cancer is left in the resection cavity. However, the use of preoperative imaging to inform excision is compromised by intraoperative deformations that change the location, volume, and shape of the tumor compared to the imaging configuration. For intra-procedural guidance specifically, incision and retraction alter the tumor presentation and geometry. Being able to compensate for retraction deformations intraoperatively may increase the utility of image guidance technologies. In this work, a breast retraction phantom and deformation modeling approach are developed to explore the potential of modeling retraction for image guidance during BCS. Surface and subsurface beads were embedded in a realistic silicone breast phantom, and CT images were acquired in undeformed and retracted states. A reconstructive, sparse-data registration method was used to model retraction. Modeling accuracy was evaluated by comparing model-predicted and ground-truth bead displacements. The average surface bead registration error after retraction modeling in a region of interest was 0.5 ± 0.1 mm (maximum 0.5 mm). The average subsurface bead registration error in a region of interest was 1.2 ± 0.6 mm (maximum 2.6 mm). A biomechanical modeling method that includes retraction may improve the accuracy of image guidance for breast conserving surgery, but more work is needed to evaluate its utility.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 70%

Modeling retraction for breast conserving surgery guidance

Espinosa

Ringel

Heiselman

et al. 2023

Medical Imaging 2023: Image-Guided Procedures, Robotic Interventions, and Modeling

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show abstract

“…Efforts have been made in the literature to model the phenomena of tissue separation [1][2][3][4][5] , mainly for applications in developing surgical simulators. Despite some work in the literature investigating the modeling of resection and retraction for surgical guidance applications [6][7][8][9][10] , to this date, it still needs to be solved. This paper introduces an approach that addresses this issue by combining the capabilities of the eXtended Finite Element Method (XFEM) for modeling tissue retraction with medical image updating techniques.…”

Section: Introductionmentioning

confidence: 99%

Image reconstruction and tissue separation modeling with XFEM for surgical visualization and guidance

Pereira,

Ringel,

Miga

2024

Medical Imaging 2024: Image-Guided Procedures, Robotic Interventions, and Modeling

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Surgical procedures require precise target localization to ensure optimal outcomes and minimize patient risks. This paper presents an approach that combines eXtended Finite Element Method (XFEM) for retraction modeling with medical image updating to improve target visualization and localization accuracy in surgical guidance. XFEM is employed to simulate tissue retraction, capturing the complex mechanical behavior of tissue separation during surgery. By incorporating XFEMderived displacement fields, a strategy for updating preoperative medical images is introduced, enabling adjustments to better visualize the tissue deformation state. XFEM's ability to model discontinuities in mechanical behavior provides a realistic representation of tissue retraction. To validate the effectiveness of the approach, experiments were conducted on tissue phantom samples. The average displacement error between the ground-truth measurements and the reconstruction using the proposed method ranged from 1.5 to 2.1 mm, with an overall average error of 1.8 ± 1.3 mm across different phantom samples. This demonstrates improvements in target localization compared to traditional methods that do not account for tissue retraction. The integration of XFEM-based retraction modeling and displacement field-driven image updating offers an interesting tool for improving surgical guidance systems, ultimately leading to more precise and successful interventions.

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Initial study of breast tissue retraction toward image guided breast surgery

Cited by 2 publications

References 7 publications

Modeling retraction for breast conserving surgery guidance

Modeling retraction for breast conserving surgery guidance

Image reconstruction and tissue separation modeling with XFEM for surgical visualization and guidance

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