Classification of irregularities.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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Applications based on Virtual Reality technology for use in construction and maintenance planning of buildings were developed (Fig. 1).
The first, applied to construction, is an interactive virtual model designed to present plans three-dimensionally (3D), connecting them to construction planning schedules, resulting in a valuable asset to the monitoring of the development of construction activity. The 4D (3D+time) application considers the time factor showing the 3D geometry of the different steps of the construction activity, according to the plan established for the construction.
A second VR model was created in order to help in the maintenance of exterior closures of walls in a building. It allows the visual and interactive transmission of information related to the physical behaviour of the elements. To this end, the basic knowledge of material most often used in façades, anomaly surveillance, techniques of rehabilitation, and inspection planning were studied. This information was included in a database that supports the periodic inspection needed in a program of preventive maintenance.
A third VR model is an application concerning the maintenance analyses of interior wall allowing the visualization of the degradation over time of the painted elements of a building. The virtual model support the inspection activity helping to choose the anomalies, the provable causes and the most adequate repair methodologies. In addition, a chromatic scale is created and associated with the walls covering elements to evaluate their degradation since they are painted until they reach their expected durability, and needed to be repainted.
VR models of construction and coating elements of exterior and interior walls.
This work brings an innovative contribution to the field of construction and maintenance supported by emergent technology. The building lifecycle is in constant evolution, so require the study of preventive maintenance, though, for example, the planning of periodic local inspections and corrective maintenance with repair activity analysis. For this reason, the VR models facilitative the visual and interactive access to results, supporting the drawing-up of inspection reports. The focus of the work is on travelling through time, or the ability to view a product or its components at different points in time throughout their life. In maintenance, the time variable is related to the progressive deterioration of the materials throughout the building’s lifecycle.
These interactive models integrate VR technology and applications implemented in Visual Basic (VB) language. The models allow interaction with the 3D geometric model of a building, visualizing components for each construction. They are linked to databases of the corresponding technical information concerning the maintenance of the materials used as interior and exterior closures. The principal objective of the interactive VR prototypes is to support decision-making in the area of maintenance planning.
Currently, the management of information related to the maintenance of buildings is based on the planning of action to be taken and on the log of completed work. The capacity to visualize the process can be added through the use of three-dimensional (3D) models which facilitate the interpretation and understanding of target elements of maintenance and of 4D (3D+time) models through which the evolution of deterioration can be visually demonstrated and understood. Furthermore, the possibility of interaction with the geometric models can be provided through the use of VR technology.
Information technology, namely 4D modelling and VR techniques, is currently in use both in the construction activity and in education (Mohammed, 2007). At the Department of Civil Engineering, some didactic models have already been generated. The research project presented in this chapter follows on from that previous educational work: two 3D geometric models which support activity in the rehabilitation of buildings (Sampaio et al., 2006); and three VR models developed to support classes in Civil Engineering (wall, bridge and roof construction) in Technical Drawing, Construction and Bridge disciplines (Sampaio et al., 2010). The didactic VR models are in common use in both face-to-face classes and on an e-learning platform.
In construction industry, from the conception to the actual implementation, project designs are presented mostly on chapter, even though the two dimensional reading is often not enough, as mistakes can be introduced in early stages of conception or elements misunderstood on the construction site. 3D models present an alternative to avoid inaccuracies, as all the information can be included with the necessary detail. Computer systems used in construction for graphic representation have experienced a vast evolution, allowing new ways of creating and presenting projects. 4D models, also labelled as 3D evolutionary models, permit a better comprehension of the project throughout its life, minimizing the information loss through the chain of events. In addition VR technology can present a step-by-step guide in assembling complex structures in an interactive way. One of the benefits of VR in construction is the possibility of a virtual scenario being visited by the different specialists, exchanging ideas and correcting mistakes. Some applications are already offering the possibility of communication between different specialties while developing a mutual project (Yerrapathruni et al. 2003).
In construction management, over the years, technical drawings have played a crucial role in communication between the numerous partners in a project. Generally, drawings represent formal solutions, and often incompatibility mistakes are only detected at advanced stages, on site, accruing additional costs. In this field 4D models promote the interaction between the geometric model and construction activity planning, allowing immediate perception of the evolution of the work. In planning, in correct evaluation and the meeting of needs as they arise, 4D models constitute a positive contribution to decision-making when establishing planning strategies (Webb and Haupt, 2003).
Virtual Reality technology can support the management of data that is normally generated and transformed or replaced throughout the lifecycle of a building. This technology constitutes an important support in the management of buildings allowing interaction and data visualization. At present, the management of building planning can be presented in 3D form and various materials can be assigned to the fixtures and furnishing enabling the user to be placed in the virtual building and view it from inside as well as outside. This study contemplates the incorporation of the 4th dimension, that is, time, into the concept of visualization. The focus of the work is on travelling through time, or the ability to view a product or its components at different points in time throughout their life. In maintenance, the time variable is related to the progressive deterioration of the materials throughout the building’s lifecycle. It is implicit that the incorporation of the time dimension into 3D visualization will enable the designer/user to make more objective decisions about the choice of the constituent components of the building.
The chapter describes both (interior and exterior walls) maintenance models, highlighting the constitution of the database supporting the models, and the organization of a user-friendly interface designed to be used by an inspection worker. During the construction of these models, the basic knowledge of the topics involved, such as aspects related to the materials, the techniques of rehabilitation and conservation and the planning of maintenance is outlined and discussed. In addition, methods of interconnecting this knowledge with the virtual model are explored. These prototypes were trailed in an actual project. The lifecycle aspects of the construction activity are in constant evolution, so require the study of preventive maintenance, through, for example, the planning of periodic local inspections and corrective maintenance with repair activity analysis. For this reason, the model facilitates the visual and interactive access to results, supporting the drawing-up of inspection reports.
The construction model brings an innovative aspect to 4D modelling as usually applied to construction planning, through the incorporation of pictures into the interface of the VR model, an important support element in the comparison between what is planned and what is in progress in situ after each construction task.
Construction management can be defined as the planning, co-ordination and control of a project from conception to completion (including commissioning) on behalf of a client (Walker, 2002).
This requires the identification of the client\'s objectives in terms of usage, function, quality, time and cost, and the establishment of relationships between the people involved, integrating, monitoring and controlling the contributors to the project and their output, and evaluating and selecting alternative solutions in pursuit of the client\'s satisfaction with the outcome of the project. It is essential, therefore, that the project designer has the depth of knowledge to be able to correctly identify the different stages of the construction planning, as well as to take into consideration the logistics and resources involved in the project. The construction planning used in the implemented prototype is realistic and considers the graphic and written documentation, measurements and quantities map, specifications and regulations relevant to the project (Leinonen et al. 2003).
