Intraoperative navigation for breast cancer surgery using 3D ultrasound images

The aim of this work was to develop an intraoperative image-guidance system for breast cancer surgery using three-dimensional (3D) ultrasound imaging. Using a 10-MHz annular array mechanical sector probe, ultrasound images were obtained from nine volunteer patients with breast cancer immediately before removal of the tumor in the operating room. A 3D tumor image was reconstructed using a workstation, then superimposed on the video image of the breast based on geometrical data. These data were obtained simultaneously by an optical 3D position sensor. The 3D images of the tumors were validated by the pathological data obtained after the surgery. In eight cases, the superimposed images were successfully obtained in approximately 15-20 min following scanning of the tumor. Scattered lesions around the main tumor were also visualized in the reconstructed tumor images, but artifacts of the ductal lesion caused by noise could not be eliminated in some cases. This system should be very effective in helping the surgeon to recognize the extent of a tumor within the breast itself and to determine the margin of surgical resection for breast conservation surgery.