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Objective:
Wire localization for breast conserving surgeries is an inefficient and imprecise technique; therefore, a reliable non-invasive alternative is sought. We investigated a novel method of image registration that combines preoperative supine breast MRIs with 3D optical scans of the breast surface; we determined whether this method provides the surgeon with accurate information on tumor shape and location at the time of surgery.
Design:
Prospective cohort.
Setting:
Academic medical center.
Patients:
Eighteen patients with palpable invasive breast cancers.
Interventions:
All patients underwent pre-operative supine MRI and intra-operative optical scanning of the breast. The surface projection of the palpable tumor edge was marked on the skin.
Main Outcome Measures:
The main outcome measure was the distance between the projected and palpated locations of the medial, lateral, cranial, and inferior edges of the tumor.
Results:
The average distance between the palpated and imaged tumor edge locations was 0.72 cm (range 0 -1.9 cm). Accuracy improved over time; the average difference in edge locations in the last 7 patients was 0.40 cm (range 0 - 1.2 cm). All four image predicted edge locations in the last 5 patients were less than 1 cm away from the palpated locations.
Conclusions:
We have successfully developed a method of tumor localization for breast conserving surgeries that utilizes preoperative supine MRI and intraoperative optical scanning of the breast. This process involves image acquisition, analysis, and volumetric registration, combined with visualization software to communicate the tumor location to the surgeon. Results from the eighteen patients imaged demonstrate that our method of localization in a surgical setting is both feasible and accurate.