Enhanced Biomechanical Modeling of the Breast for Womens Health

由于乳房的生物力学建模对于预测多模态肿瘤位置不可或缺， 诊断成像和手术期间，手术计划，为医生和患者生成模拟 教育，胸罩和服装设计的最佳乳房支持，在模型准确性的进步有 有可能显著改善妇女的健康和生活质量。尽管乳房的使用越来越多， 生物力学模型的不同应用，有持续的知识差距，在这两个解剖和 生物力学文献，阻止开发和部署准确的模型，以患者特定 应用.在诊断成像和手术中跟踪癌症需要精确的生物力学模型。 然而，生物力学模型的准确性对用于测量的几何和结构特征敏感， 描述了用于描述组织行为的解剖学特征和组成参数。 例如，各种乳房组织特性的刚度的微小改变可以通过以下方式使组织移位： 因此，彻底表征个体乳房结构的组成性质， 是获得组织运动的精确预测所必需的。此外，在缺乏准确知识的情况下， 的解剖几何和结构特征，生物力学模型已放置了过分强调的， 乳房组织的组成参数。 我们研究的长期目标是开发一个准确的乳房生物力学模型， 将乳房建模的应用转换为人群模型和患者特定应用。我们 愿景是改进模型，使其成为诊断和管理的可靠和有用的工具， 乳腺癌，外科医生教育和培训，患者教育，以更好地共同决策，以及服装 设计，特别是在乳房切除术后的恢复期。 我们目前的人类乳腺组织生物力学模型代表了最先进的技术水平，因为它是基于 实际的3D分析。然而，这是第一步，因为临床翻译仍然受到不足的限制， 筋膜支持系统的结构和生物力学特性及其 与更广泛人群中脂肪和腺体乳房结构的关系。因此，我们假设， 生物力学模型的准确性可以通过确定解剖学和生物力学 乳房筋膜支持系统的特点，了解患者特异性 参数，并验证这些模型的翻译，其固有的 不确定性，进入患者特定环境。我们的多学科乳房再造外科医生团队， 工程师、医学物理学家和病理学家都是独一无二的，他们准备进行这项创新研究， 开发一个高保真的人类乳房生物力学模型，能够再现其 行为，无论是在一般意义上还是在患者的具体意义上。

As biomechanical modeling of the breast is integral to predicting tumor location across multimodal diagnostic imaging and during surgery, surgical planning, generating simulations for physician and patient education, and brassiere and clothing design for optimal breast support, advances in model accuracy have the potential to significantly improve women's health and quality of life. Despite the growing use of breast biomechanical models for different applications, there are persistent knowledge gaps in both the anatomical and biomechanical literature that prevent an accurate model from being developed and deployed to patient-specific applications. Accurate biomechanical models are needed for tracking cancer in diagnostic imaging and surgery. However, the accuracy of biomechanical models is sensitive to the geometrical and structural features used to describe the anatomical features and the constitutive parameters used to describe the behavior of the tissues. For example, small alterations in the stiffness of the various breast tissue properties can displace tissues by more than 10 mm. Thus, thorough characterization of the constitutive properties of individual breast structures are necessary to obtain precise predictions of tissue motion. Furthermore, in the absence of precise knowledge of anatomical geometrical and structural features, biomechanical models have placed an overemphasis on the constitutive parameters of the breast tissue. The long-term goal of our research is to develop an accurate biomechanical model of the breast that transforms the applications of breast modeling for both population models and patient-specific applications. Our vision is to improve the model so that it becomes a reliable and useful tool in the diagnosis and management of breast cancer, surgeon education and training, patient education for better shared decision making, and clothing design, especially in the post mastectomy recovery period. Our present human breast tissue biomechanical model represents the state of the art, as it is based on actual 3D analyses. However, it represents a first step, as clinical translation remains limited by insufficient information about the structural and biomechanical characteristics of the fascial support system and its relationship to the adipose and glandular breast structures in the broader population. Thus, we hypothesize that the accuracy of the biomechanical model may be improved by determining the anatomical and biomechanical characteristics of the fascial support system of the breast, understanding the sensitivity of the patient-specific parameters across the population, and validating the translation of these models, with their inherent uncertainties, into the patient-specific setting. Our multi-disciplinary team of breast reconstructive surgeons, engineers, medical physicists, and pathologists are uniquely poised to perform this innovative research leading to the development of a high-fidelity biomechanical model of the human breast that is capable of reproducing its behavior, both in general and in a patient specific sense.