A prototype based on VR technology with application to these demands of construction planning, was created. This interactive virtual model presents the project in 3D, integrated with the construction planning schedule, resulting in a valuable asset in monitoring the development of the construction activity, compared to the construction planning already drawn up. The 4D application allows the time factor to be considered in conjunction with the 3D geometry of the different steps of the construction activity, according to the schedule established for the construction, thus offering a detailed analysis of the construction project. Additionally, VR technology allows the visualization of different stages of the construction and interaction with the real-time construction activity. This application clearly shows the constructive process, avoiding inaccuracies and building errors, thereby facilitating better communication between partners in the construction process. This application was developed in three stages:
Planning takes into consideration the final purpose of the presentation, and the definition of tasks; the details, therefore have to be in line with this idea. Using
Geometric modelling needs to relate correctly to the tasks as defined at the planning stage. Using
The third stage, integration of the first two stages, makes use of two programs.
The application, developed in C#, integrates all the components described with the interface as shown in Fig. 2. The application his organized as outlined below: Virtual model; pictures of construction site; planning task list; Gantt map.
Application interface.
The interaction with the application is made through Planning task list and Gantt map. Both the task list items and Gantt map bars are buttons which, when pressed, send the information to the
Any new objects can be introduced into the application, just by modelling the new elements considering their positions relative to the ones already in the simulation and programming the associated action in
Likewise, the application accepts any kind of construction project, as long as its implementation imperatives are met. Additionally, with the appropriate models, it can also be used in construction site management.
The weakness of this prototype lies in the time needed to carry out the preparation for the actual interaction with the application. Modelling a building may not be very extensive. The programming of the actions in
In the application, the geometric model of the building is presented in a sequence simulating the construction activity. For that, each modelled component of the building is connected to the programming instruction: hidden and unhidden (Fig. 3).
Hidden and unhidden instruction.
This is one of the capacities allowed by the
Fig. 4 presents a tree of links connecting the command of interaction (executed by the user) and the instruction show of the respective element (see the instruction
Diagram of actions hidden/unhidden for each element and the control of the camera.
In addition the control of the position and orientation of a camera (position, zoom and orientation of the model in relation to the observer) must be defined in accordance with the selected construction step. The position of the camera is controlled within the
Control of the translation and rotation movements of the model.
As a method of testing the application, a construction project was undertaken, more particularly, the structure of a building, using both its graphic documentation, that is, the architectural and structural blueprints, and the project description and construction planning (Fig. 6). The whole project was simplified to serve this chapter’s academic purposes: the list of tasks was defined based on the more characteristic stages of a construction process, and a few tasks focused on the construction details of certain elements.
Construction planning (list and Gantt map) and the 3D model of the building structure.
As a result,
Application\'s virtual model and task list.
Some construction details have been modelled. Progress across three different stages, of one of the columns and a detail of the reinforcement and concrete of a slab, are shown in Fig. 8.
When constructing a building, the planning sometimes needs to be changed due to unexpected occurrences. Implementing these changes in the prototype is actually very simple, as the user has only attribute new start and finishes dates to the task in
Column and slab construction: reinforcement, formwork and concreting.
All steps have been modelled and linked to the planning chart. Fig. 9 shows the details of the construction work. The date for each visualized task is shown in the upper left corner of the virtual model window.
Sequence of the construction process.
When a task is selected in the construction planning chart the static position of the model is presented. A first view is always linked to a task. This was established to provide easier interaction with the 3D model, and to focus the attention of the user on the important sections of each task, guiding them through the proper course of development of the construction. Next, the user can manipulate the virtual model, in order to choose the identical perspective as that shown in the photo. So, with the visualization of what is planned and what has been done in the real building, the construction work can be better compared and analysed (Fig. 10).
In addition by manipulating the model the user can walk through the virtual building observing any construction detail he wants to compare. Comparing with other 4D models the interaction with the present model is not completed allowed and the pictures obtain in the construction place are not linked with the model (Casimiro, 2006). This VR model is more intuitive. So the principal innovative contribution of the model is the incorporation of updated pictures taken in situ. It helps designer to follow adequately the construction process and he can introduce the necessary changes in the construction plan previously established.
Rotation applied to the virtual model.
The coating applied to building walls, naturally, performs an important aesthetic function: it is, however, essentially a protective element for the substrate on which it is applied as far as the action of environmental agents of wear and tear is concerned. The coating is fundamental to a proper overall performance of a building throughout its working life.
Materials frequently used in the coating of ordinary buildings are: paint, varnish, stone and ceramics (Eusébio and Rodrigues, 2009). In Portugal, where interior walls are concerned, the most commonly used coating is paint. It is a multi-purpose material, used under a variety of decorative effects, based on a widely-ranging palette of colours, patterns and textures and is easily applied on any type of surface. In addition, paint, compared to other materials, is less costly, not only as far as the product itself is concerned, but also in its application, since relatively non-specialized labour is required. Nevertheless, as deterioration is a given, maintenance is needed.
Factors such as the constant exposure of the coating to the weather, pollutants and the normal actions of housing use, linked to its natural ageing and, in some cases to the unsuitable application of systems of painting give rise to its deterioration and to the appearance of irregularities, which can negatively affect its performance as both an aesthetic and a protective element. According to Lopes (2004), in normal conditions of exposure and when correctly applied a paint coating can remain unaltered for about five years. Establishing suitable maintenance strategies for this type of coating is based on the knowledge of the most frequent irregularities, the analysis of the respective causes and the study of the most suitable repair methodologies.
The completed virtual model identifies the elements of the building which make up the interior wall coating so that monitoring can take place. The application is supported by a database, created for the purpose, of irregularities, their probable causes and suitable repair processes, which facilitates the inspection process. The information is recorded and associated to each monitored element, allowing subsequently, the inspection and repair activity log to be consulted, thus providing a tool for the definition of a rehabilitation strategy. In addition, the model assigns a colour to each of the coating elements, the colours defined by the time variable, so that the evolution of the deterioration of the coating material is clearly shown through the alteration in colour. The prototype is, then, a 4D model.
The model integrates a virtual environment with an application developed in Visual Basic programming language. This allows interaction with the 3D model of buildings in such a way that it becomes possible to follow the process of monitoring the coating elements, specifically, painted interior walls, in terms of maintenance, throughout the life-cycle of the building.
The General Regulations for Urban Buildings (RGEU, 1951) applied in Portugal, stipulates the frequency of maintenance work, stating that existing buildings must be repaired and undergo maintenance at least once every eight years with the aim of eliminating defects arising from normal wear and tear and to maintain then in good usable condition in all aspects of housing use referred to in that document.
