Implementation scenarios and predicted performance of the Twente Photoacoustic Mammoscope as an alternative imaging modality in breast cancer diagnosis

Hilgerink, Marjolein (2009) Implementation scenarios and predicted performance of the Twente Photoacoustic Mammoscope as an alternative imaging modality in breast cancer diagnosis.

Abstract:The purpose of this study is to predict the future performance of the Twente Photoacoustic Mammoscope (PAM), and to identify different implementation scenarios based on this performance. PAM is a recently developed breast imaging device that makes use of photoacoustics. Criteria that are important in the design of a diagnostic breast cancer imaging device are identified, and these criteria are translated into design goals for further development of PAM. The Analytic Hierarchy Process (AHP) analysis has been used to identify the relative importance of design criteria, and to identify the relative performance of four different breast cancer imaging techniques: X-ray mammography, ultrasound, magnetic resonance imaging, and PAM. The currently used breast imaging techniques are used at different stages in the diagnostic track for breast cancer, two different AHP analyses have been carried out to determine the most optimal stage for PAM. House of Quality analysis is used to translate the implementation criteria into technical improvement goals for PAM. Because of the early developmental phase of PAM, there is some uncertainty about its future performance. This uncertainty has been assimilated into a sensitivity analysis from which different scenarios of the performance of PAM result. The most important criterion in the design of a diagnostic breast imaging device is sensitivity. Factors that mainly determine the performance on sensitivity are the visualization of mass margins, mass shape and vascularization. To improve the performance of PAM with respect to these factors, the quality of the reconstruction algorithm, detector sensitivity, detector bandwidth and number of wavelengths used in PAM should be improved. From the overall performance on the costs, effectiveness, patient comfort and safety/risks criteria assessed, it can be concluded that PAM will be the most preferred alternative. This is true for all scenarios that result from the uncertainty analysis, except for the most negative scenario, in which MRI is preferred slightly over PAM. When implemented for diagnostic use, PAM can best be positioned at the start of the diagnostic track, as a substitute for the combined use of X-ray mammography and ultrasound. This research has shown that the AHP method is useful to provide guidelines for the most promising area of application for which a new technology can be implemented. It will be helpful if all participants have the same basic level of understanding about the technology that is assessed, for future research it is therefore recommended to focus on an efficient way of knowledge sharing before the AHP is carried out.
Item Type:Essay (Master)
Medisch Spectrum Twente
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
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