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Akhoondinasab M, Shafaei Y, Rahmani A, Keshavarz H. A Machine Learning-Based Model for Breast Volume Prediction Using Preoperative Anthropometric Measurements. Aesthetic Plast Surg 2024; 48:243-249. [PMID: 35614157 DOI: 10.1007/s00266-022-02937-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/03/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Accurate assessment of breast volume is helpful in preoperative planning and intraoperative judgment in both cosmetic and reconstructive breast surgery. In this prospective study, a formula was derived using machine learning algorithm (Gradient Boosted Model). METHOD A prospective study was performed on 39 female-to-male transgender patients. Bilateral mastectomy was done for all patients. Preoperative anthropometric measurements were performed on 78 breasts of these patients. Weight of breasts was calculated postoperatively with digital scale (weight), and then volume of breasts was calculated with the calibrated container (water displacement technique). Authors built a model based on Python CatBoostClassifier. Finally, an android application was built for ease of real-time utilization. RESULTS Eight anthropometric measurements were collected preoperatively as independent variables. Breast vertical perimeter at lower half, upper pole, sternal notch to nipple and nipple to IMF had most correlation with volume and weight. Based on machine learning model, the following formula established: Breast volume = (breast width) × 24.69 + (nipple to IMF) × 49.03 - (sternal notch to nipple) × 1.34 + (anterior axillary line to medial border) × 6.57 - (upper pole) × 1.27 - (chest perimeter IMF) × 5.63 + (chest perimeter nipple) × 10.40 + (breast vertical perimeter at lower half) × 9.20 - 1133.74. The R2 of the model is 0.93, and RMSE is 62.4. CONCLUSION Our formula is an accurate method for preoperative breast volume assessment. We built an android App (Breast Volume Predictor) for the real-time utilization of resulting formula. It is available at Google Play Store for free download. LEVEL OF EVIDENCE IV 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 .
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Affiliation(s)
- Mohammadreza Akhoondinasab
- Department of Plastic Surgery, School of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran
| | - Yousef Shafaei
- Department of Plastic Surgery, School of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran
| | - Amirhosein Rahmani
- Department of Plastic Surgery, School of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran.
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Norris M, O'Neill A, Blackmore T, Mills C, Sanchez A, Brown N, Wakefield-Scurr J. Can we predict the neutral breast position using the gravity-loaded breast position, age, anthropometrics and breast composition data? Clin Biomech (Bristol, Avon) 2022; 99:105760. [PMID: 36108472 DOI: 10.1016/j.clinbiomech.2022.105760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to identify the predictor variables which account for neutral breast position variance using a full independent variable dataset (the gravity-loaded breast position, age and anthropometrics, and magnetic resonance imaging breast composition data), and a simplified independent variable dataset (magnetic resonance imaging breast composition data excluded). METHODS Breast position (three-dimensional neutral and static gravity-loaded), age, anthropometrics and magnetic resonance imaging breast composition data were collected for 80 females (bra size 32A to 38D). Correlations between the neutral breast position and the gravity-loaded breast position, age, anthropometrics, and magnetic resonance imaging breast composition data were assessed. Multiple linear and multivariate multiple regression models were utilised to predict neutral breast positions, with mean absolute differences and root mean square error comparing observed and predicted neutral breast positions. FINDINGS Breast volume was the only breast composition variable to contribute as a predictor of the neutral breast position. While ≥69% of the variance in the anteroposterior and mediolateral neutral breast positions were accounted for utilising the gravity-loaded breast position, multivariate multiple regression modelling resulted in mean absolute differences >5 mm. INTERPRETATION Due to the marginal contribution of breast composition data, a full independent variable dataset may be unnecessary for this application. Additionally, the gravity-loaded breast position, age, anthropometrics, and breast composition data do not successfully predict the neutral breast position. Incorporation of the neutral breast position into breast support garments may enhance bra development. However, further identification of variables which predict the neutral breast position is required.
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Affiliation(s)
- Michelle Norris
- Lero, the Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland; Ageing Research Centre (ARC), Health Research Institute (HRI), University of Limerick, Limerick, Ireland.
| | - Aoife O'Neill
- Ageing Research Centre (ARC), Health Research Institute (HRI), University of Limerick, Limerick, Ireland; School of Allied Health, University of Limerick, Limerick, Ireland
| | - Tim Blackmore
- School of Sport, Health and Exercise Science, Spinnaker Building, University of Portsmouth, United Kingdom
| | - Chris Mills
- School of Sport, Health and Exercise Science, Spinnaker Building, University of Portsmouth, United Kingdom
| | - Amy Sanchez
- School of Sport, Health and Exercise Science, Spinnaker Building, University of Portsmouth, United Kingdom
| | - Nicola Brown
- Faculty of Sport, Health and Applied Science, St. Mary's University, Waldegrave Road, Twickenham, United Kingdom
| | - Joanna Wakefield-Scurr
- School of Sport, Health and Exercise Science, Spinnaker Building, University of Portsmouth, United Kingdom
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3
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Kim YJ. Verification of Usability of Medical Image Data Using Projective Photography for Designing Clothing for Breast Cancer Patients. Tomography 2022; 8:1820-1835. [PMID: 35894018 PMCID: PMC9326531 DOI: 10.3390/tomography8040153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Manufacturing a customized mastectomy bra, using medical images obtained for breast cancer treatment, could be suggested as an alternative instead of the anthropometric method. However, the breast shape of a medical image is deformed from the anthropometric method as the measurement posture is different between the anthropometric method for making clothes and the medical image. As a breast consists of adipose tissues and a few muscles without bones, there is a possibility that a bra can be manufactured if the volume is constant. Therefore, a hypothesis was established that the volume of the breast would be constant, even if the measurement methods were different. As a result of the comparison of 3D-SIM and PPM by MRI, 18 items could be measured simultaneously. Nine items showed differences according to the measurement method. The next step in the case of 3D-SIM was calculating the volume by separating the breast shape into a cone and a hemispherical shape; in the case of MRI, an ellipsoidal volume formula was applied. A t-test was performed on the results obtained, showing no significant difference. Therefore, it was proven that the volume of the breast does not change despite the difference in the measurement and the measurement method.
