Digital twins for non-invasive tumor localization in breast-conserving surgery: a technical pilot study

Area of Science:

• Surgical Oncology
• Medical Imaging
• Digital Health

Background:

• Accurate tumor localization is crucial in breast-conserving surgery (BCS) to minimize positive margins and re-excision.
• Current localization methods can be invasive or lack real-time intraoperative precision.

Purpose of the Study:

• To evaluate the feasibility and accuracy of using Digital Twins (DT) for non-invasive, real-time tumor localization during BCS.
• To assess the clinical utility and usability of DTs in a surgical setting.

Main Methods:

• Breast Digital Twins (DTs) were created from supine MRI data.
• DTs were registered to patients intraoperatively using a 3D sensing system during four BCS procedures.
• Alignment accuracy was quantified by measuring nipple deviations.

Main Results:

• The setup and marking times were found to be clinically acceptable.
• High perceived usability was reported, with a System Usability Scale (SUS) score of 95.
• Alignment accuracy, measured by nipple deviations, ranged from 0-5 mm.

Conclusions:

• Integrating Digital Twins into surgical workflows shows potential for enhancing intraoperative tumor localization.
• This pilot study demonstrates the preliminary accuracy and usability of DTs for BCS.
• Further research is warranted to validate these findings in larger cohorts.