Three-dimensional Surface Imaging Research Articles

Reliability and validity of handheld structured light scanners and a static stereophotogrammetry system in facial three-dimensional surface imaging

Several new systems for three-dimensional (3D) surface imaging of the face have become available to assess changes following orthognathic or facial surgery. Before they can be implemented in practice, their reliability and validity must be established. Our aim, therefore, was to study the intra- and inter-system reliability and validity of 3dMD (stereophotogrammetry), Artec Eva and Artec Space Spider (both structured light scanners). Intra- and inter-system reliability, expressed in root mean square distance, was determined by scanning a mannequin’s head and the faces of healthy volunteers multiple times. Validity was determined by comparing the linear measurements of the scans with the known distances of a 3D printed model. Post-processing errors were also calculated. Intra-system reliability after scanning the mannequin’s head was best with the Artec Space Spider (0.04 mm Spider; 0.07 mm 3dMD; 0.08 mm Eva). The least difference in inter-system reliability after scanning the mannequin’s head was between the Artec Space Spider and Artec Eva. The best intra-system reliability after scanning human subjects was with the Artec Space Spider (0.15 mm Spider; 0.20 mm Eva; 0.23 mm 3dMD). The least difference in inter-system reliability after scanning human subjects was between the Artec Eva and Artec Space Spider. The most accurate linear measurement validity occurred with the Artec Space Spider. The post-processing error was 0.01 mm for all the systems. The Artec Space Spider is the most reliable and valid scanning system.

Frontiers in Three-Dimensional Surface Imaging Systems for 3D Face Acquisition in Craniofacial Research and Practice: An Updated Literature Review.

Digitalizing all aspects of dental care is a contemporary approach to ensuring the best possible clinical outcomes. Ongoing advancements in 3D face acquisition have been driven by continuous research on craniofacial structures and treatment effects. An array of 3D surface-imaging systems are currently available for generating photorealistic 3D facial images. However, choosing a purpose-specific system is challenging for clinicians due to variations in accuracy, reliability, resolution, and portability. Therefore, this review aims to provide clinicians and researchers with an overview of currently used or potential 3D surface imaging technologies and systems for 3D face acquisition in craniofacial research and daily practice. Through a comprehensive literature search, 71 articles meeting the inclusion criteria were included in the qualitative analysis, investigating the hardware, software, and operational aspects of these systems. The review offers updated information on 3D surface imaging technologies and systems to guide clinicians in selecting an optimal 3D face acquisition system. While some of these systems have already been implemented in clinical settings, others hold promise. Furthermore, driven by technological advances, novel devices will become cost-effective and portable, and will also enable accurate quantitative assessments, rapid treatment simulations, and improved outcomes.

Patient perceptions of three-dimensional (3D) surface imaging technology and traditional methods used to assess anthropometry

BackgroundObesity and overweight are commonplace, yet attrition rates in weight management clinics are high. Traditional methods of body measurement may be a deterrent due to invasive and time-consuming measurements and negative experiences of how data are presented back to individuals. Emerging new technologies, such as three-dimensional (3D) surface imaging technology, might provide a suitable alternative. This study aimed to understand acceptability of traditional and 3D surface imaging-based body measures, and whether perceptions differ between population groups. MethodsThis study used a questionnaire to explore body image, body measurement and shape, followed by a qualitative semi-structured interview and first-hand experience of traditional and 3D surface imaging-based body measures. Results49 participants responded to the questionnaire and 26 participants attended for the body measurements and interview over a 2-month period. There were 3 main themes from the qualitative data 1) Use of technology, 2) Participant experience, expectations and perceptions and 3) Perceived benefits and uses. ConclusionFrom this study, 3D-surface imaging appeared to be acceptable to patients as a method for anthropometric measurements, which may reduce anxiety and improve attrition rates in some populations. Further work is required to understand the scalability, and the role and implications of these technologies in weight management practice. (University Research Ethics Committee reference number ER41719941).

