3-D Computer Modeling for Optimizing Body Image following Breast Reconstruction

描述(申请人提供)：我们的目标是设计一个决策支持系统，帮助乳腺癌幸存者了解乳房重建后可能出现的外观变化，从而使他们能够选择能够导致最大心理社会适应的重建策略。我们的决策支持系统将采用最先进的3D建模和可视化技术，并将建立在对乳腺癌幸存者面临的复杂身体图像考虑的复杂理解的基础上。为了实现我们的目标，我们必须取得跨越生物力学、图像处理和外科的根本性进展。因此，我们的具体目标是：(1)设计客观和定量的乳房形态和外观变化的测量方法，可以根据人体躯干的3D表面扫描自动计算出来。虽然已经提出了许多人体测量方法(如距离)，但没有革命性地进行手术规划或评估，我们将创建曲率等特性的测量，这些特性在以前的工作中基本上被忽略，我们将开发能够实现全自动分析的算法(即，通过基准点的自动定位，即，解剖标志，如乳头、胸骨切迹等)。(2)建立以物理为基础的人体乳房力学模型，并通过实验测量人体组织和某些重建手术中使用的生物相容材料的材料特性，将其参数化。这些模型将产生手术后外观的真实预测，包括随患者姿势的变化，这不能通过未能考虑到人体形状的自然约束的简单变形策略来实现。(3)开发一个原型患者决策支持系统，为乳腺癌幸存者提供有关乳房重建后可能出现的外观变化的个性化信息。决策支持系统是一种复杂的工具，它帮助人们考虑多个标准，以便从备选方案中做出选择。基于个性化模拟和测量的决策支持系统将促进患者和她的医疗团队之间的沟通，使患者能够校准她的期望，并对她的治疗选择更加满意。该系统的设计将基于我们的乳房形态测量与患者特征、手术变量以及由此产生的身体形象不满之间的统计关系。在拟议的研究中，原型决策支持系统将根据医疗保健专业人员的测试进行评估和改进。如果这个项目成功，未来的研究将被设计用来评估决策支持系统在乳腺癌幸存者使用时的影响。 公共卫生相关性：我们的目标是设计一种计算机系统，帮助乳腺癌幸存者了解乳房重建后可能出现的外观变化，从而使他们能够选择能够导致最大心理社会适应的重建策略。

DESCRIPTION (provided by applicant): Our goal is to design a decision support system to help breast cancer survivors understand their likely appearance changes following breast reconstruction and, therefore, enable them to choose a reconstruction strategy that will lead to maximal psychosocial adjustment. Our decision support system will employ state of the art 3D modeling and visualization technologies and will be founded on a sophisticated understanding of the complex body image considerations faced by breast cancer survivors. To achieve our goal, we must make fundamental advances that cross the disciplines of biomechanics, image processing, and surgery. Thus, our specific aims are: (1) To design objective and quantitative measures of breast morphology and appearance change that can be automatically computed from 3D surface scans of the human torso. While numerous anthropometric measures (such as distances) have been proposed without revolutionizing surgical planning or assessment, we will create measures of properties such as curvature that have been largely ignored in prior work and we will develop algorithms that will enable fully automated analyses (i.e., through automatic localization of fiducial points, i.e., anatomical landmarks such as nipples, sternal notch, etc.). (2) To develop mechanistic models of the human breast which are grounded in physics and parameterized using experimental measurements of the material properties of human tissues and biocompatible materials used in some reconstructive surgeries. These models will produce realistic predictions of post-operative appearance, including variation with patient pose, which cannot be achieved by simplistic morphing strategies that fail to account for natural constraints on the human form. (3) To develop a prototype patient decision support system that will provide breast cancer survivors with personalized information regarding their probable appearance changes following breast reconstruction. A decision support system is a sophisticated tool that helps a person considers multiple criteria in order to make a choice from among alternatives. A decision support system based on personalized simulations and measurements will facilitate communication between the patient and her healthcare team, allowing the patient to calibrate her expectations and be more comfortable with her treatment choices. The system design will be based on statistical relationships between our measures of breast morphology and patient characteristics, surgical variables, and resulting body image dissatisfaction. In the proposed study, the prototype decision support system will be evaluated and refined based on testing by healthcare professionals. If this project is successful, future studies would be designed to assess the impact of the decision support system when used by breast cancer survivors. PUBLIC HEALTH RELEVANCE: Our goal is to design a computer system that will assist breast cancer survivors in understanding their likely appearance changes following breast reconstruction and, therefore, enable them to choose a reconstruction strategy that will lead to maximal psychosocial adjustment.