Digital twins for non-invasive tumor localization in breast-conserving surgery: a technical pilot study.

Inaccurate tumor localization in breast-conserving surgery (BCS) can lead to positive margins and re-excision. In this technical pilot study, Digital Twins (DT) were used for non-invasive tumor localization in the operating room. Breast DTs were generated from supine breast magnetic resonance imaging and registered to patients in real-time using a 3D sensing system during four surgeries. Alignment accuracy was measured via nipple deviations (0-5 mm). Setup and marking times were clinically acceptable, with high perceived usability (SUS = 95). These preliminary results demonstrate the potential of integrating DTs into surgical workflows.