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Affiliation(s)
- Youn Joo Kim
- Department of Clothing, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul 13620, Korea
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4
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Char SN, Bloom JA, DeMarco D, Chatterjee A. Evaluating the Quality of Cost-Effectiveness Literature in Breast Surgery: What Do We Do Well and How Can We Do Better? A Systematic Review. Am Surg 2021; 88:2660-2669. [PMID: 33861654 DOI: 10.1177/00031348211011148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Surgical options for breast cancer are numerous and span multiple surgical disciplines. Decision analyses aid surgeons in making the most cost-effective choice, thus reducing health care expenditure while maximizing patient outcome. In this study, we aimed to evaluate existing breast surgery cost-effectiveness literature against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) validated scoring system. METHODS A PRISMA search was performed for cost-effectiveness within breast surgery. Articles were scored with CHEERS criteria on a 0-24 scale and qualitative data were collected. Subgroup analysis was performed comparing pre-CHEERS (published in 2013 or earlier) and post-CHEERS (published in 2014 or later) cohorts. Chi-squared analysis was performed to compare where studies lost points between cohorts. RESULTS Of 2279 articles screened, 46 articles were included. The average CHEERS score was 18.18. Points were most often lost for characterizing heterogeneity, followed by discount rate, incremental costs and outcomes, and abstract. Quality-adjusted life year was the most commonly used health outcome, with visual model or analog scales as the most commonly used measure of effectiveness obtained primarily from surgeons or physicians. Most articles characterized uncertainty by deterministic sensitivity analysis, followed by both deterministic and probabilistic, then probabilistic. Average CHEERS scores were similar between pre- and post-CHEERS cohorts (17.67 vs. 18.40, P > .05) There were several significant differences in where articles lost points between pre- and post-CHEERS cohorts. DISCUSSION In order to standardize the reporting of results, cost-effectiveness studies in breast surgery should adhere to the current CHEERS criteria and aim to better characterize heterogeneity in their analyses.
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Affiliation(s)
- Sydney N Char
- 12261Tufts University School of Medicine, Boston, MA, USA
| | - Joshua A Bloom
- Department of Surgery, 1867Tufts Medical Center, Boston, MA, USA
| | - Danielle DeMarco
- Department of Surgery, 1867Tufts Medical Center, Boston, MA, USA
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5
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Clinical Assessment of Breast Volume: Can 3D Imaging Be the Gold Standard? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3236. [PMID: 33299702 PMCID: PMC7722547 DOI: 10.1097/gox.0000000000003236] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
Background: Three-dimensional (3D) camera systems are increasingly used for computerized volume calculations. In this study we investigate whether the Vectra XT 3D imaging system is a reliable tool for determination of breast volume in clinical practice. It is compared with the current gold standard in literature, magnetic resonance imaging (MRI), and current clinical practice (plastic surgeon’s clinical estimation). Methods: Breast volumes of 29 patients (53 breasts) were evaluated. 3D images were acquired by Vectra XT 3D imaging system. Pre-existing breast MRI images were collected. Both imaging techniques were used for volume analyses, calculated by two independent investigators. Breast volume estimations were done by plastic surgeons during outpatient consultations. All volume measurements were compared using paired samples t-test, intra-class correlation coefficient, Pearson’s correlation, and Bland–Altman analysis. Results: Two 3D breast volume measurements showed an excellent reliability (intra-class correlation coefficient: 0.991), which was comparable to the reliability of MRI measurements (intra-class correlation coefficient: 0.990). Mean (SD) breast volume measured with 3D breast volume was 454 cm3 (157) and with MRI was 687 cm3 (312). These volumes were significantly different, but a linear association could be found: y(MRI) = 1.58 × (3D) – 40. Three-dimensional breast volume was not significantly different from volume estimation made by plastic surgeons (472 cm3 (69), P = 0.323). Conclusions: The 3D imaging system measures lower volumes for breasts than MRI. However, 3D measurements show a linear association with MRI and have excellent reliability, making them an objective and reproducible measuring method suitable for clinical practice.
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6
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Jeon FHK, Griffin M, Almadori A, Varghese J, Bogan S, Younis I, Mosahebi A, Butler PE. Measuring Differential Volume Using the Subtraction Tool for Three-Dimensional Breast Volumetry: A Proof of Concept Study. Surg Innov 2020; 27:659-668. [PMID: 32783704 PMCID: PMC7890686 DOI: 10.1177/1553350620945563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background. Three-dimensional (3D) photography provides a promising means of breast volumetry. Sources of error using a single-captured surface to calculate breast volume include inaccurate designation of breast boundaries and prediction of the invisible chest wall generated by computer software. An alternative approach is to measure differential volume using subtraction of 2 captured surfaces. Objectives. To explore 3D breast volumetry using the subtraction of superimposed images to calculate differential volume. To assess optimal patient positioning for accurate volumetric assessment. Methods. Known volumes of breast enhancers simulated volumetric changes to the breast (n = 12). 3D photographs were taken (3dMDtorso) with the subject positioned upright at 90° and posteriorly inclined at 30°. Patient position, breathing, distance and camera calibration were standardised. Volumetric analysis was performed using 3dMDvultus software. Results. A statistically significant difference was found between actual volume and measured volumes with subjects positioned at 90° (P < .05). No statistical difference was found at 30° (P = .078), but subsequent Bland–Altman analysis showed evidence of proportional bias (P < .05). There was good correlation between measured and actual volumes in both positions (r = .77 and r = .85, respectively). Univariate analyses showed breast enhancer volumes of 195 mL and 295 mL to incur bias. The coefficient of variation was 5.76% for single observer analysis. Conclusion. Positioning the subject at a 30° posterior incline provides more accurate results from better exposure of the inferior breast. The subtraction tool is a novel method of measuring differential volume. Future studies should explore methodology for application into the clinical setting.
