Imaging properties of 3D printed breast phantoms for lesion localization and Core needle biopsy training

Arafat Ali,Rifat Wahab,Nicole Wake,Mary Mahoney,Jimmy Huynh

doi:10.1186/s41205-020-00058-5

Abstract

BackgroundBreast cancer is the most commonly diagnosed malignancy in females and frequently requires core needle biopsy (CNB) to guide management. Adequate training resources for CNB suffer tremendous limitations in reusability, accurate simulation of breast tissue, and cost. The relatively recent advent of 3D printing offers an alternative for the development of breast phantoms for training purposes. However, the feasibility of this technology for the purpose of ultrasound (US) guided breast intervention has not been thoroughly studied.MethodsWe designed three breast phantom models that were printed in multiple resins available through Stratasys, including VeroClear, TangoPlus and Tissue Matrix. We also constructed several traditional breast phantoms using chicken breast and Knox gelatin for comparison. These phantoms were compared side-by-side for ultrasound penetrance, simulation of breast tissue integrity, anatomic accuracy, reusability, and cost.Results3D printed breast phantoms were more anatomically accurate models than traditional breast phantoms. The chicken breast phantom provided acceptable US beam penetration and material hardness for simulation of human breast tissue integrity. Sonographic image quality of the chicken breast phantom was the most accurate overall. The gelatin-based phantom also had acceptable US beam penetration and image quality; however, this material was too soft and poorly simulated breast tissue integrity. 3D printed phantoms were not visible under US.ConclusionsThere is a large unmet need for a printable material that is truly compatible with multimodality imaging for breast and other soft tissue intervention. Further research is warranted to create a realistic, reusable and affordable material to 3D print phantoms for US-guided intervention training.

Highlights

Breast cancer is the most commonly diagnosed malignancy in females and frequently requires core needle biopsy (CNB) to guide management
To best mimic human tissue properties, the fat was printed with a combination of A30Clear coated at 600 μm around Tissue Matrix and the fibroglandular tissue (FGT) was printed with a ShoreA50 combination of VeroClear and A30Clear (J750, Stratasys, Rehovot, Israel)
3D printed breast phantoms were more anatomically accurate models compared to traditional breast phantoms

Summary

Introduction

Breast cancer is the most commonly diagnosed malignancy in females and frequently requires core needle biopsy (CNB) to guide management. The feasibility of this technology for the purpose of ultrasound (US) guided breast intervention has not been thoroughly studied. Diagnostic mammograms with adjunctive ultrasound (US) are proven to aide in tumor detection and improve diagnostic accuracy, with the ultimate aim of early cancer diagnosis and reducing unnecessary biopsies [2]. Ultrasound guided core needle biopsy (CNB) is an indispensable tool for breast cancer diagnosis, in BIRADS 4 and 5 breast lesions. The high diagnostic accuracy of ultrasound guided CNB. Phantom based procedural training is a highly successful methodology for improving user confidence and mitigating patient risk [4,5,6]. Hands-on training is important for US-guided procedures, which require coordination of both the imaging probe and procedural instrument

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Results

Conclusion