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Simulation of Breast Tissue: A Study to Evaluate Optimal Compression
Dynamics
S.Anandan Shanmugam1, Edmond Zahedi2, and Mohd Alauddin Mohd Ali2
'Dept. of Biomedical Engineering, University of Malaya
2Dept. of Electric, Electronic and Systems, National University of Malaysia
E-mail: anandanum.edu.my
Abstract-This investigation aims to study the
behavior of breast tissue under different compression
in a compression chamber prototype to differentiate
strain between breast tumors and its surrounding
tissues. The simulation study gives us the optimal
compression pressure range to apply in order to have
a measurable amount of strain and also to look at
strain distribution dynamics if more than one cancer
nodules are encountered. The result of these
measurements enables the study to identify the
correct compression pattern and chamber design for
breast tissues. By doing this, it is hoped that the
development of automated instrmentation of
ultrasound elastography for the differentiation
between normal and malignant breast tissues,
utilizing B-mode ultrasound would be able to be
established.
1. Introduction
Early detection of breast cancers can
signifi'cantly improve patient survival rate and lead to
effective treatment. The overall aim of this research
project is to develop an automated mechanical setup,
conduct finite element analysis on breast model and
develop image-processing algorithms to extract
tissue elasticity information and the clinical
procedures to differentiate between normal and
malignant tissues, utilizing B-mode ultrasound. It is
hoped that this work shall provide a fast and reliable
technique for the early detection of malignant tissue
using ultrasound. Therefore the developed device is
expected to be a cost-effective tool to mass-screen a
relatively large population of Malaysian women as
such screening tool is not yet available in this
country.
Elastography is a quantitative method for imaging
the strain and elastic modulus distributions in
biological tissues where the elastographic image is
correlated with the softness/hardness of the tissue [1-
2]. Our methodology is based on small external
tissue compression in which pre-and post-
compressed B-mode images are captured and optical
flow techniques are used to estimate the relative
tissue displacements. From these displacements the
elastic modulus along the compression axis will be
estimated.
0-7803-9370-8/05/$20.00 ©2005 IEEE. 148
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aIBII5-7, September, 2005, Kuala Lumpur, MALAYSIA
The main objective of this proposed study is to
develop an automated instrument and algorithm for
detection of breast tumor using the elastography
principle from B mode ultrasound images. In order to
substantiate the proposed system, finite element
modeling (FEM) is carried out to analyze the force
distribution and displacement values in soft and hard
tissue during static and dynamic pressure loading.[5-
6] This data shall be used to build phantoms to
demonstrate the significance of the developed model
and to test the automated instrument for pressure
loading and image acquisition system.
2. Methods
A first prototype has already been developed and
tested (3-4] using this technique. The obtained results
prove the feasibility of the concept (sensitivity: 83%
& specificity: 88%). Currently the second generation
of this device is being designed and fabricated in
order to automate and reduce the earlier design
limitations such as accuracy and reliability of
measurements. The tissue under study is compressed
at predefined pressure levels to obtain pre- and post-
compression B mode ultrasound images and strain
information is processed from these images. The
results of these measurements will enable the project
to identify the correct compression modality for
breast tissues.
Figure 1 shows in general the mechanism of
pressure application to the breast tissue and the
placement of the ultrasound probe for image
acquisition during tissue compression.
Figure 1: Compression mechanism.
Breast is placed on top of a inflatable cuff in a
confined chamber. Inflation of the cuff hold the
 breast in place further compresses the tissue against compression chamber to be used for subsequent
the top cover of the compression chamnber, allowing elastographic measurement.
ultrasound image acquisition.
3. Results and discussion -."

The finite element simulation was conducted I

using FEMLAB (Comsol, Burlington MA, USA) on Im,
a 500 MHz Intel Pentium III, with 512 Mbyte RAM. 1
IM
li

A 2D ellipse geometry model of the breast was 6

drawn using the in built editor of FEMLAB. I
6
Different major axis diameter models were drawn *4*

40I
and the results shown here are based on a 8 cm s
diameter. The model consists of soft homogenous 4.,.2
fs
breast tissue with the following parameters: Young's 4.1S
4A
modulus E 6OkPa, Poisson's ratio v = 0.495 and
= 3