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Affiliation(s)
| | - Michelle Griffin
- Division of Surgery and Interventional Science, 4919University College London, UK.,Department of Plastic Surgery, Royal Free Hospital, London, UK
| | - Aurora Almadori
- Division of Surgery and Interventional Science, 4919University College London, UK
| | - Jajini Varghese
- Division of Surgery and Interventional Science, 4919University College London, UK.,Department of Plastic Surgery, Royal Free Hospital, London, UK
| | - Stephanie Bogan
- Division of Surgery and Interventional Science, 4919University College London, UK
| | - Ibby Younis
- Department of Plastic Surgery, Royal Free Hospital, London, UK
| | - Ash Mosahebi
- Division of Surgery and Interventional Science, 4919University College London, UK.,Department of Plastic Surgery, Royal Free Hospital, London, UK
| | - Peter E Butler
- Division of Surgery and Interventional Science, 4919University College London, UK.,Department of Plastic Surgery, Royal Free Hospital, London, UK
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Maximiliano J, Munhoz AM, Pedron M, de Oliveira ACP, Duarte DW, Neto R, Portinho CP, Collares MVM. Hybrid Breast Augmentation: A Reliable Formula for Preoperative Assessment of Fat Graft Volume Based on Implant Volume and Projection. Aesthet Surg J 2020; 40:NP438-NP452. [PMID: 31960904 DOI: 10.1093/asj/sjaa017] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Autogenous fat grafting (AFG) is an established technique used as an adjunct to breast augmentation (BA) to redesign breast shape. Surgeons often use experience and intuition to estimate AFG volume, which can result in incorrect assessment of donor areas and unnecessary fat removal. OBJECTIVES This aim of this study was to develop a method based on a mathematical formula, which utilizes implant volume and projection to predict AFG volume. METHODS Thirty patients (60 breasts) underwent primary hybrid BA. A software package (SketchUp) was used to simulate 3-dimensional AFG and implant volumes, which in turn were used to develop an equation for estimating AFG volume according to 3 different implant projections. The results for each group were compared, via Pearson's correlation coefficient, with the results of the clinical series. RESULTS All patients received Motiva Ergonomix SmoothSilk/SilkSurface implants, ranging in volume from 175 to 355 cc (mean, 265 cc), as well as an average AFG volume of 79.2 cc/breast (range, 50-110 cc). Twenty-nine patients (96.6%) were either very satisfied or satisfied during a mean follow-up of 18 months (range, 6-28 months). A high correlation was observed between the AFG performed in the cohort and predictions obtained from the formula (r = 0.938, P < 0.001). CONCLUSIONS The AFG volume in hybrid BA procedures can be estimated utilizing measurements based on implant volume/projection. This low-cost method can be applied to guide surgical decision-making in patients who are candidates for BA. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- João Maximiliano
- Division of Plastic Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre-RS, Brazil
| | - Alexandre Mendonça Munhoz
- Division of Plastic Surgery, Hospital Sírio-Libanês; Chief of the Breast Surgery Group, Division of Plastic Surgery, University of São Paulo School of Medicine; and Coordinator, Plastic Surgery Department, Hospital Moriah, São Paulo, Brazil
| | | | | | - Daniele Walter Duarte
- Division of Plastic Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre-RS, Brazil
| | - Rafael Neto
- Division of Plastic Surgery, Hospital Moinhos de Vento, Porto Alegre-RS, Brazil
| | - Ciro Paz Portinho
- Division of Plastic Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre-RS, Brazil
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8
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Lee TJ, Cho JM, Jo T, Han WY, Maldonado AA, Eom JS, Kim EK. Volumetric changes of the pedicled transverse rectus abdominis musculocutaneous flap and the contralateral native breast during long-term follow-up. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2019. [DOI: 10.14730/aaps.2019.01690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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9
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Beamer LC. Novel measurements for radiodermatitis research and clinical care: A pilot and feasibility study. Eur J Oncol Nurs 2019; 39:62-69. [PMID: 30850140 DOI: 10.1016/j.ejon.2019.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/12/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The role of clinician-measured breast length and bra cup size in the development of radiodermatitis over time and the efficacy of using multiple measurements of skin toxicity during radiotherapy were piloted. The feasibility of measures to be used in a larger future study was assessed. METHODS AND MATERIALS Participants included women receiving normofractionated or accelerated external breast radiotherapy provided in the supine position using 3-dimensional conformal techniques at a US community cancer center. Acute skin toxicity was assessed using the RTOG scale in 7 areas within the treatment field across 6 timepoints. The total score for the 7 areas was calculated each week. Breast length was measured, examined as an acute radiodermatitis risk factor, and compared against reported bra cup size. RM-ANOVAs examined radiodermatitis using maximum skin toxicity and 7 sites in the radiotherapy field over 6 timepoints. Correlation was implemented to explore the relationship between study variables. RESULTS Forty women consented to this study. Increase in breast length significantly correlated with increase in maximum RTOG score (p = .04); increased RTOG score in the upper medial breast quadrant (p = .04), upper lateral quadrant (p = .02), lower lateral quadrant (p = .02), inframammary fold (p = .001); with increasing BMI (p = .002) and bra cup size (p = .0003). The clinician-measured breast lengths and participant-reported bra cup sizes were discordant. Participants completed all measures and measurements including breast length. CONCLUSIONS Our results suggest that measuring breast length and assessing radiodermatitis in multiple areas of the treatment field is feasible. These measures may increase the sensitivity of skin toxicity assessment.
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Affiliation(s)
- Laura Curr Beamer
- School of Nursing, Northern Illinois University, DeKalb, IL, USA; College of Nursing, University of Utah, Salt Lake City, UT, USA.
