3D Breast Anatomy Analysis in Cancer Treatment Planning and Outcome Assessment

癌症治疗计划和结果评估中的 3D 乳房解剖分析

• 批准号: 7219169
• 负责人: Fatima Aziz Merchant
• 金额: $ 12.53万
• 依托单位: SOFT IMAGING, LLC
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-15 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7219169
• 关键词: Accounting; Address; Algorithms; American; Anatomy; Anthropometry; Appearance; Arts; Autologous; Body Image; Breast; Breast Cancer Treatment; Cancer Etiology; Cancer Patient; Cancer Survivor; Caring; Cessation of life; Characteristics; Charge; Clinical; Communication; Complex; Computer Graphics; Computer software; Consensus; Data; Decision Making; Deformity; Descriptor; Development; Diagnosis; Diagnostic; Early Diagnosis; Education; Educational process of instructing; End Point; Esthetics; Evaluation; Evidence Based Medicine; Financial compensation; Goals; Government; Guidelines; Health Care Costs; Health Personnel; Healthcare; Image; Image Analysis; Imagery; Incidence; Individual; Industry; Insurance; Judgment; Length; Letters; Life; Malignant Neoplasms; Mammaplasty; Mammary Gland Parenchyma; Marketing; Mastectomy; Measurement; Measures; Methods; Modality; Morbidity - disease rate; Morphology; National Cancer Institute; Nipples; Numbers; Operative Surgical Procedures; Outcome; Outcome Assessment; Outcome Study; Patients; Phase; Phase I Clinical Trials; Photogrammetry; Physicians; Positioning Attribute; Postoperative Period; Prior Surgery; Procedures; Process; Ptosis; Quality of life; Rate; Reconstructive Surgical Procedures; Regulation; Research; Risk; Score; Shapes; Specific qualifier value; Standards of Weights and Measures; Stereophotogrammetries; Stress; Surface; Surgeon; Surgical Flaps; Surgical Models; Survivors; System; Techniques; Technology; Testing; Three-Dimensional Image; Three-Dimensional Imaging; Three-dimensional analysis; Time; Training; Trauma; United States; Vendor; Visual; Woman; base; breast surgery; cancer care; cancer surgery; cancer therapy; clinically relevant; design; digital imaging; expectation; experience; improved; instrument; malignant breast neoplasm; mortality; multidisciplinary; psychologic; psychosocial; reconstruction; satisfaction; simulation; size; skills; software development; technological innovation; tool; treatment planning; trend; two-dimensional

DESCRIPTION (provided by applicant): Breast cancer is the second leading cause of cancer death in American women. Breast Reconstruction (BR) surgery is an important component of the breast cancer treatment process. It is the surgical procedure used to rebuild breast tissue that has been removed due to cancer surgery. Most importantly, BR surgery is integral to improving the cancer patient's quality of life. However, planning and evaluation of the surgery are done subjectively, and the result is not always satisfactory. We propose to develop tools that will aid surgeons with pre-operative planning and post-operative outcome evaluation. They will also help breast cancer survivors make informed decisions about their treatment choices, by facilitating surgeon-patient communications. Objective outcome analysis will allow more concrete communication with the patient, who can then calibrate her expectations and be more comfortable with her treatment choices. Alterations in appearance (or loss) of the breast have significant psychological and sexual implications in cancer patients. Having recently experienced the trauma and stress associated with the diagnosis and treatment of a life-threatening illness, patients hope to relieve some of the stress and rebuild a positive body image. They hope to achieve a BR result that is attractive and natural looking. Most women who choose BR do so to restore their femininity, image, and body integrity, all of which have been altered negatively by breast cancer therapy. However, there is no information available from an objective analysis of aesthetic outcomes to facilitate the patient's decision making on a procedure that will permanently alter the appearance of her breast. Standards for BR have evolved in the past decade, and patients and surgeons alike expect, symmetrical and natural looking breasts. Surgeons rely on their personal experience and on subjective visual assessment skills to achieve these results. Similarly, aesthetic outcome assessment methods, following surgery, are rather subjective, and are based on observer evaluation of physical changes in breast morphology and symmetry. To date, no consensus exists on how to assess the aesthetic result following BR. With the recent developments in three-dimensional (3D) imaging, there is now an opportunity to develop diagnostic tools that permit 3D treatment planning and objective assessment of post-operative results. The proposed study develops a method for quantitatively describing breast aesthetics. The method will objectively detect relevant changes in breast appearance, making it possible to compare aesthetic outcome between different treatment modalities. A practical technique for quantitative assessment of breast appearance would improve breast cancer care in several ways. Key applications include enabling personalized, evidence-based medicine, surgical planning, setting fair charges, and surgery education. Breast cancer is the most common life-threatening malignancy in women. Treatment advances and early detection have resulted in decreased mortality from breast cancer despite a steadily rising incidence in the United States between 1990 and 2002. Encouraged by this trend and other evidence of progress, the National Cancer Institute (NCI) has issued a challenge goal to eliminate suffering and death from cancer by the year 2015. Achieving this goal for women requires addressing the psychosocial morbidity caused by physical deformities of the breast that result from cancer treatment. A major step towards minimizing treatment-related deformities is to improve the surgical techniques of breast reconstruction. Developing quantitative tools for assessing the aesthetic outcome of BR is thus a significant step in the right direction. The goal of this Phase I study is to develop software tools that would aid the surgeon in quantifying and interpreting 3D data in a meaningful and clinically relevant fashion. 3D measurements would also be invaluable for relating patient and surgical variables meaningfully to aesthetic outcomes, and for comparing the outcomes of different kinds of breast cancer treatments (e.g., different reconstruction procedures).