density p = 500. Two occlusion nodules were .4$ 6I 4$ -4$ -* 4* #I *

i

inserted with the following parameters; (1) E =

4$ *4

lOOkPa, v = 0.499 and p = 600 (2) E= 80 kPa, v =

0.499 and p = 600. The boundary conditions were
constrained either at the top of ellipse or at the
bottom to mimic the compression from cuff and the
Perspex plate at the top.
The nominal force applied at the chosen
boundary is 20 N. On average the meshing created
4000 elements. The default structural mechanics
solver of FEMLAB was used. A typical outcome of
the simulation process is shown in figure 2.
roue*- wwi._ftwo PM.aftom.
" sWoskwaq
-b*
-X.
is
Figure 3: Von Mises stress and displacement
distribution for 2 off centered tumor nodules.
A compression chamber has been fabricated in
order to demonstrate different tissue displacements at
different pressures. The chamber is made from
Perspex to allow the breast to be placed and it is
inflated with a cuff which is computer controlled and
the pressure value at the cuff-tissue interface is
measured -using a pressure sensor and its value is fed
back to the computer. This enables the computer to
control the pressure in the cuff at predetermined
values of 10, 20, 30, 40 and 50 mmHg. This setup is
shown in figure 4.

I
k1 *. i.-
..m-

Figure 2: Von Mises stress and displacement (arrow)

distribution is shown for a force of 20N applied on
top plate and the tissue is constrained at the bottom.

This result shows the stress and displacement

distributions for one tumor occlusion. It clearly
demonstrates that the shape of the tumor changes
very little and its displacement is less than its
surrounding tissues.
Another result is shown in figure 3. It shows two Figure 4: Photograph ofthe compression chamber
tumor occlusions off centered from the main
geometry. The simulation parameters are kept the
showing the ultrasound probe, a phantom placed on
top of the pressure cuff.
same. Figure 3 again demonstrates the viability of the

149

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 Figure 5 shows another simulation showing
compression from the bottom where contour of the
breast is taken into consideration. This model also
contains 2 tumor nodules. The parameters are the
same as the earlier stated values. The lines running
across the breast model shows profiles taken to plot
the total displacement values. Five lines are taken as
samples to show the difference in displacement
values at varios depts. The plots of these
displacement values are shown in figure 6. It shows
that the total displacement values at the center profile
is much lower then the top or bottom. This can be
correlated to the placements of the tumor nodules.
X4b,n:,1nm*u4 4ow00
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431
41 .44
404
41.3
4.A1
et *U5~ 9.4 .Z
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Figure 5: Shows the stress and displacement
distribution for contoured cuff boundary condition.
44 U 4,1 04
Figure 6: Total displacement profiles at 5 different
cross sections.
These results also show that the displacements
values could be used later to estimate the tissue
stiffness and further used as features of classification
to discriminate cancerous tissues from its
surrounding tissues.
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4. Conclusion
The simulation results in this study have
provided valuable insights on how to design the
compression chamber for ultrasound elastography
measurements. Both the normal breast tissue and the
tumors have been considered as homogenous
isotropic materials. Initial results has shown the
tissue deformation pattem and stress distribution.
Displacement values appear to be significant enough
to be estimated by image flow techniques. It is clear
that this preliminary work is showing promising
results and can be fiurter enhanced to model
extended breast model. These results have shown
- 0 usefulness to develop automated instrumentation for
breast cancer detectability utilizing elastography
technique.
References
[1] J. Ophir, I. C6spedes, H. Ponnekanti, Y. Yazdi
tC and X. Li, "Elastography: a quantitative method
for imaging the elasticity of biological tissues,"
Ultrasonic Imaging, Vol. 13, pp. 1 1 1-134, 1991.
[2] J. Ophir, R. K. Miller, H. Ponnekanti, I.
Cespedes and A. D. Whittaker, "Elastography:
elasticity imaging using ultrasound with
application to muscle and breast in vive,"
02 .0I { .4 4 G4 44--04 Ultrasonic Imaging, Vol. 15, pp. 73-88, 1993.
[3] M. Mokhtari-Dizaji, E. Zahedi, M. Gity, A.A.
Sharafi, "Evaluation of Young Modulus and
Presentation of New Discriminant Functions in
Diagnosis of Normal and Abnormal Breast
Tissues by Ultrasound", I1Q' Intemational
Conference on Biomedical Engineering, 6-9
Dec. 2000, Singapore.
[4] M. Mokhtari, E. Zahedi, A.A. Sharafi,
"Development of a Breast Phantom for
Ultrasonic Imaging, 9th Intemational
Conference on Biomedical Engineering,
National University of Singapore, Dec. 1997,
Singapore.
[5] H.T.Liu, L.Z.Sun, G.Wang ad M.W.Vannier,
"Analytic modeling of breast elastography."
Medical Physics, Vol. 30(9), pp. 2340-2349,
2003.
[6] Isaac Chang, "Finite element analysis of hepatic
radiofrequency ablation probes using
temperature dependent electrical conductivity,"
04 *4 U Biomedical Engineering Online, vol. 2:12, 2003.
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