Clinical use of perioperative magnetic resonance imaging-based breast volumetric analysis in final implant volume prediction for two-stage breast reconstruction
- 주제(키워드) breast reconstruction , breast prosthesis implantation , magnetic resonance imaging , volumetric analysis , computer-generated 3D imaging
- 주제(DDC) 610
- 발행기관 아주대학교
- 지도교수 이일재
- 발행년도 2022
- 학위수여년월 2022. 8
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000031927
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Background: Breast volume is an important factor in breast reconstruction; however, the reconstruction surgeon is expected to deliver the best volume expectation with his aesthetic inspiration. Therefore, objective volumetry must be continuously developed to achieve this. This study aimed to conduct a Magnetic Resonance Imaging (MRI) based breast volumetric analysis. With periodic analysis of two-stage breast reconstruction in breast cancer patients, we suggest the possibility of clinical use of breast volumetry in final implant volume prediction. Methods. This retrospective study included 140 patients who underwent unilateral two-stage prosthetic breast reconstruction (tissue expander followed by permanent implant insertion) between January 1, 2017, and December 31, 2019. The MRI image was converted into a 3-D image with a reconstruction program (A-VIEWⓇ,Coreline Soft, Seoul, Korea). An MRI image was obtained before the breast cancer surgery and then regularly at 1, 3, 6, 12, and 24 months intervals postoperatively. The volume of the breast landmark was confirmed and automatically converted to cubic centimeters using artificial intelligence (AI). Results: In total, 140 patients were evaluated. Maximized breast volume and volume differences were noted and compared with the preoperative volume at 1 month, and minimized volume was noted at 1 year for the cancer-involved side. The correlation between MRI-based preoperative breast volumetry and the mastectomy specimen volume was 0.611. Analysis of the volume difference between the MRI-based preoperative state and the real implant volume showed a minimal difference at 1 year postoperatively. The final implant size prediction formula was calculated using the 1-year postoperative volume (p<0.001, R2=0.594). All values were statistically significant. Conclusions: To avoid breast reconstruction based solely on the surgeon’s subjective assessment, MRI-based breast volumetry could be a useful method to develop more scientific and objective breast reconstruction planning. We suggest a volume prediction formula that describes the relationship between the postoperative breast volume and the final breast implant size.
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