BCCT.plan

BCCT.plan (Ferramenta 3D para o planeamento do tratamento conservador do cancro da mama - 3D tool for planning breast cancer conservative treatment) is a funded by the Portugal Operational Programme (Portugal 2020) - NORTE-01-0247-FEDER-017688  with a budget of 532k EUR for 2016/19.

Breast cancer is the most common cancer to affect women and the leading cause of cancer deaths in women in Europe. However, breast cancer mortality rates in most European countries are decreasing since 1990, as a consequence of the combined effects of earlier detection and treatment improvements. Breast conservative surgery (BCS) combined with radiotherapy has become the treatment of choice for the majority of women presenting with early breast cancer. With identical overall survival compared to mastectomy, BCS is usually linked to a better cosmetic outcome. In turn, this is an important endpoint for breast cancer treatment and is closely related to psychosocial recovery and quality of life (QOL). However, at least 30% of the cases have fair/poor aesthetic outcomes after BCS.


Postoperative deformities after BCS and radiotherapy are difficult to treat and are a source of patient dissatisfaction. Thus, many women will live for many years with the potentially disfiguring aesthetic consequences of their treatment. When a woman faces a breast cancer diagnosis, and surgery is proposed, two options are available: breast conservative surgery or mastectomy. The decision as to which type of surgery to offer patients is subjective and based almost exclusively on the judgment and experience of the clinician. This clinical judgment takes into account several factors as tumor resection/breast volume ratio (TRBVR), tumor location or glandular density. Among these, TRBVR is considered the most important and presents a major impact on aesthetic outcome. However, there is a gap in scientific research regarding objective ways to access breast volume and tumor/breast volume ratio, a measurement that could ultimately help in the selection of the optimal BCS technique. Several methods have been described for breast volume assessment; however, these methods are not easy to perform routinely. A reliable and easy method to calculate breast volume and tumor/breast volume ratio has not yet been described.


The BCCT.plan project aims to provide objective tools to personalize surgical planning. This tool will enable alternative surgical strategies to be explored and the consequences of the available options, with respect to the appearance of the breast under analysis. Using a combination of 3D reconstruction with images of the external shape of the patient, together with simple measures of the tumor (size and location), and glandular density, taken from radiological exams, we will develop a simple 3D model of the breast. Naturally, there is a need to create a database containing radiological examinations, annotated by radiology professionals, and breast surface information, to develop the methods for 3D model creation.


Some of these methods relate to automatic algorithms that allow the information fusion of several medical image modalities and the identification and classification of suspicious malignant regions. In this sense, the database would assist in the method development and validation. The breast surface information will be acquired through aggregated photography and depth sensors (RGBD), adopting recent developments in low cost 3D technology.
This modalities and surface combination will enable the development of a standardized and reproducible analysis tool which will be based on the aesthetic outcome evaluation of both 3-dimensional shape of the reconstructed breast and its volume after BCS, obtaining a prediction of the respective aesthetic result.


This project will support surgical planning personalization, by assessing the risk of deformities after breast conserving surgery, for each patient’s TRBVR. It will serve as a decision support tool to communicate the available options to the patient and to enable standardized evaluation and a safe outcome of the procedure. The project will demonstrate the ability of virtual tools to empower patients and have a direct impact on their care. This will aid surgeon-patient communication concerning the type of breast surgery recommended, and will empower patients to take an active role in a shared decision making process. These tools will also enable the objective evaluation of the patient's aesthetic appearance after treatment.

 


PICTURE

PICTURE (Patient Information Combined for the Assessment of Specific Surgical Outcomes in Breast Cancer) is a FP7 funded by the European Commission with a budget of 2.2M EUR for 2013/15.

Breast cancer is an increasingly treatable disease, and 10-year survival now exceeds 80%. When a woman faces a breast cancer diagnosis, and surgery is proposed, two options are available: breast-conserving surgery or mastectomy. Given the high breast cancer survival rate, many women will live for many years with the potentially disfiguring aesthetic consequences of their surgical and therapeutic treatment. The cosmetic outcome of surgery is a function of many factors including tumour size and location, the volume of the breast, its density, and the dose and distribution of radiotherapy. A good aesthetic outcome is an important endpoint for breast cancer treatment and is closely related to psychosocial recovery and quality of life.

