Breast lesion co-localisation between X-ray and MR images using finite element modelling

This paper presents a novel X-ray and MR image registration technique based on individual-specific biomechanical finite element (FE) models of the breasts. Information from 3D magnetic resonance (MR) images was registered to X-ray mammographic images using non-linear FE models subject to contact mechanics constraints to simulate the large compressive deformations between the two imaging modalities. A physics-based perspective ray-casting algorithm was used to generate 2D pseudo-X-ray projections of the FE-warped 3D MR images. Unknown input parameters to the FE models, such as the location and orientation of the compression plates, were optimised to provide the best match between the pseudo and clinical X-ray images. The methods were validated using images taken before and during compression of a breast-shaped phantom, for which 12 inclusions were tracked between imaging modalities. These methods were then applied to X-ray and MR images from six breast cancer patients. Error measures (such as centroid and surface distances) of segmented tumours in simulated and actual X-ray mammograms were used to assess the accuracy of the methods. Sensitivity analysis of the lesion co-localisation accuracy to rotation about the anterior–posterior axis was then performed. For 10 of the 12 X-ray mammograms, lesion localisation accuracies of 14 mm and less were achieved. This analysis on the rotation about the anterior–posterior axis indicated that, in cases where the lesion lies in the plane parallel to the mammographic compression plates, that cuts through the nipple, such rotations have relatively minor effects. This has important implications for clinical applicability of this multi-modality lesion registration technique, which will aid in the diagnosis and treatment of breast cancer.