The time-limit indicated is applicable to all elements of the buildings generally. It is clear, however, that the regulatory period is too long for some specific components and that, frequently enough, the time-limits for action are not respected. There are, too, inefficient rent policies, leading to long periods without rehabilitation, and that the prevailing culture is one of reaction on the part of the various parties involved in the maintenance process. To these aspects should also be added the defects sometimes registered during the construction of property developments, exacerbating the poor state of repair of the buildings. This gives rise to numerous irregularities which, in turn, frequently leads to inadequate safety conditions.
According to Cóias (2009), the purpose of maintenance is to prolong the useful life of the building and to encourage adherence to the demands of safety and functionality, keeping in mind the specific set of conditions of each case and its budgetary considerations. Satisfactory management of this activity is carried out by putting into practice a maintenance plan which must take into consideration technical, economic, and functional aspects arising with each case.
Collen (2003) points out that investment in the maintenance and rehabilitation sector in Portugal is still weak compared to that in the same sector in the construction industry in the other countries of the European Community. She makes it clear, however, on a more positive note, that some measures have already begun to be implemented here: some urban regeneration programs have been created, legislation, which focuses on the sustainability of buildings, has been laid down, and the revision of constructive solutions has been carried out, all with the objective of guaranteeing that the maintenance of built heritage be an integral part of the construction sector.
The maintenance of buildings, then, is an activity of considerable importance within the construction industry; its contributory aspects of conservation and rehabilitation work need to be supported by correct methodologies of action, underpinned by scientific criteria and by suitable processes for the diagnosis of irregularities and the evaluation of their causes. This chapter aims to make a positive contribution to this field using the new computer technology tools of visualization and interaction.
The technical document Paints, Varnishes and Painted Coatings for Civil Construction published by The National Laboratory for Civil Engineering (LNEC) (Eusébio and Rodrigues, 2009), defines paint as a mixture essentially made up of pigments, binder, vehicle and additives. It has a pigmented, pasty composition, and when applied in a fine layer to a surface, presents, after the dispersion of volatile products, the appearance of a solid, collared and opaque film (Farinha, 2010).
The durability of the painted coating depends on the environment in which it is used, and on the surface it is applied to as well as the rate of deterioration of the binder in the paint. The influence of the environment is the result of the action, in conjunction or alone, of a variety of factors such as the degree of humidity, the levels of ultraviolet radiation, oxygen, ozone and alkalis, variations in temperature and of other physical or chemical agents whose effect depends considerably on the time taken to apply it (Marques, 1985). When their influence is not counteracted or minimized, imperfections can arise in the coating film, such as, the appearance of defects in the layer or paint with the loss of functionality where the desired aim of the application is concerned.
These irregularities manifest themselves in various ways and in different degrees of severity. Based on the study made of the causes of the defects, specific methodologies for their resolution were established. Fig. 11 shows common defects in painted interior walls.
Swelling, efflorescence, cracking and blistering (Moura. 2008).
The information gained from the pathological analysis of this type of coating was used to draw up a database supporting the interactive application. These data support the creation of inspection files related to the elements which are monitored in each case studied.
In order to form a user-friendly database of relatable data, groups of pathologies, shown below in Table 1, were considered. This classification provides the required automatism of access to the database and supports the presentation of synopses of the causes and repair methodology inherent in each pathology.
Classification | Irregularity | Repair methodology |
Alteration in colon | Yellowing | - Cleaning the surface and repainting with a finish both compatible with the existing coat and resistant to the prevailing conditions of exposure in its environment |
Bronzing | ||
Fading | ||
Spotting | ||
Loss of gloss | ||
Loss of hiding power | ||
Deposits | Dirt pick-up and retention | - Cleaning the surface. |
Viscosity | ||
Changes in texture | Efflorescence | - Removal by brushing scraping or washing; - repainting the surface; - When necessary apply sealer before repainting. |
Sweating | ||
Cracking | ||
Chalking | ||
Saponification | ||
Reduction in adhesion | Peeling | - Proceed by totally or partially removing the coat of paint; - Check the condition of the base and proceed with its repair where necessary; - Prepare the base of the paint work. |
Flaking | ||
Swelling |
Classification of irregularities.
During the process of an on-site inspection, the user of the application can refer to the database in order to classify the abnormality being observed, consulting the list of defects, which includes, in addition to their identification, the most relevant characteristics and some of the causes that could be at the root of their development. Table 2 lists two of the irregularities from the classification:
Classification | Irregularity | Characteristics and causes |
Alteration in colour | Yellowing | - A yellow colour caused by ageing of the film of the paint or varnish; - Action of environmental agents (solar radiation, temperature oxygen and humidity) on the binder in the paint provoking changes in its molecular structure. |
Discoloration | - Partial loss of colour of the film of paint coating; - Action of environmental agents (solar radiation, temperature, polluted atmosphere and chemically aggressive bases of application) on the binder and/or the pigments of the painted coating. |
Irregularities and Causes.
The completed application supports on-site inspections and the on-going analysis of the evolution of the degree of deterioration of the coating. The following computational systems were used in its development:
The main interface gives access to the virtual model of the building and to the inspection and maintenance modules (highlighted in Fig. 12). The first step is to make a detailed description of the building (location, year of construction, type of structure....., Fig. 13) and representative modelled elements of the interior wall coating, so that they can be monitored.
The main interface of the virtual application.
The model is manipulated in the virtual environment by using the mouse buttons (movement through the interior of the model and orientation of the camera, Fig. 13). The coordinates of the observer’s position and the direction of his/her point of view are associated with the element during the process of identification. Thus, later, when an element in the database of the application is selected using the interface, the model is displayed in the visualization window so that the target coating can be observed.
Walking through the model with the aim of accessing all the elements of the building, the user needs to be able to go up and down stairs or open doors or windows. The virtual model has been programmed, using the
Interface for the detailed description of the building and coordinates and manipulation commands in the virtual model.
Each wall surface in each of the rooms of the house is a component which has to be monitored and, therefore, to be identified. Using the model, the user must click the mouse on an element, and the message New Element is shown (highlighted in Fig. 12). Associated to this selected element is the information regarding location within the house (hall, bedroom), wall type (simple internal masonry wall) and coating (paint).
Later, on an on-site inspection visit, the element to be analysed it selected interactively on the virtual model. The inspection sheet (Fig. 15) is accessed by using the Inspection button which is found in the main interface (Fig. 12). The data which identify the selected element are transferred to the initial data boxes on the displayed page (Fig. 14).
Presentation of the information introduced into the inspection sheet.
Interface for the selection of the irregularity, probable cause, area and repair methodology.
Next, using the database, the irregularity which corresponds to the observed defect, with its probable cause (ageing) and the prescribed repair methodology (removal and repainting) is selected (see highlighted area, Fig. 15). The current size of the pathology should also be indicated since it reveals how serious it is (
How long the working life of any construction component might be is an estimate and depends on a set of modifying factors related to their inherent characteristics of quality, to the environment in which the building is set and to its conditions of use (Webb and Haupt, 2003). In maintenance strategy planning the probable dates when adverse effects might occur in each of these elements must be foreseen, and the factors which contribute to defects must be reduced and their consequences minimized.
