A virtual environment for breast exams practice with Haptics and gamification

Breast cancer is the second most frequent cancer in the world, with 250 thousands of deaths each year. Early detection of tumors by breast exams and procedures can help to reduce these numbers. More medical practice is required. Professional training for medical procedures in real environments is costly and risky both for the student and the patient. A way to reduce costs and risks of training is by the use of a virtual simulator. An environment closer to the real world in medical simulations can provide a better quality experience of to the trainee. The use of haptic devices can emulate tactile sensations and feedback forces that correspond to body structures and density of tissues. The used device has six degrees of freedom (DOF): movement on three axes (x, y, and z), rotations, and horizontal and vertical inclinations. This work presents a virtual environment for breast exams practice and sentinel nodes detection procedures that employ the use of a haptic device and a gamified interface for feedbacks. The objective is to improve early breast cancer diagnosis chances. A model for tissue deformation calculations on tridimensional patient body mesh is proposed, to add visual realism to the interactions in the virtual environment. Needle depth and its tridimensional position data are updated at real-time on needle insertion. Tumor nodes size and position are dynamically generated upon each simulation, increasing training possibilities for the student. The gamification strategy improves the practice on environment, with elements to engage the player on activity. User progress is tracked by subdivision of breast exams and procedures into smaller challenges, for better performance evaluation on the virtual environment. A gamified interface, with player score and achievements mapping is included. These gamification features have not been employed on breast simulators from previously investigated works.