Advanced Body Measurement Techniques Can Complement Current Methods of Cytotoxic Chemotherapy Dose Prescription

Within chemotherapy, estimates of a patient’s body surface area (BSA) are used to calculate drug dosages. However, the use of BSA for calculating chemotherapy dosage has been heavily criticised in previous literature, with potentially significant implications for the effectiveness and toxicity of treatment. BSA has been found to be a poor indicator of optimal drug exposure that does not account for the complex processes of cytotoxic drug distribution and elimination. In addition, differences in BSA estimates between existing formulae have been shown to be so large that they can affect patients’ mortality, particularly in patients with atypical body types. This uncertainty associated with BSA prediction may decrease the confidence of practitioners when determining chemotherapy dosages, particularly with regards to the risk of excess toxicity from over-dosing, or a reduced anti-cancer effect due to under-dosing. The use of national dose-banding in the UK may in some cases account for possible inaccuracies, but the threshold of variance in this case is small (+/−6%). Advanced body measurement techniques, utilising digital tools such as three-dimensional (3D) surface imaging, capture accurate external dimensions and detailed shape characteristics of the human body. Measures of body shape describe morphological variations that cannot be identified by traditional anthropometric techniques and improve the prediction of total body fat and distribution. It is our view that the use of advanced body measurement techniques can provide practitioners with tools for prescribing chemotherapy dosages that are valid for individuals, regardless of their body type.

Enhancing bra design for post-mastectomy patients: Incorporating MRI data and innovative textiles for optimal support and comfort

This study introduces an innovative approach to designing a customized bra to the specific needs of mastectomy patients, aiming to reduce the discrepancies in breast displacement and consequently alleviate associated pain. Through mastectomy patient interviews, recognizing the limitations of current mastectomy bras, which often fail to accommodate the unique body shapes and needs of breast cancer survivors, this research leverages Magnetic Resonance Imaging (MRI) and Three-Dimensional Surface Imaging (3D-SI) to develop a custom-fit bra prototype. The methodology involves the analysis of body shape changes post-mastectomy and the development of a prototype bra that effectively supports prostheses while minimizing common issues such as displacement, discomfort, and skin irritation. The results showcased a pronounced reduction in breast movement in all directions with the prototype bra, further enhanced using a novel cooling textile, improving the wearer’s overall comfort. Moreover, our investigation delved into the potential of integrating MRI and 3D-SI anthropometric data in bra design. By comparing two Prototype bras with differing dimensions but identical design features, we discerned marked differences in their performance. Crucially, the Prototype bra, shaped predominantly using MRI data, reduced breast displacement and evaluated better fit compared to the bra using 3D-SI data. Results from the study indicate that the prototype significantly improves fit and wearer comfort, suggesting a promising direction for future development of mastectomy bras. The findings highlight the potential of utilizing medical imaging data in garment design to create more inclusive and considerate solutions for post-surgical care.

SURFACE CHARACTERISTICS INFLUENCED BY LASER TEXTURING PARAMETERS ON BIOMEDICAL-GRADE AISI 316LVM STAINLESS STEEL

Surface roughness and wettability, which characterize the texture formed on the implant surface, are critical features for the functionality of the implant. Laser texturing is a promising processing method because of the advantages it provides in creating a particular surface topography on the surface of a metallic implant material with a nanosecond pulsed laser beam. Different experimental combinations were created using a fiber pulsed marking device on the surface of AISI 316LVM implant material using the hatch strategy; textures depending on the scan speed, frequency, and hatch distance were created on the surface. The surface roughness and wettability evaluated the effects of parameters on the texture form. Based on the experimental and statistical results, while the scan speed was the most significant parameter affecting the wettability behavior and surface roughness, the hatch strategy and frequency also affected the surface roughness to some extent. Many textured surfaces showed super-hydrophilic behavior with a contact angle of [Formula: see text]. It has been determined that surface textures with the same or close roughness values did not exhibit the same wettability behavior. The lowest surface roughness of 2 [Formula: see text]m with a [Formula: see text] contact angle was obtained at a hatch strategy of [Formula: see text]/[Formula: see text], a scan speed of 900 mm/s, a frequency of 100 kHz, and a hatch distance of 0.03 mm. Three-dimensional surface images show that while many craters formed the surface textures, overlapping consecutive beams and hatch strategies significantly affected the surface topography.