The completed model allows the user to monitor the evolution of wear and tear on the paint coating in a house. For this, technical information relative to the reference for the paint used, its durability and the date of its most recent application must be added (Fig. 17) to each element through the Maintenance Interface (also accessed from the main interface, Fig. 12).
Inspection sheet.
Based on these data, it is possible to link in the date the virtual model is consulted and visualize, in the geometric model, the level of wear and tear as a function of time (see state of repair, Fig. 17). The period of time between the date indicated and the date when the paint was applied is compared to the duration advised, in the technical literature, for repainting. The value given for this comparison is associated to the Red, Green, Blue (RGB) parameters which define the colour used for wall in the virtual model (Fig. 18).
In this way, the colour visualized on the monitored wall varies according to the period of time calculated, pale green being the colour referring to the date of painting and red indicating that the date the model was consulted coincides with that advised for repainting (Fig. 18). The data for painting and repainting are saved to a list of coating elements to be monitored in the virtual model. When an element is selected from this list, the corresponding element is represented in the virtual model, through the preview window, in the colour that corresponds to the period of the consultation.
Technical characteristics and the durability of the paint-work.
Chromatic alteration of the coating according to its state of deterioration.
Façade coatings play an important role in the durability of buildings, since they constitute the exterior layer that ensures the protection of the wall against the aggressive actions of a physical, chemical or biological nature. Naturally, they should also give the façade the required decorative effect. Since this building component is exposed to adverse atmospheric conditions it frequently shows an evident degree of deterioration, requiring maintenance work. In order to arrive at the best solution for eventual maintenance and repair work, a survey of defects and deterioration must be conducted.
In order to better understand the operation of façade coating, bibliographic research of materials usually applied to this type of material was carried out and a table of characteristics of these was drawn up. Subsequently, a survey was made of anomalies, probable causes, solutions and methods of repair for each of the coatings studied. The visualization of the maintenance data of a building and the impact of time on the performance of these exterior closure materials require an understanding of their characteristics (Gomes and Pinto, 2009) (Fig. 19):
Different types of materials applied as façade coatings and some irregularities.
Depending on the role that the façade coatings play on the wall as a whole they can be classified as finishing, sealing or thermal insulation. The most frequent materials used as coating finishes are painting, tiling and, as sealing coating of the natural stone:
Paint coating contributes to the aesthetic quality of the building and its environment and also protects the surface of the exterior wall against corrosion, deterioration and penetration of aggressive agents (Ferreira et al.,, 2009);
The ceramic coating consists essentially of tiling panels, cement and adhesive and the joints between the slabs. The application of ceramic tiling to building façades has considerable advantages particularly as some degree of waterproofing is afforded by the glazed surface along with a great resistance to acids, alkalis and vapour (Veiga and Malanho, 2009);
The use of natural stone in the coating of façade surfaces is a good solution both technically and aesthetically. The principal characteristics of the stones are: reduced water absorption, sufficient mechanical resistance to bending and impact, abrasion and shearing parallel to the face of the slabs.
The most frequent anomalies that occur in the coated façades were analysed in order to create a database linked to the virtual model that could support the planning of inspections and maintenance strategies in buildings. This database contains the identification of anomalies that can be found in each type of material used in façades and the corresponding probable cause. For each type of anomaly the most adequate repair solutions were also selected and included in the database. The following example, concerning deficiencies in tiles, illustrates the methodology implemented in this virtual application (Table 3).
Anomaly | Detachment | Cracking / Fracturing |
Specification of the anomaly | Fall in areas with deterioration of support | Failure of the support (wide cracks with well-defined orientation) |
Repair solution | Replacement of the coat (with use of a repair stand as necessary) | Replacement of the coat (with repair of cracks in the support) |
Repair methodology | 1. Removal of the tiles by cutting grinder with the aid of a hammer and chisel; 2. Timely repair of the support in areas where the detachment includes material constituent with it; 3. Digitizing layer of settlement; 4. Re-settlement of layer and tiles. | 1. Removal of the tiles by cutting grinder; 2. Removal of material adjustment in the environment and along the joint; 3. Repair of cracks, clogging with adhesive material (mastic); 4. Settlement layer made with cement in two layers interspersed with glass fibre; 5. Re-settlement of layer and tiles |
Example of anomalies and the associated repair solution.
The implementation of the prototype system makes use of graphical software programming,
Many potential users are not computer experts. Human perceptual and cognitive capabilities, therefore, were taken into account when designing this visualization tool with the result that the model is easy to use and does not require sophisticated computer skills.
It uses an interactive 3D visualization system based on the selection of elements directly within the virtual 3D world. Furthermore, associated with each component, there are integrated databases, allowing the consultation of the required data at any point in time.
The interface is composed of a display window allowing users to interact with the virtual model, and a set of buttons for inputting data and displaying results (Fig. 20).
For each new building to be monitored, the characteristics of the environment (exposure to rain and sea) and the identification of each element of the façades must be defined. The data associated to each element are the building orientation, the type of exterior wall (double or single), and the area and type of coating.
The main interface of the interactive application.
Once each monitored element has been characterized, various inspection reports can be defined and recorded and thereafter consulted when needed. An inspection sheet is accessed from the main interface (Fig. 21). The inspection sheet includes the type of covering (natural stone, Fig. 22), the anomalies (Cracking /Fracturing) and a list of possible causes to be selected and associated to the element. Several photos can be added.
Inspection sheet interface.
Selecting data in the inspection interface.
First, the 3D geometric model of a building was created (Fig. 23). In this case, the building consists of a ground-floor, a 1st floor and an attic with dwelling space. The coating elements of the walls were then modelled as independent geometric objects. In this way, each element can then support characterization data of the applied material and different kinds of information related to maintenance.
Steps in the geometric modelling process.
All coatings studied were considered in this case-study. Thus the main façade was assumed to be tiled and the remaining façades painted while hall façades are of natural stone. Fig. 24 shows how to identify a façade in the virtual model of the building.
Fig. 25 shows the inspection report of an anomaly. The developed software is easy to handle and transport for on-site inspections and comprises information of the causes, solutions and methods for repairing anomalies.
Identification of a façade element.
An inspection sheet report.
Technical drawings and explanatory texts often have little detail and are frequently insufficient in fully comprehending the object. Using VR models means that mistakes can more easily be caught before construction starts, which translates into time and cost reduction. The construction planning model can be used with any kind of construction project and, being a flexible application, accepts new data when necessary, allowing for a comparison between the planned and the constructed. The prototype can also be expanded to include other aspects of construction management, such as resource administration, or to have real-time access to the construction, through the use of cameras installed on site. The use of new mobile technologies could move the application to the construction site, clarifying any doubts about location or position of each component.