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10
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Wesselius TS, Vreeken RD, Verhulst AC, Xi T, Maal TJJ, Ulrich DJO. New software and breast boundary landmarks to calculate breast volumes from 3D surface images. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018; 41:663-670. [PMID: 30524176 PMCID: PMC6244993 DOI: 10.1007/s00238-018-1431-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/04/2018] [Indexed: 11/29/2022]
Abstract
Background A method to accurately calculate breast volumes helps achieving a better breast surgery outcome. 3D surface imaging potentially allows these calculations in a harmless, quick, and practicable way. The calculated volume from a 3D surface image is dependent on the determined breast boundary and the method of chest wall simulation by software. Currently, there is no consensus on a robust set of breast boundary landmarks and validation studies on breast volume calculation software are scarce. The purposes of this study were to determine the robustness of newly introduced breast boundary landmarks and introduce and validate a new method to simulate a chest wall. Methods Sixteen subjects who underwent a unilateral simple mastectomy were included. In addition to the natural skin fold of the breast, the sternomanubrial joint, the transition of the pectoral muscle curve into the breast curvature, and the midaxillary line were used as landmarks to indicate the breast boundary. The intra- and interrater variability of these landmarks was tested. Furthermore, new chest wall simulation software was validated on the breastless chest side of the subjects. Results The intra- and interrater variability of the three breast boundary markers was small (mean 3.5–6.7 mm), and no significant difference was found between the intra- and interrater variability (p = 0.08, p = 0.06, and p = 0.10). The mean volume error of the most accurately simulated chest wall was 4.6 ± 37 ml. Conclusion The newly introduced landmarks showed to be robust and our new chest wall simulation algorithm showed accurate results. Level of Evidence: Level IV, diagnostic study.
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Affiliation(s)
- T S Wesselius
- 1Department of Plastic-, Reconstructive-, and Hand Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands.,2Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, the Netherlands
| | - R D Vreeken
- 2Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A C Verhulst
- 1Department of Plastic-, Reconstructive-, and Hand Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands.,2Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, the Netherlands
| | - T Xi
- 2Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, the Netherlands.,3Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - T J J Maal
- 2Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, the Netherlands
| | - D J O Ulrich
- 1Department of Plastic-, Reconstructive-, and Hand Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands
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Magnetic Resonance Imaging Versus 3-Dimensional Laser Scanning for Breast Volume Assessment After Breast Reconstruction. Ann Plast Surg 2017; 78:455-459. [PMID: 28273058 DOI: 10.1097/sap.0000000000000890] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There are several methods available for measuring breast volume in the clinical setting, but the comparability and accuracy of different methods is not well described. The ideal breast volume measurement technique should be low cost, comfortable for the patient, have no ionizing radiation and be non-invasive. METHODS Prospective cohort study comparing a 3-dimensional (3D) laser scanner versus noncontrast magnetic resonance imaging (MRI) for breast volume assessment. Subjects were women undergoing breast reconstruction with autologous fat graft. Both types of scan were performed the day before fat grafting and at 6 months postoperatively. Pearson correlations and Bland-Altman tests were performed to compare the assessment methods. RESULTS Eighteen patients underwent preoperative breast MRI and 3D laser scanning. Eighteen patients also underwent assessment 6 months after surgery. The total number of breasts scanned for comparison was 36, with a total of 72 comparisons for analysis. There was a strong linear association between the 2 methods using a Pearson correlation (r = 0.79; P <0.001), and Bland-Altman showed a high level of agreement between the 2 methods. CONCLUSIONS The 3D laser scanning, with an established protocol, was found to be equivalent to non-contrast MRI for the assessment of breast volume. Given the convenience of laser scanning and potential for lower cost compared with MRI, this technique should be considered for quantifying outcomes after complex breast reconstruction when the equipment is available.
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Voiculescu Ș, Scăunașu RV, Moroșanu M, Greșanu A, Popescu B, Burcos T. The combined use of senometry and ultrasonography for breast cancer surgical planning. JOURNAL OF CLINICAL AND INVESTIGATIVE SURGERY 2017. [DOI: 10.25083/2559.5555.22.8893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective. Ultrasound exerts an important role in breast cancer diagnosis protocol, but the use of eco-senometry can also improve therapeutic options, surgical planning and technique. Methods. We describe various measurement formulas and techniques that are applied in order to acquire important information regarding the breast and its lesions. Results. Senometry and ultrasonography have been proven to be very effective, reaching up to reliability levels as high as 0.997 and accuracy levels as high as 99.6%. Conclusions. Senometry and ultrasonography have clearly demonstrated their value in breast cancer diagnosis and treatment. These methods are reliable, inexpensive and can be easily performed by the surgeon. More advances in the domain are expected in the future.
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13
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Baek WY, Byun IH, Kim YS, Lew DH, Jeong J, Roh TS. Patient Satisfaction with Implant Based Breast Reconstruction Associated with Implant Volume and Mastectomy Specimen Weight Ratio. J Breast Cancer 2017; 20:98-103. [PMID: 28382100 PMCID: PMC5378585 DOI: 10.4048/jbc.2017.20.1.98] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/07/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose Breast volume assessment is one of the most important steps during implant-based breast reconstruction because it is critical in selecting implant size. According to previous studies, there is a close relationship between the mastectomy specimen weight and resected breast volume. The aim of this study was to evaluate long-term patient satisfaction with implant-based breast reconstruction guided by the ratio of implant volume to mastectomy specimen weight. In doing so, we describe the ideal ratio for patient satisfaction. Methods A total of 84 patients who underwent implant-based breast reconstruction for breast cancer were included in this study. The patients were grouped by the ratio of implant size to mastectomy specimen weight (group 1, <65%; group 2, 65%–75%; and group 3, >75%). Outcome analysis was performed using a questionnaire of patient satisfaction and the desired implant size. Results Patient satisfaction scores concerning the postoperative body image, size, and position of the reconstructed breast were significantly higher in group 2. The average ratio of the ideal implant volume to mastectomy specimen weight for each group was 71.9% (range, 54.5%–96.7%), with the differences across the three groups being not significant (p=0.244). Conclusion Since there is an increase in breast reconstruction, selecting the appropriate breast implant is undoubtedly important. Our novel technique using the ratio of implant volume to mastectomy specimen weight provides physicians a firm guide to intraoperative selection of the proper implant in reconstructive breast surgery.
