Breast Lesion Localization

1
Breast Lesion Localization

• Team members
• Kayla Ericson, Mary Lim,
• Maja Middleton, Becky Jones,
• Eric Lee, Cullen Rotroff

2

• Advisor
• Prof. Wally Block
• Client
• JeongMi Park M.D.
• Associate Professor,
• Department of Radiology, Breast Imaging

3
Breast Lesions

• Woman finds lump (lesion) that needs to be
  removed
• Bracketing procedure done to guide surgeon in
  lumpectomy

4
Problem Statement

• Design a tool that will allow for better
  localizations of lesions and calcifications.
• One needle with 2-4 wires for directional control
  
• More efficient and complete bracketing
• Promotes patient comfort.

5
Current localization procedure

• Mammogram/ultrasound determines location of
  lesion (CC)
• Needle with wire is inserted in breast
• Correct placement of needle is verified
• Wire pushed through needle to mark lesion
  location
• Needle is removed, leaving wire in breast

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V-Hook Localization System

• Funnel-Shaped Hub Design for Wire Loading
• Siliconized Outer Cannula (tube) for Smooth
  Entry/Withdrawal
• Kopans-Type Loop Design (V-Hook)

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J-Hook Localization Device

• Homer J-Wire
• 1 Retractable Tip for better positioning
• J-Shaped Anchoring System
• Unique alloy wire reduces the risk of accidental
  transection  

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Problems With Current Designs

• Needle problems
• Needle not large enough to accommodate multiple
  wires
• Larger masses require multiple needles
• Wire problems
• Direction of V-Hook is unknown
• Shape does not most efficiently bracket tissue
• Wire is not strong enough

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Proposed Corrections to Design

• Wire
• Increase the strength and thickness
• Create a hybrid hook of current designs
• Needle
• Make needle fit four wires
• Allow for known angle insertion
• Allow for more than one wire
• 
  

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Design Specifications

• One disposable, sterile needle
• 9-20 gauge (the smaller the better)
• Multiple wires fit within the one needle
• Up to 4 possible wires
• Control direction that wires face
• Control distance that wires traverse
• Thicker in diameter than current wires

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Current Alternative Models

• SKI POLE Design
• Elaborate wire system engulfs lesion or
  calcification mass
• Product recently discontinued

• SenoRx Anchor Guide Localization Device
• Symmetrically distributed J hooks
• Anchor system palpates mass
• Max. 1.5 cm radius
• Detachable handle with retractor shaft

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Becky Jones and Maja Middleton
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Side view of needle and wires

• Four wire insertion
• Four directions (anterior, posterior,
  medial, lateral)

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Top View of Needle

• Guided insertion
• Four key and lock notches for wires
• Notches follow down the whole length of the
  needle

15
Evaluation of Needle Design

• Allows for better wire guiding down needle
• Divots in wall for wire to fit
• Keeps wire flush against needle wall
• Allows for needle to be as small as possible
• Shows direction of wire insertion

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Side view of wire

• Two notches for guidance down needle
• Variable curvatures (X)
• Variable lengths (Y)
• J-wire/Hook-wire
• Mark at top

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Evaluation of wire design

• J-wire/Hook-wire combination for better tissue
  grabbing and bracketing
• Different lengths for the wire
• 5, 7.5, or 10 cm
• Different widths of curved wire
• 1, 1.5, 2, 2.5, or 3 cm

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More Wire Evaluation

• Have two notches for insertion guiding
• Have a mark to indicate total insertion
• Thicker wire for better tissue navigation

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Future Work

• Tedious production process
• Requires more decision into wire choice

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Cullen Rotroff and Kayla Ericson
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Needle

• Non-orthogonal injection
• Dual chamber
• Locking gate
• Single injection for multiple wires

side view open
side view closed
top view closed
top view open
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Wire

• 1,2,and 3 cm. wires
• J-hook style
• V-hook tip- anchor
• Thermal-locking
• mechanism

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Cons

• Tissue tearing
• Efficiency of gate system
• Long wire injection accuracy
• Consistent thermal release melting point
• Cost
• Necessity of thermal release

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Eric Leeand Mary Lim
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Design

• Device composed of central skeleton and 4 wires
• Wires are attached to central skeleton via slots
• Drawcords control wire curvature
• Individual wire depth controlled by pushing down
  notch
• Markings on central skeleton to show wire depth

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• Questions?