The developed VR models to support the maintenance of walls interior and exterior enables the visual and interactive transmission of information related to the physical behaviour of the elements. As the VR models are linked to each database in an interactive environment and have user-friendly interfaces with easily manipulation of the data, they engender collaborative systems. With these applications, the user may fully interact with the programs referring to the virtual models at any stage of the maintenance process and can analyse the best solution for repair work. They can also support the planning of maintenance strategies. The main aim of the application is to facilitate maintenance enabling the rapid and easy identification of irregularities, as well as the possible prediction of their occurrence through the available inspection record. This analysis has been shown as playing an important role in conservation and in the reduction of costs related to the wear and tear of buildings and contributes to the better management of buildings where maintenance is concerned. The developed software is easy to handle and transport for on-site inspections and comprises information of the causes, solutions and methods for repairing anomalies.
In addition to the inspection component, a maintenance component was developed which, being visualized in a VR environment, as well as being highly intuitive, facilitates the analysis of the state of repair of buildings. By means of a chromatic scale applied to the monitored elements, displayed in the walk-through of the geometrically modelled building, it is possible to identify the elements which, predictably, will need timely action. With the possibility of altering the time parameter freely, the user can carry out this analysis either for past instants or for future events, being able, in this way, to forecast future operations. This capacity of the model, therefore, contributes to the avoidance of costs associated to irregularities which, with the passage of time, become more serious and therefore more onerous.
The use of new mobile technologies could move the application to the construction site, clarifying any doubts about location or position of each component. As each 3D model is linked to a database in an interactive environment and has a user-friendly interface with easily manipulation of the data, it engenders a collaborative system. With these applications, the user may fully interact with the programs referring to each virtual model at any stage of the construction and maintenance processes and can analyse the best solution for alternative to construction plane and repair work. The maintenance applications can also support the planning of maintenance strategies and promote the use of IT tools with advanced graphic and interactive capabilities in order to facilitate and expedite the inspection process. The virtual model, moreover, allows users to see, in the virtual environment, the state of repair of the coating.
Two other VR models are now in progress, concerning the inspection activity of floors and roofs of buildings. With these two other modules the research project will be complete. Then the complete VR application will support different aspects of the maintenance process in buildings.
Virtual Reality technology with its capability of interaction and connectivity between elements was employed in the developed prototypes within a research project, offering several benefits both in presenting and developing projects and in supporting decision-making in the construction and maintenance domain.
The models support construction activity. The VR construction model allows the presentation of each step comparing what is planned with the real situation observed, the pictures taken in situ. The model, therefore, helps the designer and owner to redefine the early plan introducing changes to the work in progress. Thus, economic benefits of updating the planning schedule are achieved along with better, error-free construction with no unnecessary delays. The maintenance model supports the global analysis of the need for repair tasks in a building, helping the designer to define an adequate plan of rehabilitation work. The plan must incorporate the repair of all anomalies detected during an inspection visit, which are reported, with the help of the VR model, it, too, bringing economic benefits.
Both maintenance models show the characteristics of each element of the building in the model and the information related to inspection, anomalies and repair works. The information about pathologies, causes and repair methods, collected from a specialized bibliography, has been organized in such a way as to establish a database to be used as a base for the drawing up of a tool to support building maintenance.
The authors gratefully acknowledge the financial support of the Foundation for Science and Technology, a Governmental Organization for the research project PTDC/ ECM/67748/ 2006,
In 1968 James Maxwell Glover Wilson and Gunnar Jungner supported by the World Health Organization published a research named [1]. In 1972 the American Cancer Society together with the National Cancer Institute developed the Breast Cancer Detection Demonstration Project, aimed to perform X-ray mammography breast cancer screening for more than quarter of a million of American women.
Since then, X-ray mammography has become not only the main screening method but also the ‘gold’ standard in diagnostics. It is important to distinguish the difference between screening tests and early diagnostics. Early diagnostics implies early detection of tumors in patients with symptoms. Screening test means early detection of tumors in patients without symptoms [2]. Nowadays, screening uses X-ray mammography as the method of early diagnostics of breast cancer. However, used as a screening method, X-ray mammography has its limitations and drawbacks. We’ll name some problems of the main screening method.
Women with cancer detected by age group.
Table 2 shows operational characteristics of X-ray mammography received during a 6-year period from a large group of patients with symptoms [6].
The number of patients attending the symptomatic breast clinic, by age and final diagnosis of either having breast cancer or not having breast cancer.
Sensitivity of X-ray mammography used for breast cancer diagnostics above 80%, which would satisfy screening requirements, is observed only in the 70–79, 80–89 and 90+ age groups.
These data show the necessity to implement additional effective screening programs for young women including screening with the application of alternative technology in order to lengthen the preclinical detection stage, which would lead to the decrease of breast cancer mortality rate [17]. In order to overcome the existing limitations, it is necessary to use modern alternative methods of breast examination that would be equal to the ‘gold’ standard in its effectiveness. Electrical impedance mammography is a diagnostic method satisfying the criteria set by the World Health Organization for screening for diseases. MEIK v.5.6, electrical impedance mammograph developed and manufactured by PKF ‘Sim-technika,’ Russia, uses advanced technologies of imaging and processing of electrical impedance images of breast. It is a noninvasive technology of image creation, it uses 3D-tomography system, it is a form of ‘soft-field’ tomography, it applies ‘non-local’ method of tomographic image creation and cross-sectional approach to data collection, it uses back-projection method as the algorithm of image reconstruction, and finally it allows to receive quantitative diagnostic information. The electrical properties of biological tissue as of colloid-dispersed system in an alternating electric field depend on the concentration and behavior of the chemical components of the tissue. The electric properties of a tumor differ significantly from those of the surrounding tissues. The aim of screening is to detect breast cancer including early breast cancer (tumor size below 1 cm) and to form a survey or high-risk group. In order to reach these aims, the following actions need to be undertaken: search for areas with abnormal conductivity, detection of distorted mammographic scheme and evaluation of age-related electrical conductivity.
Definition | Electrical conductivity | Percentile limits |
---|---|---|
Amorphous structure | More than 0.66 | >90‰ |
Mixed type with amorphous component prevailing | 0.57–0.65 | 75–90‰ |
Mixed type | 0.30–0.56 | 25–75‰ |
Mixed type with acinar-ductal component prevailing | 0.22–0.29 | 10–25‰ |
Acinar-ductal type prevailing | Less than 0.22 | <10‰ |
Percentile limits for different types of breast structure in electrical impedance mammography.