Comparison of analog and digitally evaluated volume of the female breast in reconstructive breast surgery. Validation of a noninvasive measurement method with 3D camera1.

Reconstructive surgery is established as a standard treatment option after mastectomy due to cancer. It is crucial to patients to achieve a natural and symmetric looking breast through reconstruction. Anthropometric measurements are used to assess the objective symmetry of the breast, which are prone to errors and difficult to reproduce. The aim of this work is to validate breast volumetry using three-dimensional surface imaging. We compared preoperatively analog and digitally evaluated volume of the breast with our gold standard, direct water displacement measurement of the mastectomy specimen. We examined 34 breast specimens in total. Each measurement method (Breast Sculptor, VAM, Breast-V) for breast volume/mass determination demonstrates acceptable agreement ranges when compared with resected volumes and masses. The strongest volumetry instrument is Breast Sculptor (digital), the weakest is Breast-V (analog). 3D surface imaging is a quick, effective, and convenient method to evaluate breast shape and volume. The accuracy, reproducibility, and reliability of 3D surface imaging were comparable with MRI in our study.This takes us a step closer to the long-term goal of establishing robust instruments to plan breast reconstructive surgery, achieve better surgical results, and contribute to quality assurance in breast surgery.

Methods and software for capturing three-dimensional digital images using spatial demodulation

The paper proposes the generalized technique of demodulation, which can be applied for capturing digital three-dimensional images in optical microscopes. This technique allows the calculation of the contrast of harmonic spatial modulation with any values of phase angles. The input data is a stack of digital images with harmonic spatial modulation. Three digital images with different phases of modulation captured in the same focus position are processed to get one data set about the contrast distribution. This data makes it possible to compose the three-dimensional images by the selection of the maximal values of the contrast in three-dimensional space. The paper contains the analytical solution of the system with three linear equations that helps to identify the principal parameters of harmonic spatial modulation, including its average value and contrast. As a result, the expression for contrast calculation is present in an analytical form. This expression is valid for any modulation phase angles that do not coincide. The paper contains MathCAD modeling, which illustrates the procedure of composing the three-dimensional images.
 The modeling confirms the correctness of described calculations and demonstrates the built of the three-dimensional surface image as a composition of the contrast distribution map and the corresponded height map. The advantage of the proposed technique is the possibility to apply the economical units for the formation of a harmonious spatial modulation. These units can be installed on most optical microscopes with digital cameras and motorized focusing drives without purchasing expensive commercial software. It significantly reduces the price of transforming these optical microscopes into instruments for capturing digital three-dimensional images.

A single camera unit-based three-dimensional surface imaging technique

A single camera unit-based three-dimensional surface imaging technique

PC35. PATIENT REPORTED OUTCOMES AND NIPPLE POSITION FOLLOWING NIPPLE-SPARING MASTECTOMY (NSM): A PROSPECTIVE EXAMINATION OF PREPECTORAL AND SUBPECTORAL PATIENTS

