Towards tracking breast cancer across medical images using subject-specific biomechanical models

Breast cancer detection, diagnosis and treatment increasingly involves images of the breast taken with different degrees of breast deformation. We introduce a new biomechanical modelling framework for predicting breast deformation and thus aiding the combination of information derived from the various images. In this paper, we focus on MR images of the breast under different loading conditions, and consider methods to map information between the images. We generate subject-specific finite element models of the breast by semi-automatically fitting geometrical models to segmented data from breast MR images, and characterizing the subject-specific mechanical properties of the breast tissues. We identified the unloaded reference configuration of the breast by acquiring MR images of the breast under neutral buoyancy (immersed in water). Such imaging is clearly not practical in the clinical setting, however this previously unavailable data provides us with important data with which to validate models of breast biomechanics, and provides a common configuration with which to refer and interpret all breast images. We demonstrate our modelling framework using a pilot study that was conducted to assess the mechanical performance of a subject-specific homogeneous biomechanical model in predicting deformations of the breast of a volunteer in a prone gravity-loaded configuration. The model captured the gross characteristics of the breast deformation with an RMS error of 4.2 mm in predicting the skin surface of the gravity-loaded shape, which included tissue displacements of over 20 mm. Internal tissue features identified from the MR images were tracked from the reference state to the prone gravity-loaded configuration with a mean error of 3.7 mm. We consider the modelling assumptions and discuss how the framework could be refined in order to further improve the tissue tracking accuracy.