Therefore, the electrical conductivity index can be used for the evaluation of breast structure from the point of view of electrical impedance mammography. It is a known fact that the structure of breast defines the breast density. For this reason, the defined ranges of electrical conductivity correspond to different types of ‘density’ of breast. Table 4 shows the structure of the breast according to the electrical impedance mammography and types of density according to American College of Radiology [ACR] classification. ‘Dense’ breast, i.e. the so-called acinar-ductal type, is characterized by low electrical conductivity index. High electrical conductivity index is common for amorphous type of breast [consisting mostly of adipose and connective tissue]. The image shows examples of electrical impedance mammograms of patients from different age groups with different structure of breast: a 25-year-old patient with acinar-ductal type (Figure 1) and extreme breast density and 63-year-old patient with amorphous structure and low breast density (Figure 2).
The structure of the breast according to electrical impedance mammography and types of density according to the American College of Radiology [ACR] classification.
Type IV (ACR IV). Acinar-ductal type. Extreme tissue density.
Type I (ACR I). Amorphous type. Low tissue density.
On the Figure 2 you can find examples of electrical impedance mammograms of the same age group but with different breast structure: 36-year-old patient with acinar-ductal type and high tissue density and 34-year-old patient with amorphous structure and low tissue density (Figure 2). In order to form a survey group, it is necessary to determine not only the breast structure but also the correspondence between the structure type and age-related electrical conductivity of the breast.
Diagnostic table of age-related electrical conductivity of breast.
The electrical properties of cancer tumor differ greatly from the electrical properties of the surrounding tissues. It was established during several researches that malignant tumors have lower electrical impedance than normal tissues. The results of these studies are given in Table 6 [29].
Authors, year | Frequency range investigated | Nature of study and results |
---|---|---|
Fricke et al. [29], 1926 | 20 kHz | They measured the parallel capacitance and resistance of the following excised samples from the breast—fat, gland, mastitis, fibroadenoma and carcinoma They found significantly higher permittivity of the tumor tissue at 20 kHz than the normal or benign tissues. |
Singh et al. [30], 1979 | 100 Hz–100 kHz | They performed in vivo impedance measurements on female breasts with and without tumors. Their results showed that malignant tumors have higher relative permittivity and lower resistance than those of normal breast tissue |
Chaudhary et al. [31], 1984 | 3 MHz–3 GHz | They examined excised normal and malignant breast tissues and found that the conductivity and permittivity of malignant tissues are higher than those of normal tissues, especially at frequencies lesser than 100 MHz. |
Surowiec et al. [32], 1988 | 20 kHz–100 MHz | They conducted in vitro dielectric studies in three different samples of breast tissues—the main tumor tissue, the tissue immediately surrounding the tumor and the peripheral normal tissue. They found that the tumor tissues have a low-frequency (100 kHz) conductivity around 2–4 mS/cm which is higher than the conductivity of normal tissue (below 1 mS/cm) and lower than that of the tissue surrounding the tumor (8 mS/cm). |
Morimoto et al. [33, 34], 1990 | 0–200 kHz | They measured the extracellular and intracellular resistances and membrane capacitance of breast tumors in vivo. They concluded that there are statistically significant differences between normal and cancerous tissues. However, it has been reported that malignant tumors have lowered capacitance compared to benign tumors. This is different from the results of the study conducted by Jossinet [36] and Fricke [33] which have recorded higher capacitance values for malignant tumors. |
Jossinet [35], 1996 | 488 Hz–1 MHz | The study examined six groups of normal and pathological breast tissues in vitro. The variability of impedivity within each group was assessed by statistical methods. It was found that the variability was smaller in adipose tissue, carcinoma and fibroadenoma above 10 kHz. |
Jossinet [36], 1998 | 488 Hz–1 MHz | Using the same data from [35], it was found that the cancerous tissue differed significantly from fibroadenoma and mammary gland tissues by the modulus of impedivity up to 31.25 kHz and from the remaining tissue groups (connective tissue, adipose tissue and mastopathy) by the low-frequency-limit resistivity and the phase angle from 125 kHz to 1 MHz. It was also observed that neither the impedivity nor the low-frequency-limit resistivity nor the fractional power value was different between the groups of normal and benign tissues. |
Jossinet et al. [37], 1999 | 488 Hz–1 MHz | Again using the same excised data collected for previous studies, they defined a set of eight parameters that could differentiate cancerous breast tissues from noncancerous ones. They concluded that a combination of the parameters over various frequencies is necessary for the accurate differentiation among tissues. |
Chauveau et al. [38], 1999 | 10 kHz–10 MHz | They conducted an in vitro study of normal and pathological breast tissues and observed significant differences in their dielectric properties. They have determined three indices based on extracellular resistance, intracellular resistance and membrane capacitance to differentiate between various tissue pathologies—normal, invasive ductal carcinoma (IDC), IDC with stromal reaction and fibrocystic changes. |
The results of several researches of the electrical properties of cancer tumor.
S. Haltiwanger published the results of several studies about the specific features of tumor cells that influence their electrical activity:
Cancer cells have cell membranes that exhibit different electrochemical properties and a different distribution of electrical charges than normal tissues [30].
Cancer cells also have different lipid and sterol content than normal cells [31].
Cancer cells have altered membrane composition and membrane permeability, which results in the movement of potassium, magnesium and calcium out of the cell and the accumulation of sodium and water into the cell [32].
Cancer cells have lower potassium concentrations and higher sodium and water content than normal cells [33, 34].
The result of these mineral movements, membrane composition changes, energy abnormalities and membrane charge distribution abnormalities is a drop in the normal membrane potential and membrane capacitance.
An increase in the intracellular concentration of positively charged sodium ions and an increase in negative charges on the cell coat (glycocalyx) are two of the major factors causing cancerous cells to have lower membrane potential than healthy cells [31].
Two of the most outstanding electrical features of cancer cells are that they constantly maintain their membrane potential at a low value and their intracellular concentration of sodium at a high concentration [34, 35].
A sustained elevation of intracellular sodium may act as a mitotic trigger causing cells to go into cell division [35].
The results of the researches confirm that electrical conductivity is an appropriate parameter for the differentiation between healthy tissue and tumor tissue. The fundamental difference of electrical impedance scanning from other tomographic methods is that besides visual evaluation of the image, the electrical impedance mammography offers quantitative information [28]. If the diagnostic method under discussion yields a quantitative result, a value is defined, the overpassing of which is deemed to be a sufficient cause for qualitative evaluation, i.e. the so-called differentiation point. It is essential to define a precise differentiation point. The point with electrical conductivity exceeding 3 standard deviations [std] is considered to be the point of differentiation between breast cancer patients and healthy people. The detection of areas with high electrical conductivity exceeding 3 std. outside the lactiferous sinus in electrical impedance mammograms, which differs greatly from the electrical conductivity of normal breast tissue, is used as a diagnostic criteria for the detection of breast cancer [28]. Moreover, sizes of tumors as a rule do not exceed 10 mm.