The PICTURE project aims to address these issues by providing objective tools, tailored to the individual patient, to predict the aesthetic outcome of breast conserving surgery. Using a combination of 3D photography and routinely acquired radiological images (i.e. mammography, ultrasound and MRI, when available), together with information about the tumour (size, location, shape etc.) we will develop techniques to biomechanically model the anatomy of the breast and the effect of surgical removal of cancerous tissue. This digital patient representation and associated predictive tools will enable alternative surgical strategies to be explored and the consequences of the available options, with respect to the appearance of the breast, to be visualised. This will aid communication with the patient of the type of breast surgery recommended by the surgeon, and will empower patients to take an active role in a shared decision making process.

We will also develop tools to enable the patient's aesthetic appearance after treatment to be objectively evaluated. Current techniques use subjective methods, such as assessment by an expert panel, or computer analysis of 2-dimensional photography to estimate, for instance, breast asymmetry. By adopting recent developments in low cost 3D photography and depth sensing technology, we will develop a standardised, reproducible analysis tool which will base the aesthetic outcome evaluation on both the 3-dimensional shape of the reconstructed breast and its volume. This will establish standardised quality assurance and evaluation procedures, enabling institutions across Europe to be compared and factors that have a positive or negative impact on surgical outcome identified.

 

3d BCT

3d BCT (3D Models for Aesthetic Evaluation and Prediction of Breast Cancer Interventions) project (PTDC/SAU-ENB/114951/2009), funded by the Portuguese Foundation for Science and Technology (FCT), with a budget of 69K EUR for 2011/14.

In 3d BCT we investigate new methods to reconstruct 3D data from one or more uncalibrated views of the breast of the patient. We research a model fitting method, allowing the system to automatically fit a generic deformable model to patient specific three-dimensional (3D) breast surface measurements using a physically-based framework. This can be used to quantitatively and reliably assess the aesthetic outcome of breast reconstructive surgery. In addition this will also allow the surgeon to quantitatively analyze the degrees of various deformities and asymmetries in the shape of the breast. Finally, a model creation mode will allow a surgeon to interactively adjust the shape of the breast by varying key shape variables, analogous to the aesthetic and structural elements surgeons inherently vary manually during breast reconstruction. Our contribution will be a set of global deformations with very intuitive parameters that a physician can apply to a generic geometric primitive in order to model the breast of a patient for pre-operative planning purposes and for communicating and demonstrating this plan to the patient.

 

Semantic PACS

Semantic PACS (Picture Archiving and Communication System with Semantic Search Engine) project (project nº 003472), funded by the Portuguese Agency for Innovation (ADI), with a budget of 320K EUR for 2009/11.

Semantic PACS aims to develop a software module to integrate with PACS that supports automatic, semantic based, description and search methods directly over medical images. In opposition with existent systems, this solution will make possible to generate on-the-fly diagnosis reports based on the similarity of medical images archived in the system.
In this project we created a mammograpy database. The INbreast database has been created through the investment of significant time and effort, and we are committed to the promotion of the INbreast Database as a valuable, special and unique asset of our Research Group.

see how you can get the INbreast database.

 

BCCT

BCCT (Advanced Objective Method for the Evaluation of the Aesthetical Result of Breast Interventions) project (PTDC/EIA/64914/2006), funded by the Portuguese Foundation for Science and Technology (FCT), with a budget of 95K EUR for 2007/10.

In BCCT we investigate the development of a totally objective methodology for the evaluation of the overall aesthetic outcome of breast cancer treatments. The results of this project, in the form of a software system, BCCT.core, is being used by many international groups in prospective studies: Nottingham Breast Institute, UK; Leiden University Medical Centre, The Netherlands; Cancer Care Center, Sydney, Australia; University of Heidelberg, Breast Center, Heidelberg, Germany; Medical University, Vienna, Austria; etc. This work has also been mentioned in an Editorial of the Breast Journal.

see BCCT.core webpage.