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Affiliation(s)
- Woo Yeol Baek
- Institute of Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Il Hwan Byun
- Institute of Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Young Seok Kim
- Institute of Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Dae Hyun Lew
- Institute of Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Joon Jeong
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Tai Suk Roh
- Institute of Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea
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14
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Seoud L, Ramsay J, Parent S, Cheriet F. A novel fully automatic measurement of apparent breast volume from trunk surface mesh. Med Eng Phys 2017; 41:46-54. [PMID: 28126421 DOI: 10.1016/j.medengphy.2017.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/26/2016] [Accepted: 01/01/2017] [Indexed: 11/30/2022]
Abstract
This paper presents a novel method for assessing apparent breast volume from trunk surface mesh without any manual intervention. The proposed method requires a closed and smooth triangular mesh of the trunk. It comprises four main steps: automatic nipple localization, automatic breasts delineation, chest-wall interpolation and volume computation. The mean curvature is computed for each vertex using a quadratic fitting approach and used as an indicator to determine the convex fold of the breasts. The delineation is modeled as an ellipse in the frontal plane and all the vertices inside it are removed. The remaining ones are used to interpolate the chest wall with radial basis functions. The voxels inside the resulting mesh without breasts are then subtracted from the original voxelized volume to generate the breasts volume. The validation is conducted on 30 adolescent female for each of which an MRI and a trunk surface (TS) acquisitions were available. Three breast volumes are considered: the anatomical volumes (AV) manually segmented on the MRI, the external volumes computed with the proposed method first in prone position (EVP) using the trunk mesh extracted from the MRI, and second, in standing position (EVS) using the TS's mesh. Significant correlations (R> 0.77) are found between each two of the three volumes. AVs are much larger than both EVS and EPS. In fact, the manual segmentation using MRI slices allows for a direct visualization of the breast posterior delineation. Computed automatically, EVS and EPS are highly similar, indicating that the proposed method is robust to changes from prone to standing position. No significant difference between the regressions on the left and right breasts is noted. Fully-automatic 3D breast volumetry from trunk surface mesh is feasible and provides measurements that are highly correlated to manual MRI volumetry and robust to changes in posture.
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Affiliation(s)
| | - Joyce Ramsay
- Sainte Justine University Hospital Research Center, Montreal, Canada
| | - Stefan Parent
- Sainte Justine University Hospital Research Center, Montreal, Canada
| | - Farida Cheriet
- Department of Computer and Software Engineering, Polytechnique Montreal, Canada; Sainte Justine University Hospital Research Center, Montreal, Canada
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The accuracy of breast volume measurement methods: A systematic review. Breast 2016; 28:121-9. [PMID: 27288864 DOI: 10.1016/j.breast.2016.05.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/20/2016] [Accepted: 05/21/2016] [Indexed: 11/23/2022] Open
Abstract
Breast volume is a key metric in breast surgery and there are a number of different methods which measure it. However, a lack of knowledge regarding a method's accuracy and comparability has made it difficult to establish a clinical standard. We have performed a systematic review of the literature to examine the various techniques for measurement of breast volume and to assess their accuracy and usefulness in clinical practice. Each of the fifteen studies we identified had more than ten live participants and assessed volume measurement accuracy using a gold-standard based on the volume, or mass, of a mastectomy specimen. Many of the studies from this review report large (>200 ml) uncertainty in breast volume and many fail to assess measurement accuracy using appropriate statistical tools. Of the methods assessed, MRI scanning consistently demonstrated the highest accuracy with three studies reporting errors lower than 10% for small (250 ml), medium (500 ml) and large (1000 ml) breasts. However, as a high-cost, non-routine assessment other methods may be more appropriate.
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Chae MP, Rozen WM, Spychal RT, Hunter-Smith DJ. Breast volumetric analysis for aesthetic planning in breast reconstruction: a literature review of techniques. Gland Surg 2016; 5:212-26. [PMID: 27047788 DOI: 10.3978/j.issn.2227-684x.2015.10.03] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Accurate volumetric analysis is an essential component of preoperative planning in both reconstructive and aesthetic breast procedures towards achieving symmetrization and patient-satisfactory outcome. Numerous comparative studies and reviews of individual techniques have been reported. However, a unifying review of all techniques comparing their accuracy, reliability, and practicality has been lacking. METHODS A review of the published English literature dating from 1950 to 2015 using databases, such as PubMed, Medline, Web of Science, and EMBASE, was undertaken. RESULTS Since Bouman's first description of water displacement method, a range of volumetric assessment techniques have been described: thermoplastic casting, direct anthropomorphic measurement, two-dimensional (2D) imaging, and computed tomography (CT)/magnetic resonance imaging (MRI) scans. However, most have been unreliable, difficult to execute and demonstrate limited practicability. Introduction of 3D surface imaging has revolutionized the field due to its ease of use, fast speed, accuracy, and reliability. However, its widespread use has been limited by its high cost and lack of high level of evidence. Recent developments have unveiled the first web-based 3D surface imaging program, 4D imaging, and 3D printing. CONCLUSIONS Despite its importance, an accurate, reliable, and simple breast volumetric analysis tool has been elusive until the introduction of 3D surface imaging technology. However, its high cost has limited its wide usage. Novel adjunct technologies, such as web-based 3D surface imaging program, 4D imaging, and 3D printing, appear promising.
