Grant: Collaborative Health Research Projects (NSERC partnered)

Permanent-seed breast brachytherapy is a treatment in which radioactive seeds are inserted into the breast using hollow needles and can be considered as a patient-friendly and cost-effective option for women diagnosed with early breast cancer. However, it is a relatively new procedure that lacks an established surgical protocol and assist devices similar to what exists for the well-established prostate brachytherapy procedure. Issues in breast brachytherapy include difficulty and reliability of ultrasound (US) imaging and needle guidance under it, which results in inaccuracies in placing seeds within the breast. This results in uncertainties for doctors looking to adopt breast brachytherapy, which is exacerbated by the already-existing steep learning curve associated with brachytherapy in general. This is because, in practice, seed-carrying needles often do not follow their planned paths due to needle deflection and tissue deformation, resulting in seeds being placed inaccurately, which can result in an undesirable radiation dose being delivered to the breast. Many of the above concerns contribute to the reluctance of doctors and hospitals to adopt breast brachytherapy. However, these concerns can be addressed with computer and mechatronic assistance and image guidance to improve the accuracy and reliability of seed placement using accurate measurements, objective assessments, and reproducible movements. Our objective is to provide solutions to the unique issues of breast brachytherapy using mechatronic systems and computer algorithms for visualization and control of seed deposition. We will develop a US probe positioner, a hand-held needle steering assistant, and software to match images taken before and after the surgery and monitor seed placement so that the surgeon is free from many of these problems and is fully in control of the most critical action, i.e., needle insertion, and the most important outcome monitoring task, i.e., seed location tracking.