PURPOSE: Nipple-sparing mastectomy (NSM) is becoming more popular. The role of pocket dissection (prepectoral vs subpectoral) in implant-based reconstruction on patient reported outcomes (PRO’s) and nipple position following NSM has not yet been explored. We hypothesize that prepectoral reconstruction results in superior PRO’s and more anatomical nipple position compared to subpectoral reconstructions following NSM. METHODS: Surgical details and short-term complication in NSM patients from 2018 to 2021 were prospectively collected. PROs were obtained preoperatively, 6 and 12 months postoperatively. Nipple displacement from baseline was analyzed using three-dimensional(3D) surface imaging by three independent researchers. RESULTS: 216 patients who underwent 391 NSM were divided into two cohorts, subpectoral and prepectoral. There were no differences in demographics or comorbidities between cohorts. Prepectoral patients (N=83 (86%) vs. 54 (44%); p<0.001) reported better physical well-being of the chest preoperatively (median 76, IQR 67,92 vs 72, IQR 64,80; p=0.022). No other differences in PRO’s or complications were observed. Linear regression suggested that radiation is the most important factor impacting satisfaction following NSM. 3D photographs for 97 patients were analyzed and 175 nipple positions were measured in 3 dimensions. Controlling for implant size, there was greater elevation and less projection of the nipple compared to baseline in subpectoral cohort (elevation: median -16 mm, IQR -24,-7 vs -3 mm, IQR -12,5; p<0.001; projection: median -1 mm, IQR -9,6 vs -6 mm, IQR -14,4; p=0.002). CONCLUSION: Implant pocket did not impact PRO’s or short-term complications in patients who underwent NSM. Patients with prepectoral reconstruction had less nipple displacement and more nipple projection following NSM.

Three-Dimensional Surface Analysis for Preoperative Prediction of Breast Volume: A Validation Study.

Few studies have examined whether preoperative three-dimensional surface imaging can accurately predict breast volume. Reliably predicting breast volume preoperatively can assist with breast reconstruction planning, patient education, and perioperative risk stratification. The authors conducted a review of patients who underwent mastectomy from 2020 to 2021 and included all patients who had preoperative VECTRA XT three-dimensional imaging. VECTRA Analysis Module (VAM) and VECTRA Body Sculptor (VBS) were used for volumetric analysis using standard anatomical breast borders. Breast weights were obtained intraoperatively. Predictive accuracy was defined as VAM estimates ±10% of mastectomy specimen weight or ±100 g of mastectomy weight. The study included 179 patients (266 breasts). There was no significant difference ( P = 0.22) between mean mastectomy weight of 620.8 ± 360.3 g and mean VAM estimate of 609.5 ± 361.9 g. Mean VBS estimate was 498.9 ± 337.6 g, which differed from mean mastectomy weight ( P < 0.001). When defining predictive accuracy as ±100 g, 58.7% of VAM and 44.4% of VBS estimates were accurate. Body mass index, body surface area, and ptosis grade significantly affected VAM and VBS breast volume predictions. VAM is more accurate at predicting mastectomy weight than VBS, likely because of VAM's analysis of surface topography rather than discrete surface landmarks. Discrepancies between VECTRA estimates and mastectomy weight were likely attributable to differences between surgical mastectomy borders and breast borders used in volumetric analysis. Surgeons should consider the physical characteristics of patients when using three-dimensional imaging. Diagnostic, I.

A novel standardized approach for the 3D evaluation of upper eyelid area and volume.

