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

描述（由申请人提供）：我们的目标是设计一个决策支持系统，以帮助乳腺癌幸存者了解乳房重建后可能出现的外观变化，因此，使他们能够选择一种重建策略，这将导致最大的心理社会调整。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所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，我们必须在生物力学、图像处理和外科手术等学科上取得根本性的进展。因此，我们的具体目标是：（1）设计可以从人体躯干的3D表面扫描自动计算的乳房形态和外观变化的客观和定量测量。虽然已经提出了许多人体测量（如距离），但没有彻底改变手术计划或评估，我们将创建在先前工作中基本上被忽略的特性（如曲率）的测量，并且我们将开发能够实现全自动分析的算法（即，通过自动定位基准点，即，解剖学标志，例如乳头、胸骨切迹等）。(2)开发人体乳房的机械模型，该模型以物理学为基础，并使用人体组织材料特性的实验测量和一些重建手术中使用的生物相容性材料进行参数化。这些模型将产生手术后外观的现实预测，包括患者姿势的变化，这不能通过简单的变形策略来实现，因为这些策略不能考虑人体的自然约束。(3)开发一个原型患者决策支持系统，为乳腺癌幸存者提供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，可以帮助人们考虑多种标准，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与其医疗团队之间的沟通，使患者能够校准其期望，并对治疗选择更加满意。系统设计将基于我们的乳房形态测量值与患者特征、手术变量和由此产生的身体图像不满意度之间的统计关系。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。如果该项目成功，未来的研究将设计用于评估决策支持系统在乳腺癌幸存者使用时的影响。

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.