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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
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Real-time wireless tumor tracking during breast conserving surgery.

Natasja Janssen1, Roeland Eppenga2, Marie-Jeanne Vrancken Peeters2

  • 1Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

International Journal of Computer Assisted Radiology and Surgery
|November 15, 2017
PubMed
Summary
This summary is machine-generated.

A new surgical navigation system for breast conserving surgery (BCS) shows promise in improving tumor resection rates compared to conventional methods. While effective in phantom studies, further real-world application is needed.

Keywords:
Breast conserving surgeryEM navigationReal-timeTrackingWireless

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Area of Science:

  • Surgical Oncology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Breast conserving surgery (BCS) is a standard treatment for breast cancer.
  • Accurate tumor localization is crucial for successful BCS, especially for non-palpable tumors.
  • Conventional methods like iodine seed-guided BCS have limitations in precision.

Purpose of the Study:

  • To evaluate a novel surgical navigation system for BCS utilizing real-time tumor tracking.
  • To compare the navigation-guided BCS (Nav-BCS) with conventional iodine seed-guided BCS ([Formula: see text]I-BCS).
  • To assess the system's impact on resection margin and excision time.

Main Methods:

  • Development of breast phantoms with spherical and complex tumors containing wireless transponders (Nav-BCS) or iodine seeds ([Formula: see text]I-BCS).
  • Real-time tumor tracking using the Calypso 4D Localization System with CT-based 3D visualization.
  • Comparison of Nav-BCS and [Formula: see text]I-BCS by five surgical oncologists on phantoms, measuring resection margins and excision times.

Main Results:

  • Nav-BCS demonstrated a lower rate of incomplete tumor resections (6.7%) compared to [Formula: see text]I-BCS (20%).
  • Minimum resection margins were comparable for spherical tumors but showed a trend favoring Nav-BCS for complex tumors.
  • Excision times were significantly longer for Nav-BCS (9.5 min) compared to [Formula: see text]I-BCS (5.8 min) (p < 0.05).

Conclusions:

  • The novel surgical navigation system enhances intra-operative awareness of tumor location and orientation.
  • The system holds potential for improving surgical outcomes in BCS, particularly for non-palpable tumors.
  • Further clinical validation with extensive experience on real breast tissue is recommended.