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Affiliation(s)
- Michael P Chae
- 1 Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia ; 2 Department of Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria 3199, Australia
| | - Warren Matthew Rozen
- 1 Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia ; 2 Department of Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria 3199, Australia
| | - Robert T Spychal
- 1 Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia ; 2 Department of Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria 3199, Australia
| | - David J Hunter-Smith
- 1 Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia ; 2 Department of Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria 3199, Australia
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Objective breast volume, shape and surface area assessment: a systematic review of breast measurement methods. Aesthetic Plast Surg 2014; 38:1116-30. [PMID: 25338712 DOI: 10.1007/s00266-014-0412-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 09/28/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND There are many methods of measuring the breast and their clinical applications are well described in the literature. However, there has been no attempt to compare these various methods to allow the user to have a broad overview of the subject. The authors have attempted to summarise all the available methods to measure the breast in this article to provide a useful reference for all. METHODS A comprehensive literature search of PubMed was performed, and the resulting articles were screened and reviewed. The data regarding the methods' mechanism, reliability, time and cost were evaluated and compared. RESULTS A total of 74 articles dating from 1970 to 2013 were included in this study. All of the methods can be classified into those that measure (1) volume, (2) shape and (3) surface area. Each category consists of several methods that work through different mechanisms and they vary in their reliability and feasibility. Based on their mechanism, the volume measurement methods were further grouped into the natural shape methods, the stereological method, the geometrical methods and the mathematical modelling method. CONCLUSIONS More objective breast evaluation can be achieved if all three dimensions (volume, shape and surface area) are considered. In the volume measurements, 3D modelling and the MRI are the most reliable tools. Linear measurement (geometry) and mathematical modelling are less accurate but are more economical. In the shape measurements, besides the traditional linear measurement, 3D methods that can deliver colour-coded maps and Swanson's 2D photographic measurement system are capable of depicting and tracking breast shape changes after surgery. Although the surface area metric has not been used extensively, it has potential in clinical and research applications. LEVEL OF EVIDENCE IV 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.
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Ramsay J, Joncas J, Gilbert G, Trop I, Cheriet F, Labelle H, Parent S. Is Breast Asymmetry Present in Girls with Adolescent Idiopathic Scoliosis? Spine Deform 2014; 2:374-379. [PMID: 27927335 DOI: 10.1016/j.jspd.2014.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 05/11/2014] [Accepted: 05/24/2014] [Indexed: 11/29/2022]
Abstract
STUDY DESIGN Cross-sectional descriptive study. OBJECTIVES To characterize breast asymmetry (BA), as defined by breast volume difference, in girls with significant adolescent idiopathic scoliosis (AIS), using magnetic resonance imaging (MRI). SUMMARY AND BACKGROUND BA is a frequent concern among girls with AIS. It is commonly believed that this results from chest wall deformity. Although many women exhibit physiological BA, the prevalence is not known in adolescents and it remains unclear if it is more frequent in AIS. Breasts vary in shape and size and many ways of measuring them have been explored. MRI shows the highest precision at defining breast tissue. METHODS Thirty patients were enrolled on the basis of their thoracic curvature, skeletal and breast maturity, without regard to their perception on their BA. MRI acquisitions were performed in prone with a 1.5-Tesla system using a 16-channel breast coil. Segmentation was achieved using the ITK-SNAP 2.4.0 software and subsequently manually refined. RESULTS The mean left breast volume (528.32 ± 205.96 cc) was greater compared with the mean right breast volume (495.18 ± 170.16 cc) with a significant difference between them. The mean BA was found to be 8.32% ± 6.43% (p < .0001). A weak positive correlation was observed between BA and thoracic Cobb angle (0.177, p = .349) as well as thoracic gibbosity angle (0.289, p = .122). The left breast was consistently larger in 65.5% of the patients. Twenty patients (66.7%) displayed BA ≥5%. CONCLUSIONS We have described BA in patients with significant AIS using MRI. This method is feasible, objective, and very precise. The majority of patients had a larger left breast, which could compound the apparent BA secondary to trunk rotation. In many cases, BA is present independently of thoracic deformity. This knowledge will assist in counseling AIS patients in regards to their concerns with BA.
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Affiliation(s)
- Joyce Ramsay
- Sainte-Justine University Hospital Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; University of Montreal, 2910 Edouard-Montpetit Blvd, Montreal, Quebec H3C 3J7, Canada
| | - Julie Joncas
- Sainte-Justine University Hospital Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Guillaume Gilbert
- MR Clinical Science, Philips Healthcare, 281 Hillmount Road, Markham, Ontario L6C 2S3, Canada; Hôtel-Dieu University of Montreal Hospital Center, 3840 Saint Urbain Street, Montreal, Quebec H2W 1T8 Canada
| | - Isabelle Trop
- Hôtel-Dieu University of Montreal Hospital Center, 3840 Saint Urbain Street, Montreal, Quebec H2W 1T8 Canada
| | - Farida Cheriet
- Sainte-Justine University Hospital Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; Polytechnique Montreal, 2500 Chemin de Polytechnique, Montreal, Quebec, H3T 1J4 Canada
| | - Hubert Labelle
- Sainte-Justine University Hospital Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Stefan Parent
- Sainte-Justine University Hospital Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; University of Montreal, 2910 Edouard-Montpetit Blvd, Montreal, Quebec H3C 3J7, Canada.
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Thigh girth loss in women with lower body fat distribution increases breast volume. Plast Reconstr Surg 2013; 132:483e-484e. [PMID: 23985677 DOI: 10.1097/prs.0b013e31829ad4a3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Autologous fat transplantation: volumetric tools for estimation of volume survival. A systematic review. Aesthetic Plast Surg 2013; 37:380-7. [PMID: 23354764 DOI: 10.1007/s00266-012-0046-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 11/29/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED Autologous fat transplantation has gained great recognition in aesthetic and reconstructive surgery. Two main aspects are of predominant importance for progress control after autologous fat transplantation to the breast: quantitative information about the rate of fat survival in terms of effective volume persistence and qualitative information about the breast tissue to exclude potential complications of autologous fat transplantation. There are several tools available for use in evaluating the rate of volume survival. They are extensively compared in this review. The anthropometric method, thermoplastic casts, and Archimedes' principle of water displacement are not up to date anymore because of major drawbacks, first and foremost being reduced reproducibility and exactness. They have been replaced by more exact and reproducible tools such as MRI volumetry or 3D body surface scans. For qualitative and quantitative progress control, MRI volumetry offers all the necessary information: evaluation of fat survival and diagnostically valuable imaging to exclude possible complications of autologous fat transplantation. For frequent follow-up, e.g., monthly volume analysis, repeated MRI exams would not be good for the patient and are not cost effective. In these cases, 3D surface imaging is a good tool and especially helpful in a private practice setting where fast data acquisition is needed. This tool also offers the possibility of simulating the results of autologous fat transplantation. LEVEL OF EVIDENCE V 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 .
