Introduction The commonest ultrasound guided surgical procedure performed worldwide is biopsy of breast lumps. This diagnostic procedure for carcinoma of the breast requires the utmost precision, and that is why extensive skill development employing simulation is required before surgeons or radiologists perform this procedure on patients. Commercial models are available priced at several hundred pounds, but unfortunately is not suitable for high fidelity simulation training due to needle tract development and difficulty in accommodating the large bore biopsy needles that is generally used obtain specimens for definitive tissue diagnosis of breast malignancy.
Cheaper homemade phantoms suffer from similar limitations, are usually perishable and might not accurately resemble breast tissue. Animal tissue looks visually and ultrasonically different because it comes from different body parts. The latter two groups is perishable, and animal tissue have infection control and cultural issues. When we developed a material that achieved all the criteria for the perfect US medium,1 and felt like breast tissue, we resolved to see whether we could manufacture a low cost high fidelity simulation breast phantom.
Method We prepared 700 ml ADAMgel (Aqueous Dietary fibre Antifreeze Mix gel) and poured it into a section of a nylon stocking and suspended it to cool down.
Result This formed a breast phantom of the correct shape and texture, with similar ultrasonographic, tactile and haptic characteristics, resistant to needle tract formation even with large bore biopsy needles. As the substance is selfhealing it was possible to insert/remove/change various targets in the phantom as often as needed. This material is non-perishable and has shown no deterioration since its invention. The nylon stocking section would have to be replaced periodically. The total cost was <£1.
Conclusion High fidelity reusable breast phantoms are not only possible, but can be done at a reasonable cost.
Sultan S, Shorten G, Iohom G. Simulators for training in ultrasound guided procedures. Med Ultrasound 2013;5(2):125–131
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