锥光束乳腺CT体积测量在乳腺癌保留乳头乳晕乳房切除术后假体乳房重建手术中的应用

目的 探讨锥光束乳腺CT(cone-bean breast computed tomography,CBBCT)在保留乳头乳晕乳房切除(nipplesparing mastectomy,NSM)术后假体乳房重建手术中的应用价值。方法 选择2020年7月1日至2022年1月31日于广西医科大学附属肿瘤医院乳腺外科接受NSM术后假体乳房重建的52例乳腺癌患者为研究对象，采用Spearman秩相关分析患侧乳腺和对侧乳房CBBCT测量的体积与临床手工线性测量法测量的置入假体体积之间的相关性，建立简单线性回归方程预测CBBCT推算的假体体积，并比较其与置入假体体积的差异。采用Harris美容评分标准评价术后3个月的美容效果。结果 所有患者均完成假体乳房重建术，未出现假体破裂、假体移位等并发症。患侧乳腺CBBCT测量体积、对侧乳房CBBCT测量体积均与置入假体体积相关(r_s=0.73,0.81)。基于对侧乳房CBBCT测量体积构建线性预测模型y=0.001x+4.897(R²=0.7,P<0.001)，临床验证显示，模型预测的假体体积与放置假体体积...

Application of cone-beam breast CT volume measurement in prosthetic breast reconstruction after nipple-sparing mastectomy in breast cancer

Objective To investigate the application value of cone-beam breast computed tomography (CBBCT) in prosthetic breast reconstruction after nipple-sparing mastectomy (NSM). Methods A total of 52 breast cancer patients who received prosthetic breast reconstruction after NSM at Guangxi Medical University Cancer Hospital from July 1, 2020 to January 31, 2022 were selected as the subjects. Spearman rank correlation was used to analyze the correlation between the measured volumes of the affected breast CBBCT and the contralateral breast CBBCT and the implanted prosthesis volume obtained by the clinical manual linear measurement method. A simple linear regression equation was established to predict the prosthesis volume calculated by CBBCT, and to compare it with the volume of implanted prosthesis. The Harris beauty score was used to evaluate the cosmetic effect 3 months after surgery. Results All patients completed breast prosthesis reconstruction without prosthesis rupture, prosthesis displacement and other complications. The measured volumes of the affected breast CBBCT and the contralateral breast CBBCT were correlated with the implanted prosthesis volume (r_s=0.73, 0.81). A linear prediction model y=0.001x+4.897 (R²=0.7, P<0.001) was constructed based on the measured volume of the contralateral breast CBBCT. The clinical validation showed that there was no significant difference between the model predicted volume and the implanted volume of prosthesis (t=0.03, P=0.98), and the mean absolute error value was only 0.1 cm³. The Harris beauty score showed that the cosmetic effect was excellent in 4 cases and good in 6 cases 3 months after operation. Conclusions CBBCT can effectively predict the volume of implanted prosthesis in breast reconstruction surgery after NSM.