A novel finite element model–based navigation system–supported workflow for breast tumor excision

  • Dominik EsslingerEmail author
  • Philipp Rapp
  • Luzia Knödler
  • Heike Preibsch
  • Cristina Tarín
  • Oliver Sawodny
  • Sara Y. Brucker
  • Markus Hahn
Original Article


In the case of female breast cancer, a breast-conserving excision is often desirable. This surgery is based on preoperatively gathered MRI, mammography, and sonography images. These images are recorded in multiple patient positions, e. g., 2D mammography images in standing position with a compressed breast and 3D MRI images in prone position. In contrast, the surgery happens in supine or beach chair position. Due to these different perspectives and the flexible, thus challenging, breast tissue, the excision puts high demands on the physician. Therefore, this publication presents a novel eight-step excision support workflow that can be used to include information captured preoperatively through medical imaging based on a finite element (FE) model. In addition, an indoor positioning system is integrated in the workflow in order to track surgical devices and the sonography transducer during surgery. The preoperative part of the navigation system–supported workflow is outlined exemplarily based on first experimental results including 3D scans of a patient in different patient positions and her MRI images.

Graphical Abstract

Finite Element model based navigation system supported workflow for breast tumor excision is based on eight steps and allows inclusion of information from medical images recorded in multiple patient positions.


Breast tumors Image-guided surgery Lumpectomy Finite element analysis Medical imaging 


Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Written informed consent was obtained from all individual participants included in the study in accordance with the approval of the Ethical Committee of the Faculty of Medicine at the University Hospital Tübingen, Germany.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© International Federation for Medical and Biological Engineering 2019

Authors and Affiliations

  1. 1.Institute for System DynamicsUniversity of StuttgartStuttgartGermany
  2. 2.Department of Diagnostic and Interventional RadiologyEberhard-Karls-Universität TübingenTübingenGermany
  3. 3.Department of Women’s HealthResearch Centre for Women’s HealthTübingenGermany

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