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Dual modality surgical guidance of 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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摘要

Although breast conserving therapy has some advantages over the traditional mastectomy procedure, the biggest disadvantage is the chance of local re-occurrence in which a second surgery is often required. Adequate surgical removal of breast tumors requires accurate tumor localization in order to ensure a balance between optimal cosmetic results and minimization of the risk for local re-occurrence. These challenges have motivated the search for alternative, more accurate methods for intraoperative localization of non-palpable breast lesions. The overall goal of this project was to develop an innovative technique for radioguided localization of non-palpable breast lesions that is more accurate, easier for the breast surgeon, and more comfortable for the patient than the current practice of wire localization.;The technique uses a dual modality breast imaging system to place a marker composed of radiolabeled albumin (99mTc-MAA or 111ln-MAA) into the lesion. Preliminary studies were made to evaluate the localization accuracy of the system, which showed that the dual modality breast scanner is capable of accurate 3-dimensional localization using either X-ray or gamma ray imaging. A 3-axis needle positioning system was built and integrated into the dual modality breast scanner and its accuracy tested. A pilot clinical trial to evaluate the dual-modality surgical guidance technique was designed and preliminary clinical data collected. Detailed results were presented on the first three subjects; although a total of seven subjects have been recruited to the study to date. So far, it has been demonstrated that the radioguided surgery technique can be performed with approximately 10 times less radiomarker activity than is currently being used by other researchers employing 99mTc-MAA as a radiomarker, while maintaining comparable localization accuracy.;Although the DMSG technique has not been tested in a large cohort of subjects, the preliminary data on the first few are encouraging. Feedback on the technique from the surgeons, for this limited population, has been positive. Recruitment to the study is ongoing.
机译：尽管保留乳房的疗法比传统的乳房切除术有一些优势，但是最大的缺点是局部复发的机会，通常需要再次手术。为了保证最佳的美容效果和最小化局部复发的风险之间的平衡，对乳房肿瘤进行适当的手术切除需要精确的肿瘤定位。这些挑战促使人们寻求其他更准确的术中不可触及乳腺病变的定位方法。该项目的总体目标是开发一种创新技术，用于对无法触及的乳腺病变进行放射性引导定位，与当前的导线定位实践相比，该技术更加准确，对乳腺外科医生更容易并使患者更舒适。双模态乳房成像系统，将由放射性标记的白蛋白（99mTc-MAA或111ln-MAA）组成的标记物置于病变部位。进行了初步研究以评估系统的定位精度，结果表明，双模态乳房扫描仪能够使用X射线或伽马射线成像进行精确的3维定位。内置了三轴针定位系统，并将其集成到双模态乳房扫描仪中，并对其准确性进行了测试。设计了评估双模式手术指导技术的临床试验试验，并收集了初步临床数据。在前三个主题中给出了详细的结果。到目前为止，尽管已招募了七个受试者。到目前为止，已经证明，与其他采用99mTc-MAA作为放射性标记物的研究人员目前使用的放射性标记物活性相比，可以在保持相当的定位精度的同时进行放射性引导手术技术，其放射性标记物活性大约要低10倍。尚未在大量受试者中进行测试，因此前几个方面的初步数据令人鼓舞。对于这一有限的人群，外科医生对此技术的反馈是积极的。这项研究的招募正在进行中。

著录项

  • 作者

    Judy, Patricia Goodale.;

  • 作者单位

    University of Virginia.;

  • 授予单位 University of Virginia.;
  • 学科 Engineering Biomedical.;Physics Radiation.;Health Sciences Surgery.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 222 p.
  • 总页数 222
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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