Azar F S, Metaxas D N, Schnall M D
Department of Bioengineering, University of Pennsylvania, Philadelphia, USA.
Acad Radiol. 2001 Oct;8(10):965-75. doi: 10.1016/S1076-6332(03)80640-2.
Live guidance during needle breast procedures is not currently possible with high-field-strength (1.5-T), superconducting magnetic resonance (MR) imaging. The physician can calculate only the approximate location and extent of a tumor in the compressed patient breast before inserting the needle, and the tissue specimen removed at biopsy may not actually belong to the lesion of interest. The authors developed a virtual reality system for guiding breast biopsy with MR imaging, which uses a deformable finite element model of the breast.
The geometry of the model is constructed from MR data, and its mechanical properties are modeled by using a nonlinear material model. This method allows the breast to be imaged with or without mild compression before the procedure. The breast is then compressed, and the finite element model is used to predict the position of the tumor during the procedure. Three breasts of patients with cancer were imaged with and without compression. Deformable models of these breasts were built, virtually compressed, and used to predict tumor positions in the real compressed breasts. The models were also used to register MR data sets of the same patient breast imaged with different amounts of compression.
The model is shown to predict reasonably well the displacement by plate compression of breast lesions 5 mm or larger.
A deformable model of the breast based on finite elements with nonlinear material properties can help in modeling and predicting breast deformation. The entire procedure lasts less than half an hour, making it clinically practical.
目前,在高场强(1.5T)超导磁共振(MR)成像引导下进行乳腺穿刺操作时无法实现实时引导。在插入穿刺针之前,医生只能估算受压迫乳腺内肿瘤的大致位置和范围,而活检获取的组织标本可能并非实际感兴趣的病变组织。作者开发了一种用于磁共振成像引导乳腺活检的虚拟现实系统,该系统使用了乳腺的可变形有限元模型。
模型的几何形状由磁共振数据构建而成,其力学特性通过非线性材料模型进行模拟。这种方法使得在操作前乳腺可以在有或无轻度压迫的情况下进行成像。然后对乳腺进行压迫,利用有限元模型预测操作过程中肿瘤的位置。对3例癌症患者的乳腺在有压迫和无压迫情况下进行了成像。构建了这些乳腺的可变形模型,进行虚拟压迫,并用于预测实际受压迫乳腺中肿瘤的位置。这些模型还用于对同一患者乳腺在不同压迫程度下成像的磁共振数据集进行配准。
结果表明,该模型能够较好地预测直径5毫米及以上乳腺病变在平板压迫下的位移。
基于具有非线性材料特性的有限元的乳腺可变形模型有助于对乳腺变形进行建模和预测。整个过程耗时不到半小时,具有临床实用性。