A pilot multi-institutional study to evaluate the accuracy of a supine MRI based guidance system, the Breast Cancer Locator™, in patients with palpable breast cancer.

BACKGROUND: Evaluate whether the Breast Cancer Locator™ (BCL), a novel guidance system based on supine MRI images, can be safely and effectively deployed by several surgeons at multiple sites. METHODS: Patients with palpable breast cancer underwent supine MRI at their local institution. A three dimensional (3D) digital image of the tumor in the breast was derived from supine MRI images and used to generate 1) an interactive 3D virtual image of the tumor in the breast (Visualizer) and 2) a plastic bra-like form that allowed the surgeon to place a central wire and bracketing wires in the breast (BCL). The primary objective was to determine the proportion of patients who had the central localization wire deployed within the cancer on specimen mammogram. RESULTS: Fourteen patients were enrolled at 4 different sites by 6 surgeons. BCLs were successfully manufactured for all patients. The central wire was deployed within the tumor on specimen mammogram in 12 of the 13 patients who had a central wire placed (92%). The cancer was excised with negative margins in 14/14 cases (100%). No adverse events occurred. CONCLUSIONS: Supine MRI image acquisition was accomplished successfully across multiple sites. Multiple surgeons utilized the BCL system to localize cancers accurately and safely.

A dynamic mechanical analysis technique for porous media.

Dynamic mechanical analysis (DMA) is a common way to measure the mechanical properties of materials as functions of frequency. Traditionally, a viscoelastic mechanical model is applied and current DMA techniques fit an analytical approximation to measured dynamic motion data by neglecting inertial forces and adding empirical correction factors to account for transverse boundary displacements. Here, a finite-element (FE) approach to processing DMA data was developed to estimate poroelastic material properties. Frequency-dependent inertial forces, which are significant in soft media and often neglected in DMA, were included in the FE model. The technique applies a constitutive relation to the DMA measurements and exploits a nonlinear inversion to estimate the material properties in the model that best fit the model response to the DMA data. A viscoelastic version of this approach was developed to validate the approach by comparing complex modulus estimates to the direct DMA results. Both analytical and FE poroelastic models were also developed to explore their behavior in the DMA testing environment. All of the models were applied to tofu as a representative soft poroelastic material that is a common phantom in elastography imaging studies. Five samples of three different stiffnesses were tested from 1-14 Hz with rough platens placed on the top and bottom surfaces of the material specimen under test to restrict transverse displacements and promote fluid-solid interaction. The viscoelastic models were identical in the static case, and nearly the same at frequency with inertial forces accounting for some of the discrepancy. The poroelastic analytical method was not sufficient when the relevant physical boundary constraints were applied, whereas the poroelastic FE approach produced high quality estimates of shear modulus and hydraulic conductivity. These results illustrated appropriate shear modulus contrast between tofu samples and yielded a consistent contrast in hydraulic conductivity as well.