Figure 3 shows the electrical impedance mammogram of a breast cancer patient with the following parameters: IC = 0.56, std. = 0.12. In the mammogram, at the 3 o’clock position near the areola, a focus without a sharp contour is visualized, its IC being equal to 0.94. Therefore, the IC in the area of interest exceeds the mammogram IC by more than 3 std.
Upper row: Electrical impedance mammogram of a breast cancer patient. At the 3 o’clock position near the areola a focus without a sharp contour, with abnormal electrical conductivity, is visualized. It is colored red (7 × 10 mm). The lower row shows X-ray and ultrasound images for the same patient.
Below X-ray images [fibroadipose involution, the upper external quadrant shows a mass less than 1 cm in size with uneven contour] and ultrasound mammograms [the external quadrant contains a lesion of irregular shape with uneven structure, 7 × 8 mm in size, with vascularization] of the same patient are presented.
For the last few years, clinical studies have been held in different countries determining the potential of electrical impedance mammography in breast cancer diagnostics. All these studies used electrical impedance computer mammograph MEIK v.5.6, abnormal electrical conductivity being the diagnostic criterion [28].
Sachin Prasad and colleagues performed a study to determine the diagnostic efficiency of 3D electrical impedance tomography [EIT] compared to mammography (mg) and ultrasonography (USG) in breast imaging [36]. A group of 88 patients with various breast complaints was examined using combined mammography and ultrasonography [MG & USG] or either of these modalities alone. The same patients were then examined using the 3D EIT imaging system MEIK. The study revealed that there was no overall significant difference in sensitivity between MG-USG [p = 0.219] and MG-EIT [p = 0.779] and USG-EIT [p = 0.169].
O. Raneta and colleagues [37] performed a study to analyze the possibilities of electrical impedance tomography [EIT] application in the differential diagnosis of pathologic lesions of the breast either solely or in combination with MMG/USG [37]. A group of 870 eligible women with suspected pathological breast lesion discovered by mammography [MMG] or ultrasound examination [USG] were recommended to pass histological examination to verify the diagnosis. The sensitivity of MMG increased from 87.8% when using it as an independent method to 94.5% with EIT added. The sensitivity of USG increased from 86.7% when used as an independent method to 93.3% with EIT added. The results of the study showed that the use of EIT in addition to MMG/USG can improve the sensitivity of these methods and increase the rate of early detection of breast cancer with minimal economic costs and time input of highly qualified staff.
Daglar and colleagues [38] performed a study to compare the usefulness of the breast electrical conductivity measures performed in a surgical examination room against conventional breast screening modalities for identifying the symptomatic lesions of the breast tissue [38]. A group of 181 patients were examined with ultrasonography [USG], mammography [MG] and electrical impedance scanning [EIS] modalities, which were followed up for 24 months to clarify the lesion tumor progression relationship. EIS exhibited compatible sensitivity [81.2%], accuracy [84.6%] and PPV [81.8%] rates with USG in BI-RADS 4 subgroup, combination of these modalities raised sensitivity rates to 92.31%, accuracy and PPV to 100%. EIS results in BI-RADS 3 subgroup were pointed out 77.8% specificity and 87.5% NPV rates. Breast electrical impedance measures should be useful to reduce the number of the unnecessary follow-up and biopsy rates in the clinical setting.
Xu Feng and colleagues [39] performed a study to investigate the diagnostic accuracy of electrical impedance tomography [EIT] for benign and malignant breast diseases in comparison to conventional ultrasonography and mammography [39]. A total of 121 patients with 126 breast lesions who underwent ultrasonography mammography and EIT were enrolled in the study. All of these lesions were confirmed by pathological biopsy. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EIT, ultrasonography and mammography were calculated with histology used as the ‘gold’ standard. The accuracy of EIT, ultrasonography and mammography were 75.4, 81.7 and 76.1%, respectively. The sensitivity was 76.8, 94.6 and 74.4%, respectively. The specificity was 74.3, 71.4 and 77.6%, respectively. The accuracy, sensitivity and specificity of EIT combined with ultrasound in the diagnosis of breast lesions were 91.3, 98.2 and 85.7%, respectively. The accuracy [χ2 = 4.896, P = 0.027] and specificity [χ2 = 4.242, P = 0.039] were significantly higher on EIT than ultrasound. The accuracy, sensitivity and specificity of EIT combined with mammography were 95.5, 97.4 and 93.9%, respectively, which were significantly higher than those of mammography [χ2 = 13.474, P < 0.001; χ2 = 8.573, P = 0.003; χ2 = 5.333, P = 0.021]. Used together with ultrasound or mammography, the electrical impedance tomography could be a valuable complementary examination in the diagnosis of breast diseases. Furthermore, EIT could provide very useful additional information for metabolic assessment of mammary glands, which may be used for early screening of breast diseases.
Blanca Murillo-Ortiz and colleagues [40] performed a study to know the effectiveness of the electrical impedance mammography for the detection of mammary carcinoma in 615 women from 25 to 70 years of age [40]. The sensitivity and specificity of the electrical impedance mammography (MEIK) was 85 and 97%, respectively.
Therefore, the studies showed high level of sensitivity and specificity, which allows to use abnormal electrical conductivity as the diagnostic criterion in screenings for early detection of breast cancer.
Distortion of normal mammographic scheme appears in case of structural changes, such as pathological shadows and microcalcifications. These focal changes can be easily detected with the help of medical equipment checking the density of tissue. But along with focal changes, breast cancer can reveal itself through diffuse changes of breast structure, which also leads to the disruption of normal mammographic scheme, and this can be detected with electrical impedance mammography. For X-ray diagnostics, diffuse changes are a difficult matter since they do not change the density of breast tissue.
As the disease develops, which leads to the destruction of the basement membrane of the epithelium, the lesion and surrounding tissues may undergo various phenomena followed by changes of electrical properties of the tumor mass:
Edema and softening of fibrous connective tissue
Slimming, hyalinosis, calcification
Appearance of purulent areas
Lymphocytic infiltration of tissue
Therefore, tumor growth is naturally accompanied by the changes of electrical properties of tumor and surrounding tissues. The criteria of distortion of normal mammographic scheme in cases of breast cancer are changes of contour, anatomical changes, local changes of electrical conductivity and change of comparative electrical conductivity. As previously stated, the electrical impedance method gives a possibility of quantitative imaging [28]. Quantitative analysis of an electrical impedance image allows to receive a histogram of electrical conductivity distribution and compares it with reference values. As a rule, distorted mammographic scheme in case of breast cancer is accompanied by changes of electrical conductivity of breast tissues. This phenomenon facilitates visual and quantitative interpretation of the lesion and can be used for diagnostic purposes. Figure 4 shows several variants of distorted mammographic scheme in cases of breast cancer and their visual evaluation [1, contour deformation; 2,4, thickening of contour; 3, anatomic distortion; 5,6, local changes].