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Mopuri N, Masud D, Iwuagwu FC. Simple method to measure volume difference in asymmetric and hypoplastic breasts. J Plast Reconstr Aesthet Surg 2013; 66:142-3. [DOI: 10.1016/j.bjps.2012.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 08/16/2012] [Indexed: 11/29/2022]
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Assessment of breast volume change after transverse rectus abdominis myocutaneous flap. Arch Plast Surg 2012; 39:631-5. [PMID: 23233889 PMCID: PMC3518007 DOI: 10.5999/aps.2012.39.6.631] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Revised: 07/16/2012] [Accepted: 07/23/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The evaluation of a breast after breast reconstruction depends on a surgeon's subjective criteria. We used computed tomography (CT) scans to obtain an objective evaluation of the postoperative results by measuring the breast volume of patients who had undergone breast reconstruction using pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. This research will help in the objective postoperative evaluation of reconstructed breasts, and also in the preoperative flap size designs. METHODS A total of 27 patients underwent breast reconstruction using pedicled TRAM flaps after mastectomy from September 2007 to July 2010. Of these, 10 patients who were followed up and underwent CT scans 2 or more times during the follow-up period were included in this study. We evaluated the change in breast volume over time using CT scans, and the interval breast volume change between CT scans. RESULTS All of the 10 patients' reconstructed breasts showed a volume decrease over time. The breast volume changes in the intervals between CT scans were as follows: 5.65% decrease between the first CT and second CT scan, 2.3% decrease between the second CT and third CT scan, (statistically significant) and 1.89% decrease between the third CT and forth CT scan. (not statistically significant). CONCLUSIONS This research shows the possibility of objectively evaluating the postoperative breast volume changes. The findings will be helpful in designing the size of TRAM flaps to use on defects after mastectomy. Based on these results, we should also closely observe the reconstructed breast volume for at least 2 years.
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Fujii T, Yamaguchi S, Yajima R, Tsutsumi S, Asao T, Kuwano H. Accurate Assessment of Breast Volume by Computed Tomography Using Three-dimensional Imaging Device. Am Surg 2012. [DOI: 10.1177/000313481207800930] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preoperative assessment of breast volume could contribute significantly to the planning of breast reconstructive surgery. However, breast volume measurements are not carried out on a routine basis, because there is still no commonly accepted standard method for such measurements. In the current study, we assessed whether routine computed tomography (CT) of the chest using a three-dimensional device could provide accurate estimation of breast volumes in patients with breast cancer. Ten consecutive patients and 11 breasts with breast cancer that underwent mastectomy with immediate breast reconstruction were enrolledin this study. Ineach case, a three-dimensional image was constructed according to the CT data using a volume-rendering technique. Computed breast volumes were compared with known breast volumes obtained from surgical specimens. The mean breast volume of surgical specimens was 324.1 ± 173.5 mL. The mean breast volume value was established to be 351.6 ± 174.3 mL with three-dimensional CT in a novel method. There was a strong linear association between breast volumes of surgical specimens and breast volumes measured by the three-dimensional CT method when using a Pearson correlation (r = 0.985, P < 0.001). Our results suggest that the calculation of breast volume using three-dimensional CT is accurate enough to have a significant clinical benefit in planning reconstructive breast surgery. This method can help the surgeon predict the esthetic effect of various breast surgeries and guide the choice of the most appropriate implant preoperatively.
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Affiliation(s)
- Takaaki Fujii
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Satoru Yamaguchi
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Reina Yajima
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Soichi Tsutsumi
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Takayuki Asao
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Hiroyuki Kuwano
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan
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Breast volumetry using a three-dimensional surface assessment technique. Aesthetic Plast Surg 2011; 35:847-55. [PMID: 21487916 DOI: 10.1007/s00266-011-9708-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 03/09/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Breast volume is a relevant measure for the prevention and prediction of diseases and for aesthetic surgery. This study evaluated a new technique to determine breast volume and compared measures using a three-dimensional (3D) body surface scanner and magnetic resonance imaging (MRI) scans, with the latter used as the standard method. METHODS Both MRI scans and body surface 3D scans were obtained from 22 women. For each method, breast volumes were assessed. The MRI calculations of the breast volumes were performed by a specially trained radiologist using analysis software. A textured 3D image was generated by a calibrated digital texture camera after breast surface data acquisition. The volume assessment of the 3D photography was calculated using a software package after manual outlining of the breast and automated projection of a dorsal limit. Linear regression was used to predict the MRI volume assessment with the 3D image volume assessment. RESULTS The mean breast volume according to MRI volumetry was 442.8 ml on the left side and 471.8 ml on the right side. The mean breast volume using a 3D body surface volume assessment method was 273.8 ml (observer A) and 226.2 ml (observer B) on the left side and 284.4 ml (observer A) and 234.9 ml (observer B) on the right side. The use of linear regression models showed R (2) values of 0.59-0.77. The mean time for MRI recording and volume assessment was 68.0 ± 14.1 min for both sides and 11.6 ± 1.5 min for 3D recording and volume assessment. CONCLUSIONS The 3D surface-based volume measurements are feasible in terms of time and can predict the MRI breast volume with sufficient accuracy. This might facilitate the broad use of such an assessment technique in a large-scale epidemiologic study using breast volume as a study aim. Additionally, further development of volume assessments could help to implement this technique in breast surgery procedures.
