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首页> 外文学位 >Coregistration of serial breast MR studies for augmenting neoadjuvant chemotherapy response evaluation in breast cancer patients.
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Coregistration of serial breast MR studies for augmenting neoadjuvant chemotherapy response evaluation in breast cancer patients.

机译：增强乳腺癌患者新系列辅助化疗反应评估的系列乳房MR研究的核心。

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Neoadjuvant chemotherapy (NAC) is gaining popularity as an important part of breast conservation surgery in breast cancer patients and MRI is the primary modality of choice for predicting residual disease after therapy. By comparing residual tumor sizes in the follow-up (F/U) MR scans with the pre-treatment tumor size from baseline (B/L) scan, weighted decisions can be made regarding appropriate changes to the chemo regimen or effectiveness of the treatment for the particular patient. But due to the deformable nature of the breast, its shape in breast MR acquisitions of the same patient in different studies (taken 2-4 weeks from baseline study) is significantly different. Thus, the exact correspondence between the B/L and F/U scans is lost. In the presence of multi-centric or multi-focal breast cancer, an objective evaluation of tumor regression may be challenging. Also, inflammation due to treatment, i.e. mastitis, is a common occurrence and may be misdiagnosed as residual disease. Transporting the clinical results of neoadjuvant chemotherapy to the operating table is also arduous. Clinical evaluation using MR is done when the patient is in the prone position, while in the operating room, the patient is lying on her back, in the supine position. The obvious difference in both coordinate frames combined with the elastic nature of the breast makes the transition a challenging problem.; In this dissertation, we proposed a registration framework to augment quantitative assessment of patient response to NAC. By estimating the motion between consecutive temporal volumes of the patient, the precise location of the B/L tumor in the F/U scan can be determined. For this, we use image-based volumetric approaches that address boundary mapping as well as internal mapping. An important criteria involving tumor volume preservation was also incorporated to avoid tumor scaling due to non-rigid transformations which may convey a false sense of positive or negative response to chemotherapy. Another framework for registration of prone and supine datasets is also outlined. The registration framework has been successfully tested against well-calibrated phantoms and synthetic images and diverse patient data reflecting typical clinical scenarios.
机译：新辅助化疗（NAC）作为乳腺癌患者乳房保护手术的重要组成部分而日益普及，而MRI是预测治疗后残留疾病的主要选择方式。通过将后续（F / U）MR扫描中的残留肿瘤大小与基线（B / L）扫描中的治疗前肿瘤大小进行比较，可以对化学疗法的适当改变或治疗效果做出加权决策针对特定患者。但是由于乳房的可变形性，在不同研究（距基线研究2-4周）中同一患者的乳房MR采集中其形状明显不同。因此，丢失了B / L和F / U扫描之间的确切对应关系。在存在多中心或多灶性乳腺癌的情况下，对肿瘤消退的客观评估可能具有挑战性。另外，由于治疗引起的炎症即乳腺炎是常见的现象，并且可能被误诊为残留疾病。将新辅助化疗的临床结果运送到手术台也很艰巨。当患者处于俯卧位置时，使用MR进行临床评估，而在手术室中，患者仰卧时仰卧。两个坐标系的明显差异加上乳房的弹性使过渡成为一个具有挑战性的问题。在本文中，我们提出了一个注册框架，以增强对NAC患者反应的定量评估。通过估计患者连续时间量之间的运动，可以确定B / L肿瘤在F / U扫描中的精确位置。为此，我们使用基于图像的体积方法来处理边界映射以及内部映射。还纳入了涉及肿瘤体积保存的重要标准，以避免由于非刚性转化而引起的肿瘤扩大，这可能传达对化学疗法的阳性或阴性反应的错误感觉。还概述了俯卧和仰卧数据集注册的另一个框架。该注册框架已针对经过良好校准的体模和合成图像以及反映典型临床情况的各种患者数据进行了成功测试。

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