Several variants of distorted mammographic scheme in cases of breast cancer.
For the classification of a patient (healthy or affected), test of differences in the form of distributions [λ criterion], i.e. Kolmogorov-Smirnov test in Dx modification, is used [41]. This criterion, which is a nonparametric test, allows to determine the statistical value of differences in the distribution of any normal or abnormal features, including the distribution of electrical conductivity in electrical impedance tomograms. For the assessment of informativeness of distribution divergence, Kulback informativeness measure is applied [41]. High informativeness of the detected differences allows to refer the patient with high degree of probability to one class or the other (e.g. norm or cancer). In case of breast cancer, histogram of affected breast gets displaced, and Dx criterion exceeds 40% (Figure 5).
Upper row, EIM. Seven scan planes. Breast cancer. Bottom row, EIM. Seven scan planes. Healthy breast. The second row shows the divergence between the histograms of electrical conductivity distribution of the affected and healthy breast.
Table 7 shows the comparative electrical conductivity data for patients with breast cancer, benign changes, for healthy patients and for those with different types of breast structure; the data was received during clinical studies in the hospitals of Russia. It is evident that divergence of histograms of electrical conductivity distribution by more than 40% is observed only in cases of breast cancer, and actually divergence of histograms of electrical conductivity distribution by more than 30% in the majority of cases is observed during oncological processes in the breast.
Percentage distribution of healthy patients, patients with benign changes and breast cancer depending on the percentage of comparative electrical conductivity of the breasts.
During the oncological process, natural changes of general and local electrical conductivity occur. And distortion of normal mammographic scheme may occur at an early stage of the disease. This is the reason why this criterion is included in the EIM scale of breast cancer diagnostics [41].
A scoring scale used for the evaluation of mass lesions in the breast by means of electrical impedance mammography allowed to relate the information received with BI-RADS ACR categorization (Table 8). The EIM scoring scale allowed to standardize the description of mass lesions examined by means of electrical impedance mammography and to use the patient follow-up algorithm developed by the American College of Radiology.
EIM | ACR |
---|---|
Common scale | BI-RADS categories |
No score | BI-RADS 0 poor image |
0–1 | BI-RADS 1 lesion is not defined |
2–3 | BI-RADS 2 benign tumors—routine mammography |
4 | BI-RADS 3 probably benign findings |
5–7 | BI-RADS 4 suspicious abnormality—biopsy |
>8 | BI-RADS 5 highly suggestive of malignancy—treatment/biopsy |
EIM scale and ACR BI-RADS.
Therefore, the distortion of normal mammographic scheme along with abnormal electrical conductivity is one of the most frequent diagnostic indicators of breast cancer.
Sensitivity and specificity are operational characteristics that allow to evaluate the effectiveness of a diagnostic method. Operational characteristics are influenced by several factors: size and area of pathology, age of patients in the groups under study and prevalence in the group under study. In the process of sensitivity and specificity calculation, the disease prevalence in the group is not taken into account. It is a significant benefit since it gives a possibility to spread the data received in a group of people onto other groups, with different prevalence. However, it is also a drawback of evaluation. The diagnostic test data should be spread cautiously onto groups of people that differ significantly from the group under study.
The calculation method used for operational characteristics such as sensitivity and specificity has its own peculiarities in cases of low and high prevalence.
Characteristics of screenings:
Unrestricted population of sampling group, as a rule including many thousands of people
Low prevalence
Standard methodology
Significant prevailing of healthy patients over patients with pathologies
Impossibility to use reference method and histological verification of the diagnosis due to a large number of healthy patients
Significant prevailing of patients with early stages of disease from among the number of those with revealed pathologies
Impossibility to apply operational characteristics: specificity and sensitivity
Characteristics of a diagnostic study:
Restricted sampling population, several dozens of respondents
High prevalence
Standardized methodology
Significant prevailing of patients with pathologies over healthy ones
Significant prevailing of patients with progressing disease over those with early stages
Use of referential method and histological verification of diagnosis
Application of operational characteristics: sensitivity and specificity
Characteristics of a diagnostic study:
Unrestricted sampling population and timing
Medium prevalence
Standardized methodology
Prevailing of healthy patients over patients with pathologies
Full range of disease manifestation: from early-stage patients to patients with progressing disease
Use of referential method and histological verification of diagnosis
Application of operational characteristics: specificity and sensitivity
Is it correct to spread operational characteristics received from the second and third examples onto the screening?
Spreading the estimations received in high-prevalence conditions onto low-prevalence conditions should be done with caution. High-prevalence spectrum of disease manifestations differs from low-prevalence spectrum. Since diagnostic centers accumulate patients with a certain disease, in the structure of high-prevalence cases of progressing disease dominate significantly over early stages of disease.
Since every stage of disease has its own symptoms or specific criteria, for every stage the diagnostic criteria should have their own operational characteristics.
Operational characteristics are determined on the basis of restricted sample group of patients with verified diagnoses. Since reference tests, as a rule, are indifferent for the respondents, in such studies the number of persons not affected by the disease under study is minimal. In case of data spreading, it can influence the expected number of false-positive and false-negative results.
The optimal study for receiving operational characteristics of the method used from the point of view of patient selection, prevalence level, from the point of view of commonality of the methodology used and the usage of the reference method and histological verification is not a low-prevalence study, such as screening, and is not a high-prevalence study as inpatient examination but a study held in an imaging room for the prevalence typical for the settlement. Shifting of operational characteristics in the situation of medium prevalence is preferable since it has a well-balanced data set.
Electrical impedance mammography is a tool for primary breast cancer screening. It is confirmed by its high informativeness, safety for the staff and patient, portability and mobility. Operational characteristics (sensitivity and specificity) are determined on a restricted sample group, the so-called high- and medium-prevalence group, with the use of reference method (X-ray mammography) and verified diagnosis. The studies were held in oncological centers and clinics. The study on a group of patients with high and medium prevalence demonstrated high sensitivity and specificity of the electrical impedance mammography. The received operational characteristics can be spread onto groups of patients with low prevalence and be used during planning of screening studies. It allows to use the electrical impedance mammography for primary breast cancer screening of big groups of population with low prevalence. The electrical impedance mammography fulfills its functional screening tasks without ionizing radiation and other potentially hazardous means. It can be used to perform examinations for women of all age groups in outpatient departments, schools, clinics for women, maternity hospitals and sanatoriums, i.e. in the gathering places for women. In such a way, the problem of organization of mass screening for women can easily be solved.
The authors declare no conflict of interest.
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