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

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

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Citations (Scopus)

Abstract

Breast conservation therapy (BCT) is a desirable option for many women diagnosed with early stage breast cancer and involves a lumpectomy followed by radiotherapy. However, approximately 50% of eligible women will elect for mastectomy over BCT despite equal survival benefit (provided margins of excised tissue are cancer free) due to uncertainty in outcome with regards to complete excision of cancerous cells, risk of local recurrence, and cosmesis. Determining surgical margins intraoperatively is difficult and achieving negative margins is not as robust as it needs to be, resulting in high re-operation rates and often mastectomy. Magnetic resonance images (MRI) can provide detailed information about tumor margin extents, however diagnostic images are acquired in a fundamentally different patient presentation than that used in surgery. Therefore, the high quality diagnostic MRIs taken in the prone position with pendant breast are not optimal for use in surgical planning/guidance due to the drastic shape change between preoperative images and the common supine surgical position. This work proposes to investigate the value of supine MRI in an effort to localize tumors intraoperatively using image-guidance. Mock intraoperative setups (realistic patient positioning in non-sterile environment) and preoperative imaging data were collected from a patient scheduled for a lumpectomy. The mock intraoperative data included a tracked laser range scan of the patient's breast surface, tracked center points of MR visible fiducials on the patient's breast, and tracked B-mode ultrasound and strain images. The preoperative data included a supine MRI with visible fiducial markers. Fiducial markers localized in the MRI were rigidly registered to their mock intraoperative counterparts using an optically tracked stylus. The root mean square (RMS) fiducial registration error using the tracked markers was 3.4mm. Following registration, the average closest point distance between the MR generated surface nodes and the LRS point cloud was 1.76±0.502 mm.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2014
Subtitle of host publicationImage-Guided Procedures, Robotic Interventions, and Modeling
PublisherSPIE
ISBN (Print)9780819498298
DOIs
StatePublished - Jan 1 2014
EventMedical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling - San Diego, CA, United States
Duration: Feb 18 2014Feb 20 2014

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume9036
ISSN (Print)1605-7422

Other

OtherMedical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling
CountryUnited States
CitySan Diego, CA
Period2/18/142/20/14

Fingerprint

Computer-Assisted Surgery
Segmental Mastectomy
Magnetic resonance
surgery
breast
Surgery
magnetic resonance
Breast
Magnetic Resonance Spectroscopy
Fiducial Markers
Mastectomy
Tumors
margins
Conservation
markers
Patient Positioning
Prone Position
Neoplasms
Supine Position
Radiotherapy

Keywords

  • BCT
  • MRI
  • breast cancer
  • lumpectomy
  • registration
  • surgical guidance
  • ultrasound

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging

Cite this

Conley, R. H., Meszoely, I. M., Pheiffer, T. S., Weis, J. A., Yankeelov, T., & Miga, M. I. (2014). Image to physical space registration of supine breast MRI for image guided breast surgery. In Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling [90362N] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 9036). SPIE. https://doi.org/10.1117/12.2043817

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; Miga, Michael I.

Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling. SPIE, 2014. 90362N (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 9036).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Conley, RH, Meszoely, IM, Pheiffer, TS, Weis, JA, Yankeelov, T & Miga, MI 2014, Image to physical space registration of supine breast MRI for image guided breast surgery. in Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling., 90362N, Progress in Biomedical Optics and Imaging - Proceedings of SPIE, vol. 9036, SPIE, Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling, San Diego, CA, United States, 2/18/14. https://doi.org/10.1117/12.2043817
Conley RH, Meszoely IM, Pheiffer TS, Weis JA, Yankeelov T, Miga MI. Image to physical space registration of supine breast MRI for image guided breast surgery. In Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling. SPIE. 2014. 90362N. (Progress in Biomedical Optics and Imaging - Proceedings of SPIE). https://doi.org/10.1117/12.2043817
Conley, Rebekah H. ; Meszoely, Ingrid M. ; Pheiffer, Thomas S. ; Weis, Jared A. ; Yankeelov, Thomas ; Miga, Michael I. / Image to physical space registration of supine breast MRI for image guided breast surgery. Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling. SPIE, 2014. (Progress in Biomedical Optics and Imaging - Proceedings of SPIE).
@inproceedings{3a817d04c55c45ac8360ba9bed76d3e2,
title = "Image to physical space registration of supine breast MRI for image guided breast surgery",
abstract = "Breast conservation therapy (BCT) is a desirable option for many women diagnosed with early stage breast cancer and involves a lumpectomy followed by radiotherapy. However, approximately 50{\%} of eligible women will elect for mastectomy over BCT despite equal survival benefit (provided margins of excised tissue are cancer free) due to uncertainty in outcome with regards to complete excision of cancerous cells, risk of local recurrence, and cosmesis. Determining surgical margins intraoperatively is difficult and achieving negative margins is not as robust as it needs to be, resulting in high re-operation rates and often mastectomy. Magnetic resonance images (MRI) can provide detailed information about tumor margin extents, however diagnostic images are acquired in a fundamentally different patient presentation than that used in surgery. Therefore, the high quality diagnostic MRIs taken in the prone position with pendant breast are not optimal for use in surgical planning/guidance due to the drastic shape change between preoperative images and the common supine surgical position. This work proposes to investigate the value of supine MRI in an effort to localize tumors intraoperatively using image-guidance. Mock intraoperative setups (realistic patient positioning in non-sterile environment) and preoperative imaging data were collected from a patient scheduled for a lumpectomy. The mock intraoperative data included a tracked laser range scan of the patient's breast surface, tracked center points of MR visible fiducials on the patient's breast, and tracked B-mode ultrasound and strain images. The preoperative data included a supine MRI with visible fiducial markers. Fiducial markers localized in the MRI were rigidly registered to their mock intraoperative counterparts using an optically tracked stylus. The root mean square (RMS) fiducial registration error using the tracked markers was 3.4mm. Following registration, the average closest point distance between the MR generated surface nodes and the LRS point cloud was 1.76±0.502 mm.",
keywords = "BCT, MRI, breast cancer, lumpectomy, registration, surgical guidance, ultrasound",
author = "Conley, {Rebekah H.} and Meszoely, {Ingrid M.} and Pheiffer, {Thomas S.} and Weis, {Jared A.} and Thomas Yankeelov and Miga, {Michael I.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1117/12.2043817",
language = "English (US)",
isbn = "9780819498298",
series = "Progress in Biomedical Optics and Imaging - Proceedings of SPIE",
publisher = "SPIE",
booktitle = "Medical Imaging 2014",
address = "United States",

