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Dual Modality Surgical Guidance for Non-palpable Breast Lesions

机译:不可触及的乳腺病变的双模式手术指导

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Currently, the majority of lumpectomy and excisional biopsy procedures are performed using the wire localization (WL) technique; however, this technique suffers from several drawbacks including inaccuracy in placement of the wire, possible displacement of the wire prior to surgery, and ambiguity of the lesion's location along the wire. We propose dual modality surgical guidance (DMSG) as a means to overcome many of the problems associated with WL. The approach uses a dual modality (digital mammography and breast scintigraphy) breast imaging system developed in our lab to place a small radioactive marker (a radiomarker), directly into the lesion. Here we present the results of measurements of the localization and injection accuracy of our system. The localization accuracy, evaluated by determining the difference between the known and measured inter-well separations, were within 0.76 mm (standard deviation of 0.46 mm) of the true distances for x-ray imaging and within 0.66 mm (standard deviation of 0.43) for gamma imaging. Our maximum error in injection accuracy in any of the three Cartesian coordinates was 1.8 mm. On average, the errors were 0.6, 0.4, and 0.9 mm for x, y, and z respectively. The results of these phantom tests provide encouragement that our upright digital mammography unit can accurately a) locate a lesion in three dimensions, b) inject a radiomarker into the lesion, and c) assess the offset between the lesion and radiomarker centers.
机译:目前,大多数的肿块切除术和切除活检术都是使用线材定位(WL)技术进行的;然而,该技术具有若干缺点,包括线的放置不准确,手术前线的可能移位以及病变沿着线的位置的歧义性。我们提出双模式外科手术指导(DMSG)作为克服与WL相关的许多问题的一种手段。该方法使用了在我们实验室中开发的双模态(数字乳房X线照相术和乳房闪烁闪烁照相术)乳房成像系统,可以将小的放射性标记物(放射性标记物)直接放置在病变部位。在这里,我们介绍了系统定位和注入精度的测量结果。通过确定已知孔间距与测量孔间距之间的差异评估的定位精度,对于X射线成像,其真实距离在0.76毫米(标准偏差为0.46毫米)之内;对于X射线成像,其精确度在0.66毫米(标准偏差为0.43)之内。伽玛成像。在三个笛卡尔坐标系中,我们的最大注射精度误差为1.8毫米。平均而言,x,y和z的误差分别为0.6、0.4和0.9 mm。这些体模测试的结果令人鼓舞,我们的立式数字乳房X线照相设备可以准确地a)在三个维度上定位病变,b)在病变中注入放射性标记,以及c)评估病变与放射性标记中心之间的偏移。

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