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Kayar R, Civelek S, Cobanoglu M, Gungor O, Catal H, Emiroglu M. Five methods of breast volume measurement: a comparative study of measurements of specimen volume in 30 mastectomy cases. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2011; 5:43-52. [PMID: 21494401 PMCID: PMC3076010 DOI: 10.4137/bcbcr.s6128] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND To compare breast volume measurement techniques in terms of accuracy, convenience, and cost. METHODS Breast volumes of 30 patients who were scheduled to undergo total mastectomy surgery were measured preoperatively by using five different methods (mammography, anatomic [anthropometric], thermoplastic casting, the Archimedes procedure, and the Grossman-Roudner device). Specimen volume after total mastectomy was measured in each patient with the water displacement method (Archimedes). The results were compared statistically with the values obtained by the five different methods. RESULTS The mean mastectomy specimen volume was 623.5 (range 150-1490) mL. The breast volume values were established to be 615.7 mL (r = 0.997) with the mammographic method, 645.4 mL (r = 0.975) with the anthropometric method, 565.8 mL (r = 0.934) with the Grossman-Roudner device, 583.2 mL (r = 0.989) with the Archimedes procedure, and 544.7 mL (r = 0.94) with the casting technique. Examination of r values revealed that the most accurate method was mammography for all volume ranges, followed by the Archimedes method. CONCLUSION The present study demonstrated that the most accurate method of breast volume measurement is mammography, followed by the Archimedes method. However, when patient comfort, ease of application, and cost were taken into consideration, the Grossman-Roudner device and anatomic measurement were relatively less expensive, and easier methods with an acceptable degree of accuracy.
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Affiliation(s)
- Ragip Kayar
- Surgical Department, Izmir Tepecik Training and Research Hospital, Turkey
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McGhee DE, Steele JR. Optimising breast support in female patients through correct bra fit. A cross-sectional study. J Sci Med Sport 2010; 13:568-72. [DOI: 10.1016/j.jsams.2010.03.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 02/10/2010] [Accepted: 03/11/2010] [Indexed: 11/25/2022]
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Pozzobon AV, Sabino Neto M, Veiga DF, Abla LEF, Pereira JB, Biasi TL, Ferreira LM, Yamashita LA, Kawano F, Nakano EM, Shigueoka DC. Magnetic resonance images and linear measurements in the surgical treatment of breast asymmetry. Aesthetic Plast Surg 2009; 33:196-203. [PMID: 18709409 DOI: 10.1007/s00266-008-9224-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 07/10/2008] [Indexed: 11/26/2022]
Abstract
BACKGROUND Objective evaluation of breast asymmetry surgical treatment should consider not only breast shape but also breast volume. METHODS For this study, 22 patients with primary breast asymmetry were evaluated by magnetic resonance imaging (MRI) as well as linear measurements preoperatively and 6 months postoperatively. The mean difference between the pre- and postoperative linear measurements was graduated from excellent to poor. Breast volume was estimated by MRI from axial reconstruction for three-dimensional application using the Cavalieri formula and specific software. RESULTS A strong correlation (r = 0.817) was found between the pre- and postoperative breast volumes, as increased or decreased by the surgical procedure. Patients with less postoperative volume differences tended to have the best ratings with linear measurements. When the same surgical procedure was performed bilaterally or when only one breast was treated by surgery, greater volume symmetry was observed. CONCLUSIONS Linear measurements and MRI are objective methods for evaluating postoperative symmetry, and when used in association, can help plastic surgeons to achieve favorable results in mammary asymmetry treatment.
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Affiliation(s)
- Adriana V Pozzobon
- Department of Plastic Surgery, Federal University of São Paulo, Sao Paulo, Brazil.
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Innovative techniques: a novel technique for intraoperative estimation of breast implant size in aesthetic and reconstructive breast surgery. Aesthetic Plast Surg 2008; 32:126-9. [PMID: 17929080 DOI: 10.1007/s00266-007-9045-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The estimation of breast implant size in both aesthetic and reconstructive surgery often is a matter of clinical and intraoperative trial and error, with subsequent differences in the resulting postoperative outcomes. Numerous techniques for preoperative estimation of implant size are in current use. However, although such techniques are inexpensive, they often are inaccurate and prone to error on the part of both the surgeon and the patient. Techniques for intraoperative estimation of breast implant size involve either the use of trial sizers or the surgeon's own guesswork based on the preoperative consultation. A novel technique is presented that uses commonly available surgical gauze swabs. The senior author has applied this technique in both aesthetic and reconstructive breast surgery for many years. This easily reproducible method is inexpensive and produces reliable and highly satisfactory results.
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Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, Endlich M, Mueller A, Schwenzer-Zimmerer K, Papadopulos NA, Biemer E. Comparison between breast volume measurement using 3D surface imaging and classical techniques. Breast 2006; 16:137-45. [PMID: 17029808 DOI: 10.1016/j.breast.2006.08.001] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2006] [Revised: 06/04/2006] [Accepted: 08/09/2006] [Indexed: 10/24/2022] Open
Abstract
Quantification of the complex breast region can be helpful in breast surgery, which is shaped by subjective influences. However, there is no generally recognized method for breast volume calculation. Three-dimensional (3D) body surface imaging represents a new alternative for breast volume computation. The aim of this work was to compare breast volume calculation with 3D scanning and three classic methods, focusing on relative advantages, disadvantages, and reproducibility. Repeated breast volume calculations of both breasts in six patients (n=12) were performed using a 3D laser scanner, nuclear magnetic resonance imaging (MRI), thermoplastic castings, and anthropomorphic measurements. Mean volumes (cc) and mean measurement deviations were calculated, and regression analyses were performed. MRI showed the highest measurement precision, with a mean deviation (expressed as a percentage of mean breast volume) of 1.56+/-0.52% compared with 2.27+/-0.99% for the 3D scanner, 7.97+/-3.53% for thermoplastic castings, and 6.26+/-1.56% for the anthropomorphic measurements. Breast volume calculations using MRI showed the best agreement with 3D scanning measurement (r=0.990), followed by anthropomorphic measurement (r=0.947), and thermoplastic castings (r=0.727). Compared with three classical methods of breast volume calculation, 3D scanning provides acceptable accuracy for breast volume measurements, better spatial interpretation of the anatomical area to be operated on (due to lack of chest deformation), non-invasiveness, and good patient tolerance. After this preliminary study and further development, we believe that 3D body surface scanning could provide better preoperative planning and postoperative control in everyday clinical practice.
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Affiliation(s)
- Laszlo Kovacs
- Department of Plastic and Reconstructive Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger strabe 22, D-81675 Munich, Germany.
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