MRI Guided Magnetic Nanoparticle Based Drug Delivery for ...
MRI Guided Mixed Reality for Breast Conserving Surgery...
Transcript of MRI Guided Mixed Reality for Breast Conserving Surgery...
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MRI Guided Mixed Reality for Breast Conserving Surgery - Preliminary Setup
Suba Srinivasan Mentors: Brian A. Hargreaves and Bruce L. Daniel
Amanda J. Wheeler
M E D I C I N E
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Breast Conserving Surgery - Lumpectomy• Early stage breast cancer treatment
• removal of abnormal or cancerous tissue with an extra margin
• followed by radiation therapy to reduce recurrence of breast cancer
• lumpectomy is shown to be as effective as mastectomy while maintaining the appearance of the breast
http://www.surgery.usc.edu/
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Cons - Lumpectomy
normal tissue edge
cancer cells
normal tissue
Negative margin
Positive margin
edgecancer cells
http://www.clrcut.com/
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Cons - Lumpectomy
• Database of 316,114 patients with Stage 0 to II breast cancer
• 23.6% of lumpectomy patients underwent a second surgery
• Adds cost and anxiety, delays adjuvant therapy and reduces cosmesis
cancer cells
normal tissue edge
cancer cells
normal tissue
Negative Positive
edge
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Cons - Lumpectomy• 37.9% of repeat surgeries were completion mastectomy
• 56.4% of the tumors in these completion mastecomy patients had < 2 cm tumors
• This is about 5600 avoidable mastectomies/yr
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Current Breast Imaging Techniques
13 mm cluster of microcalcifications
6 mm IDC, 8mm IDC and 40 mm
DCIS
http://www.cancer.gov/
Mam
mog
raph
y
http://weill.cornell.edu/mri/MRI/Chest/breast_mass_mri.htm
MRI
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Wire LocalizationPre-localization Post-localization
• removed 4mm IDC • 30 mm DCIS • close margins • mastectomy • 3mm DCIS at biopsy site
for non-palpable tumors
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Goal
To enable surgeons to do more definitive surgeries by
• acquiring MR images in close to surgical position - supine instead of prone breast MRI
• Projecting these MR images on to the patient for surgical planning
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Prone vs. Supine Breast MRI
Pro
ne M
RI
Sup
ine
MR
I
Pron
eSu
pine
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Microsoft Hololens
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Hololens - Mixed Reality
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MR Markers for Registration
3D M
RI
Jung Hwa Bae & Chris Ploch Dept. of Mechanical Engineering
Kevin Kennedy, Microsoft
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Phantom MRI Data
https://wiki.cancerimagingarchive.net/display/Public/QIN+Breast+DCE-MRI
Patie
nt M
RI
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Deformable RegistrationAf
ter
MRI mask
Phantom-mask
Befo
re
https://www.slicer.org/
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SegmentationTumor
SkinChest
Warped dataset
http://www.itksnap.org/
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Next steps• How accurately do we
perceive these ‘holograms’?
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Next steps• Experiments in normal volunteers
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AcknowledgmentsMicrosoft
Lewey Geselowitz Kevin Kennedy
Peter Vale Kevin Collins
Department of Mechanical Engineering
Jung Hwa Bae Chris Joseph Ploch
Mark Cutkosky
Brady Quist Steffi Perkins Hans Weber
Riccardo Stara