Three-dimensional (3D) surface imaging and morphometrics are becoming the preferred craniofacial surface imaging modality. However, as a unique advantage of 3D imaging, areal and volumetric measurements have been rarely conducted and validated for evaluating soft tissue change in the periocular region, especially the upper eyelids. Therefore, based on an existing periocular landmark identification strategy, we proposed a novel modified method to define a standardized upper eyelid region for areal and volumetric measurements and validate its reliability for future clinical application. Forty-four healthy adult volunteers were enrolled in this cross-sectional study. Three-dimensional facial images were taken with a 3D imaging system. Subsequently, the upper eyelid region selection and areal and volumetric measurements were conducted using a modified landmarks localization strategy to evaluate their intrarater, interrater, and intramethod reliability. Areal measurement of the upper eyelid revealed highly reliable outcomes for intraclass correlation coefficient (ICC), mean absolute difference (MAD), relative error measurement (REM), technical error of measurement (TEM), and relative technical error of measurement (%TEM) of 0.982, 0.1620 cm2, 2.9%, 0.1510 cm2, and 2.7% for intrarater reliability, respectively; 0.969, 0.2076 cm2, 3.7%, 0.1930 cm2, and 3.5% for interrater reliability, respectively; and 0.917, 0.3636 cm2, 6.5%, 0.3354 cm2, and 6.0% for intramethod reliability, respectively. Unsatisfactory results were found for the volumetric measurement of the upper eyelid: the ICC, MAD, REM, TEM, and %TEM estimates for intrarater reliability were 0.992, 0.2299 mL, 10.3%, 0.2414 mL, and 10.8%, respectively; for interrater reliability, these values were 0.985, 0.2749 mL, 12.3%, 0.3253 mL, and 14.6%, respectively; and for intramethod reliability, these values were 0.433, 1.6716 mL, 77.9%, 2.0615 mL, and 96.1%, respectively. This is the first study to propose a standardized upper eyelid region selection strategy and simultaneously validate its reliability for 3D areal and volumetric measurements. This study confirmed the high-level reliability of areal measurement and poor reliability of volumetric measurement based on direct measurements using a single image, which may provide better results when this method is combined with the image overlapping and registration procedure. However, this is subject to further validation. Nonetheless, this method could provide quantitative areal and volumetric data on the upper eyelids and might have widespread application potential in the future.

Novel framework for determining TPS-calculated doses corresponding to detector locations using 3D camera in in vivo surface dosimetry

Purpose. To address the shortcomings of current procedures for evaluating the measured-to-planned dose agreement in in vivo dosimetry (IVD), this study aimed to develop an accurate and efficient novel framework to identify the detector location placed on a patient’s skin surface using a 3D camera and determine the planned dose at the same anatomical position corresponding to the detector location. Methods. Breast cancer treatment was simulated using an anthropomorphic adult female phantom (ATOM 702D; CIRS, Norfolk, VA, USA). An optically stimulated luminescent dosimeter was used for surface dose measurements (MyOSLchip, RadPro International GmbH, Germany) at six IVD points. Three-dimensional surface imaging (3DSI) of the phantom with the detector was performed in the treatment position using a 3D camera. The developed framework, iSMART, was designed to import 3DSI and treatment planning data for determining the position of the IVD detectors in the 3D treatment planning DICOM image. The clinical usefulness of iSMART was evaluated in terms of accuracy and efficiency, for comparison with the results obtained using cone-beam computed tomography (CBCT) image guidance. Results. The relative dose difference between the planned doses determined using iSMART and CBCT images displayed similar accuracies (within approximately ±2.0%) at all detector locations. The relative dose differences between the planned and measured doses at the six detector locations ranged from –4.8% to 3.1% for the CBCT images and –3.5% to 2.1% for iSMART. The total time required to read the planned doses at six detector locations averaged at 8.1 and 0.8 min for the CBCT images and iSMART, respectively. Conclusions. The proposed framework can improve the robustness of IVD analyses and aid in accurate and efficient evaluations of the measured-to-planned dose agreement.

Razvoj i primena 3D sistema za snimanje u pripremi mineralnih sirovina

Three-dimensional (3D) surface imaging systems have gained popularity in monitoring the status and condition of separation processes by characterizing the internal and external structures of particles such as size, shape, density and composition. This review article mainly focuses on demonstrating the state of the art of 3D imaging systems in mineral processing based of the recent growth in 3D sensors. The structure of this manuscript comprises an overview of the two 3D imaging systems, including RhoVol and X-ray computed tomography, based on the basic principles. Their applications in mineral processing are then explained. By integrating with other imaging tools and the 3D printing technology, 3D surface imaging systems will play an important role in the automation and control of mineral processing in the future.

