3D Breast Anatomy Analysis in Cancer Treatment Planning and Outcome Assessment

描述(申请人提供)：乳腺癌是美国女性癌症死亡的第二大原因。乳房重建(BR)手术是乳腺癌治疗过程中的重要组成部分。这是一种外科手术，用于重建因癌症手术而被切除的乳房组织。最重要的是，BR手术对于提高癌症患者的生活质量是不可或缺的。然而，手术的计划和评估都是主观的，结果并不总是令人满意的。我们建议开发工具，帮助外科医生进行术前计划和术后结果评估。他们还将通过促进外科医生和患者的沟通，帮助乳腺癌幸存者做出关于他们治疗选择的明智决定。客观的结果分析将允许与患者进行更具体的沟通，然后患者可以调整她的期望，并对她的治疗选择更满意。乳房外观(或缺失)的改变对癌症患者具有重大的心理和性影响。最近经历了与诊断和治疗危及生命的疾病相关的创伤和压力，患者希望减轻一些压力，重建积极的身体形象。他们希望得到一个吸引人、看起来自然的BR效果。大多数选择BR的女性这样做是为了恢复她们的女性气质、形象和身体完整性，所有这些都在乳腺癌治疗后发生了负面改变。然而，从客观的美学结果分析中还没有任何信息可以帮助患者做出决定，这将永久地改变她的乳房外观。BR的标准在过去十年中发生了变化，患者和外科医生都希望拥有对称和自然的乳房。外科医生依靠他们的个人经验和主观的视觉评估技能来实现这些结果。同样，手术后的美学结果评估方法是相当主观的，并且基于观察者对乳房形态和对称性的物理变化的评估。到目前为止，对于如何评价BR术后的美学效果还没有达成共识。随着三维(3D)成像的最新发展，现在有机会开发诊断工具，使3D治疗计划和术后结果的客观评估成为可能。这项拟议的研究开发了一种定量描述乳房美学的方法。该方法将客观地检测乳房外观的相关变化，从而可以比较不同治疗方式之间的美学结果。一种实用的乳房外观定量评估技术将在几个方面改善乳腺癌的护理。主要应用包括实现个性化、循证医学、外科计划、设定公平收费和外科教育。乳腺癌是女性最常见的威胁生命的恶性肿瘤。尽管1990至2002年间，美国的乳腺癌发病率稳步上升，但治疗的进步和早期发现降低了乳腺癌的死亡率。在这一趋势和其他进展证据的鼓舞下，国家癌症研究所(NCI)发布了一个挑战目标，到2015年消除癌症带来的痛苦和死亡。要实现妇女的这一目标，就需要解决因癌症治疗导致的乳房身体畸形引起的心理社会发病率问题。减少与治疗相关的畸形的一个重要步骤是改进乳房重建的外科技术。因此，开发用于评估BR美学效果的量化工具是朝着正确方向迈出的重要一步。这项第一阶段研究的目标是开发软件工具，帮助外科医生以有意义和临床相关的方式量化和解释3D数据。3D测量对于将患者和手术变量与美学结果有意义地联系起来，以及比较不同类型乳腺癌治疗的结果(例如，不同的重建程序)也是非常宝贵的。

DESCRIPTION (provided by applicant): Breast cancer is the second leading cause of cancer death in American women. Breast Reconstruction (BR) surgery is an important component of the breast cancer treatment process. It is the surgical procedure used to rebuild breast tissue that has been removed due to cancer surgery. Most importantly, BR surgery is integral to improving the cancer patient's quality of life. However, planning and evaluation of the surgery are done subjectively, and the result is not always satisfactory. We propose to develop tools that will aid surgeons with pre-operative planning and post-operative outcome evaluation. They will also help breast cancer survivors make informed decisions about their treatment choices, by facilitating surgeon-patient communications. Objective outcome analysis will allow more concrete communication with the patient, who can then calibrate her expectations and be more comfortable with her treatment choices. Alterations in appearance (or loss) of the breast have significant psychological and sexual implications in cancer patients. Having recently experienced the trauma and stress associated with the diagnosis and treatment of a life-threatening illness, patients hope to relieve some of the stress and rebuild a positive body image. They hope to achieve a BR result that is attractive and natural looking. Most women who choose BR do so to restore their femininity, image, and body integrity, all of which have been altered negatively by breast cancer therapy. However, there is no information available from an objective analysis of aesthetic outcomes to facilitate the patient's decision making on a procedure that will permanently alter the appearance of her breast. Standards for BR have evolved in the past decade, and patients and surgeons alike expect, symmetrical and natural looking breasts. Surgeons rely on their personal experience and on subjective visual assessment skills to achieve these results. Similarly, aesthetic outcome assessment methods, following surgery, are rather subjective, and are based on observer evaluation of physical changes in breast morphology and symmetry. To date, no consensus exists on how to assess the aesthetic result following BR. With the recent developments in three-dimensional (3D) imaging, there is now an opportunity to develop diagnostic tools that permit 3D treatment planning and objective assessment of post-operative results. The proposed study develops a method for quantitatively describing breast aesthetics. The method will objectively detect relevant changes in breast appearance, making it possible to compare aesthetic outcome between different treatment modalities. A practical technique for quantitative assessment of breast appearance would improve breast cancer care in several ways. Key applications include enabling personalized, evidence-based medicine, surgical planning, setting fair charges, and surgery education. Breast cancer is the most common life-threatening malignancy in women. Treatment advances and early detection have resulted in decreased mortality from breast cancer despite a steadily rising incidence in the United States between 1990 and 2002. Encouraged by this trend and other evidence of progress, the National Cancer Institute (NCI) has issued a challenge goal to eliminate suffering and death from cancer by the year 2015. Achieving this goal for women requires addressing the psychosocial morbidity caused by physical deformities of the breast that result from cancer treatment. A major step towards minimizing treatment-related deformities is to improve the surgical techniques of breast reconstruction. Developing quantitative tools for assessing the aesthetic outcome of BR is thus a significant step in the right direction. The goal of this Phase I study is to develop software tools that would aid the surgeon in quantifying and interpreting 3D data in a meaningful and clinically relevant fashion. 3D measurements would also be invaluable for relating patient and surgical variables meaningfully to aesthetic outcomes, and for comparing the outcomes of different kinds of breast cancer treatments (e.g., different reconstruction procedures).