描述（由申请人提供）：乳腺癌是美国女性癌症死亡的第二大原因。乳房重建（BR）手术是乳腺癌治疗过程的重要组成部分。这是用于重建因癌症手术而被切除的乳房组织的外科手术。最重要的是，BR 手术对于改善癌症患者的生活质量至关重要。然而，手术的计划和评估都是主观的，结果并不总是令人满意。我们建议开发工具来帮助外科医生进行术前规划和术后结果评估。他们还将通过促进外科医生与患者的沟通，帮助乳腺癌幸存者就其治疗选择做出明智的决定。客观的结果分析将允许与患者进行更具体的沟通，然后患者可以调整她的期望并对她的治疗选择更加满意。乳房外观的改变（或丧失）对癌症患者具有显着的心理和性影响。最近经历了与危及生命的疾病的诊断和治疗相关的创伤和压力后，患者希望减轻一些压力并重建积极的身体形象。他们希望获得有吸引力且自然的 BR 结果。大多数选择 BR 的女性这样做是为了恢复她们的女性气质、形象和身体完整性，所有这些都因乳腺癌治疗而发生了负面改变。然而，没有从美学结果的客观分析中获得任何信息来帮助患者做出永久改变乳房外观的手术决策。 BR 标准在过去十年中不断发展，患者和外科医生都期望拥有对称且自然的乳房。外科医生依靠他们的个人经验和主观视觉评估技能来实现这些结果。同样，手术后的美学结果评估方法相当主观，并且基于观察者对乳房形态和对称性物理变化的评估。迄今为止，对于如何评估 BR 后的美学效果尚未达成共识。随着三维 (3D) 成像的最新发展，现在有机会开发允许 3D 治疗计划和客观评估术后结果的诊断工具。拟议的研究开发了一种定量描述乳房美学的方法。该方法将客观地检测乳房外观的相关变化，从而可以比较不同治疗方式之间的美学结果。定量评估乳房外观的实用技术将从多个方面改善乳腺癌护理。主要应用包括实现个性化、循证医学、手术规划、设定公平收费和手术教育。乳腺癌是女性最常见的危及生命的恶性肿瘤。尽管 1990 年至 2002 年间美国乳腺癌发病率稳步上升，但治疗方法的进步和早期检测已导致乳腺癌死亡率下降。受这一趋势和其他进展证据的鼓舞，美国国家癌症研究所 (NCI) 发布了一项挑战目标：到 2015 年消除癌症带来的痛苦和死亡。为女性实现这一目标需要解决因癌症治疗导致的乳房身体畸形所造成的社会心理发病率。减少治疗相关畸形的一个重要步骤是改进乳房重建的手术技术。因此，开发用于评估 BR 美学效果的定量工具是朝着正确方向迈出的重要一步。这项第一阶段研究的目标是开发软件工具，帮助外科医生以有意义且与临床相关的方式量化和解释 3D 数据。 3D 测量对于将患者和手术变量与美学结果有意义地联系起来，以及比较不同类型乳腺癌治疗（例如不同的重建程序）的结果也非常有价值。

项目成果

Automated Identification of Fiducial Points on 3D Torso Images.

• DOI: 10.4137/becb.s11800
• 发表时间: 2013
• 期刊: Biomedical engineering and computational biology
• 影响因子: 2.8
• 作者: Kawale MM;Reece GP;Crosby MA;Beahm EK;Fingeret MC;Markey MK;Merchant FA
• 通讯作者: Merchant FA

Validation of stereophotogrammetry of the human torso.

• DOI: 10.4137/bcbcr.s6352
• 发表时间: 2011-02-15
• 期刊: Breast cancer : basic and clinical research
• 作者: Lee J;Kawale M;Merchant FA;Weston J;Fingeret MC;Ladewig D;Reece GP;Crosby MA;Beahm EK;Markey MK
• 通讯作者: Markey MK

3D Symmetry Measure Invariant to Subject Pose During Image Acquisition.

• DOI: 10.4137/bcbcr.s7140
• 发表时间: 2011
• 期刊: Breast cancer : basic and clinical research
• 作者: Kawale M;Lee J;Leung SY;Fingeret MC;Reece GP;Crosby MA;Beahm EK;Markey MK;Merchant FA
• 通讯作者: Merchant FA