Detection of Fungal Infections on the Wood Surface Using LTM Imaging

Wood used in production processes can be infected by various fungi growing on its surface. The presence of fungi on the wood surface results from the method of storage, handling and transport of the wood. However, the presence of fungi on wood carries a high risk to the health of production operators and users. At the same time, it has a negative impact on the quality and durability of manufactured products. Because of the risks indicated, an attempt was made to develop an industrial, automated system for detecting fungal infections. This paper presents a vision method for detecting fungal infections on the wood surface. A description of the vision system using the laser triangulation method (LTM) to build a three-dimensional surface image is shown. The paper consists of an analysis of the imaging resolution and a description of the concept of using laser illuminator power selection for identifying fungal-infested surfaces. Imaging results for the selected wavelength of electromagnetic radiation are presented. Measurements and parameters describing the identified areas are shown. It was found that it is possible to choose imaging method parameters and laser illumination power allowing identification under industrial conditions of a fungus-infected region on a wood surface while using the image to determine product measurement parameters.

Reliability and Measurement Error of Breast Volume Calculation Using Three-Dimensional Surface Imaging.

Background: Breast lymphedema after breast cancer is challenging to quantify. Three-dimensional (3D) surface imaging is one available technique to measure breast volume, however, the measurement properties of available software programs have not been fully determined. The aim of this study was to determine equivalency of measurements with two software programs as well as reliability, standard error of measurement (SEM), and smallest detectable change (SDC). Methods and Results: Retrospective three-dimensional surface imaging (3D-SI) of 100 breasts taken before or after breast conserving surgery for breast cancer were retrieved for reliability analysis. Three assessors followed a standardized measurement technique using two software programs, Vectra® 3D Analysis Module (VAM) and Breast Sculptor®. Mean breast volume was 489.9 ± 206 cc using VAM and 480.1 ± 229.1 cc using Breast Sculptor. Lin's concordance showed poor agreement between programs (0.81-0.88). Measurements using VAM had excellent intra- and inter-rater reliability with SEM = 4.1% for one assessor and 8.7% for multiple assessors. Breast Sculptor also had excellent intra-rater and substantial inter-rater reliability but the SEM was much larger at 14.5% (intra-rater) and 19.1% (inter-rater). The SDC value was lowest for VAM and a single rater with 56 cc indicating a meaningful change beyond measurement error. Conclusion: Breast volume measurements captured with 3D-SI using VECTRA-XT are highly reliable, but the volumes, SEM, and SDC varied between the two software programs. Measurement error was lowest with VAM software. Although the usefulness of VECTRA-XT and VAM software to detect change in breast volume is promising, further solutions to reduce measurement error are required to improve clinical utility to measure breast lymphedema.

Classification of Alar Dynamic Aesthetic in an Asian Female Population: Experts or Automatic Algorithms?

To provide referenced classifications of alar dynamic aesthetics from both subjective and objective perspectives for determining proper surgical strategies in alarplasty. A total of 150 healthy Asian female participants were instructed to perform two standardized facial movements including a resting pose and a maximum smile while taking care not to show their teeth. The participants were recorded using a dynamic three-dimensional surface imaging system. Frames depicting the resting position and the alar maximum enlargement during the smile were exported separately for anthropometric analysis and classification. The alar dynamic aesthetic was assessed through measurement of the anthropomorphic changes comparing the resting and maximum smile statuses and then transformed into quantitative analysis through the algorithm [Formula: see text]. Subjective classification and evaluation of the subject cosmetic deficiencies and proposals for therapeutic interventions to improve the subjects' alar dynamic aesthetic were performed by three senior plastic surgeons through visualization of the resting and smiling images. The surgeons were asked to divide and classify the subjects into three groups (Class I, Class II and Class III) according to the surgeons' perceptions of degree of the subjects' deficiencies in alar dynamic aesthetic. The more deficiency there was in the aesthetic, the higher the class that the subject was assigned into. The surgeons were presented with the full set of images of the patients on two separate occasions each three months apart, to assess interobserver reliability. Clustering analysis, which is based on machine learning, was applied for objective classification of the images. According to the senior plastic surgeon experts' subjective classification, the subjects' alar flaring mobility was judged as follows: Class I (6.78 ± 3.84%), Class II (10.35 ± 4.18%), and Class III (18.68 ± 4.15%), while alar base mobility was judged as Class I (12.71 ± 7.57%), Class II (20.06 ± 10.06%), and Class III (30.86 ± 13.20%). By clustering analysis, alar flaring mobility was determined to be Class I (7.01 ± 3.51%), Class II (11.18 ± 4.76%), and Class III (12.72 ± 5.66%), while alar base mobility was Class I (9.07 ± 4.23%), Class II (21.88 ± 4.25%), and Class III (38.59 ± 7.08%). No statistical significance was found in the distribution and assignment of classes between the two methodologies. Classifications of alar dynamic aesthetics could arouse attention to facial dynamic aesthetics and provide referenced quantitative parameters for plastic surgeons to determine appropriate treatments for alarplasty. For patients with Class I mobility, treatments are not recommended, while minimally invasive treatments can be deemed to be optional for patients with Class II alar mobility to potentially improve alar dynamic aesthetics. For patients with Class III alar mobility, surgical treatments are strongly recommended as options. Combing subjective classification with automated algorithms can provide a novel perspective and improve reliability for facial aesthetic classification analysis. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluation of setup accuracy for prone breast radiotherapy with a three-dimensional surface imaging system