}

TY - GEN

T1 - Image to physical space registration of supine breast MRI for image guided breast surgery

AU - Conley, Rebekah H.

AU - Meszoely, Ingrid M.

AU - Pheiffer, Thomas S.

AU - Weis, Jared A.

AU - Yankeelov, Thomas

AU - Miga, Michael I.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Breast conservation therapy (BCT) is a desirable option for many women diagnosed with early stage breast cancer and involves a lumpectomy followed by radiotherapy. However, approximately 50% of eligible women will elect for mastectomy over BCT despite equal survival benefit (provided margins of excised tissue are cancer free) due to uncertainty in outcome with regards to complete excision of cancerous cells, risk of local recurrence, and cosmesis. Determining surgical margins intraoperatively is difficult and achieving negative margins is not as robust as it needs to be, resulting in high re-operation rates and often mastectomy. Magnetic resonance images (MRI) can provide detailed information about tumor margin extents, however diagnostic images are acquired in a fundamentally different patient presentation than that used in surgery. Therefore, the high quality diagnostic MRIs taken in the prone position with pendant breast are not optimal for use in surgical planning/guidance due to the drastic shape change between preoperative images and the common supine surgical position. This work proposes to investigate the value of supine MRI in an effort to localize tumors intraoperatively using image-guidance. Mock intraoperative setups (realistic patient positioning in non-sterile environment) and preoperative imaging data were collected from a patient scheduled for a lumpectomy. The mock intraoperative data included a tracked laser range scan of the patient's breast surface, tracked center points of MR visible fiducials on the patient's breast, and tracked B-mode ultrasound and strain images. The preoperative data included a supine MRI with visible fiducial markers. Fiducial markers localized in the MRI were rigidly registered to their mock intraoperative counterparts using an optically tracked stylus. The root mean square (RMS) fiducial registration error using the tracked markers was 3.4mm. Following registration, the average closest point distance between the MR generated surface nodes and the LRS point cloud was 1.76±0.502 mm.

AB - Breast conservation therapy (BCT) is a desirable option for many women diagnosed with early stage breast cancer and involves a lumpectomy followed by radiotherapy. However, approximately 50% of eligible women will elect for mastectomy over BCT despite equal survival benefit (provided margins of excised tissue are cancer free) due to uncertainty in outcome with regards to complete excision of cancerous cells, risk of local recurrence, and cosmesis. Determining surgical margins intraoperatively is difficult and achieving negative margins is not as robust as it needs to be, resulting in high re-operation rates and often mastectomy. Magnetic resonance images (MRI) can provide detailed information about tumor margin extents, however diagnostic images are acquired in a fundamentally different patient presentation than that used in surgery. Therefore, the high quality diagnostic MRIs taken in the prone position with pendant breast are not optimal for use in surgical planning/guidance due to the drastic shape change between preoperative images and the common supine surgical position. This work proposes to investigate the value of supine MRI in an effort to localize tumors intraoperatively using image-guidance. Mock intraoperative setups (realistic patient positioning in non-sterile environment) and preoperative imaging data were collected from a patient scheduled for a lumpectomy. The mock intraoperative data included a tracked laser range scan of the patient's breast surface, tracked center points of MR visible fiducials on the patient's breast, and tracked B-mode ultrasound and strain images. The preoperative data included a supine MRI with visible fiducial markers. Fiducial markers localized in the MRI were rigidly registered to their mock intraoperative counterparts using an optically tracked stylus. The root mean square (RMS) fiducial registration error using the tracked markers was 3.4mm. Following registration, the average closest point distance between the MR generated surface nodes and the LRS point cloud was 1.76±0.502 mm.

KW - BCT

KW - MRI

KW - breast cancer

KW - lumpectomy

KW - registration

KW - surgical guidance

KW - ultrasound

UR - http://www.scopus.com/inward/record.url?scp=84902176365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902176365&partnerID=8YFLogxK

U2 - 10.1117/12.2043817

DO - 10.1117/12.2043817

M3 - Conference contribution

AN - SCOPUS:84902176365

SN - 9780819498298

T3 - Progress in Biomedical Optics and Imaging - Proceedings of SPIE

BT - Medical Imaging 2014

PB - SPIE

ER -