Evaluation of setup accuracy for prone breast radiotherapy with a three-dimensional surface imaging system

Nonsubjective Assessment of Shape, Volume and Symmetry during Breast Augmentation with Handheld 3D Device.

Three-dimensional Surface Imaging (3DSI) has become a valuable tool for planning and documenting surgical procedures. Although surface scanners have allowed for a better understanding of breast shape, size, and asymmetry during patient consultation, its use has not been included in intraoperative assessment so far. Validation of the reliability of the intraoperative use of a portable handheld 3DSI equipment as a tool to evaluate morphological changes during breast augmentation surgery. The patients who underwent bilateral subpectoral breast augmentation through an inframammary incision were included in this study. Intraoperative 3DSI was performed with the Artec Eva device, allowing for visualization of the surgical area before incision, after use of breast sizers and implant, and after wound closure. Intraoperatively manual measurements of breast distances and volume changes due to known sizer and implant volumes were in comparison with digital measurements calculated from 3DSI of the surgical area. Bilateral breasts of 40 patients were 3D photographed before incision and after suture successfully. A further 108 implant sizer uses were digitally documented. There was no significant difference between manual tape measurement and digital breast distance measurement. Pre- to postoperative 3D volume change showed no significant difference to the known sizer and implant volume.

Objective evaluation of volumetric changes during breast augmentation using intraoperative three-dimensional surface imaging

Breast volume estimation and implant size are crucial factors to achieve a symmetrical result in esthetic and reconstructive breast surgery. Although three-dimensional surface imaging (3DSI) has allowed for a better understanding of breast shape, size, and asymmetry during patient consultation, its use has been limited regarding intraoperative decision-making. To validate the intraoperative use of a portable hand-held 3D surface imaging device as an objective tool to assess volumetric changes during breast augmentation surgery. Patients receiving bilateral, submuscular breast augmentation were enrolled for this study. Intraoperative 3DSI was conducted using the Sense 3D scanner, allowing for digitalization of the operating field. Intraoperatively gauged volume changes caused by known implant volumes were compared with digital measurements calculated from 3D surface images of the operating field. Digital intraoperative breast volumes were compared to the pre- and postoperative Vectra XT reference system. Eighty individual breasts of 40 patients were successfully 3D imaged before incision and after wound closure. There was no significant difference between digital breast volumes by intraoperative and outpatient 3DSI. Intraoperative pre- to postoperative 3D breast volume change showed no significant difference to the known implant volume (p=0.124, mean deviation of 5.8±24.3mL and 2.0±9.0%). Our findings showed a high correlation regarding intraoperative digital breast volumetric changes. Intraoperative use of 3DSI yielded objective data during breast augmentation. This novel technique could beneficially impact future breast implant selection, especially in cases with breast asymmetry and the need for differently sized implants.