Anthropometric optical surface imaging system repeatability, precision, and validation

Classification of Skull Shape Deformities Related to Craniosynostosis on 3D Photogrammetry

Implementation of the Utrecht Cranial Shape Quantificator (UCSQ) classification method on 3D photogrammetry in patients with different types of craniosynostosis is the aim of the present study. Five children (age <1 year) of every group of the common craniosynostoses (scaphocephaly, brachycephaly, trigonocephaly, right-sided and left-sided anterior plagiocephaly) were randomly included. The program 3-Matic (v13.0) was used to import and analyze the included 3dMD photos. Three external landmarks were placed. Using the landmarks, a base plane was created, as well as a plane 4 cm superior to the base plane. Using UCSQ, we created sinusoid curves of the patients, the resulting curves were analyzed and values were extracted for calculations. Results per patient were run through a diagnostic flowchart in order to determine correctness of the flowchart when using 3D photogrammetry. Each of the patients (n=25) of the different craniosynostosis subgroups is diagnosed correctly based on the different steps in the flowchart. This study proposes and implements a diagnostic approach of craniosynostosis based on 3D photogrammetry. By using a diagnostic flowchart based on specific characteristics for every type of craniosynostosis related to specific skull deformities, diagnosis can be established. All variables are expressed in number and are therefore objective.

Sexual dimorphism in the size and shape of the non-obstetric pelvis across anthropoids

OBJECTIVES

The presence of sexual dimorphism in the birth canals of anthropoid primates is well documented, and birth canal dimorphism tends to be especially robust among species that give birth to relatively large neonates. However, it is less clear whether birth canal dimorphism is accompanied by dimorphism in parts of the pelvis not directly under selection for birth, particularly including bi-iliac breadth, biactetabular breadth, lengths of the ischium and ilium, and 3D shape. This study investigates the patterns of dimorphism among anthropoid primates in those parts of the pelvis which do not directly contribute to the bony birth canal, here termed the non-obstetric pelvis.

METHODS

3D landmark data were collected on the bony pelves of 899 anthropoid primates. Specifically, landmark data were collected on parts of the pelvis not thought to be directly involved in selection for parturition, including portions of the posterior and superior ilium, acetabulum, and lateral ischium. Principal components analysis and Euclidean distance matrix analysis were used to ascertain sexual dimorphism in pelvic sizes and shapes within each species.

RESULTS

Results show that dimorphism in non-obstetric pelvic size and shape exists across anthropoids, just as is seen in the birth canal. However, the magnitude of dimorphism in non-obstetric pelvic shape tends to be greater among anthropoid species that give birth to relatively large neonates compared with those birthing smaller neonates relative to maternal pelvic size.

CONCLUSIONS

Though all anthropoids included in the study show some degree of sexual dimorphism in non-obstetric pelvic size and/or shape, species which give birth to large neonates relative to maternal pelvic size have the highest levels of dimorphism in pelvic shape. Moreover, the magnitude of dimorphism in certain parts of the non-obstetric pelvis mirrors patterns seen in the birth canal. The results of this study are promising for ascertaining pelvic dimorphism and relative neonate size in fossil primates, particularly in fragmentary remains which do not preserve a complete bony birth canal.

Accuracy and Reliability of Kinect Motion Sensing Input Device’s 3D Models: A Comparison to Direct Anthropometry and 2D Photogrammetry

AIM: This study aims to evaluate the accuracy and reliability of Kinect motion sensing input device’s three-dimensional (3D) models by comparing it with direct anthropometry and digital 2D photogrammetry. MATERIALS AND METHODS: Six profiles and four frontal parameters were directly measured on the faces of 80 participants. The same measurements were repeated using two-dimensional (2D) photogrammetry and (3D) images obtained from Kinect device. Another observer made the same measurements for 30% of the images obtained with 3D technique, and interobserver reproducibility was evaluated for 3D images. Intraobserver reproducibility was evaluated. Statistical analysis was conducted using the paired samples t-test, interclass correlation coefficient, and Bland-Altman limits of agreement. RESULTS: The highest mean difference was 0.0084 mm between direct measurement and photogrammetry, 0.027 mm between direct measurement and 3D Kinect’s models, and 0.018 mm between photogrammetry and 3D Kinect’s. The lowest agreement value was 0.016 in the all parameter between the photogrammetry and 3D Kinect’s methods. Agreement between the two observers varied from 0.999 Sn-Me to 1 with the rest of linear measurements. CONCLUSION: Measurements done using 3D Images obtained from Kinect device indicate that it may be an accurate and reliable imaging method for use in orthodontics. It also provides an easy low-cost 3D imaging technique that has become increasingly popular in clinical settings, offering advantages for surgical planning and outcome evaluation.

Postcranial Skeletal Differences in Free-Range and Captive-Born Primates

Skeletal morphology is important in evolutionary, genetic, developmental, physiological, and functional studies. Although samples from free-ranging individuals may be preferable, constraints of sample size, demography, or conservation status may necessitate the inclusion of captive-born individuals. Captivity may be associated with physical, physiological, or behavioral differences that may affect skeletal form. This study assesses differences in postcranial skeletal form between free-range and captive-born Macaca mulatta and Saguinus oedipus. Samples included free-range M. mulatta from Cayo Santiago (Caribbean Primate Research Center) and captive-born macaques from the Wisconsin National Primate Research Center. S. oedipus samples included free-range born and captive-born individuals from the Oak Ridge Associated Universities Marmoset Research Center. Twenty-four dimensions of various bones, including the scapula, upper limb, innominate and lower limb, were recorded for adults. Age of epiphyseal closure was recorded for immature captive-born M. mulatta. Analysis of variance and principal component analyses tested significant differences between free-range born and captive-born individuals in each species. Significant differences were present in size and shape of postcrania between free-range and captive-born within taxa. Free-range macaques were larger than captive-born macaques, but this pattern did not consistently carry over to the Saguinus samples. Shape differences, while present throughout the skeleton, were especially prominent in the scapula. Differences in developmental timing, nutrition, and physical activity can be expected to contribute to the observed differences in postcranial skeletal form. These differences should be considered when captive-born primates are included in morphological or evolutionary studies. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc. Anat Rec, 302:761-774, 2019. © 2018 Wiley Periodicals, Inc.

Comparison of Plaster Casting with Three-Dimensional Cranial Imaging

Objective

The development of a new cranial imaging system to capture a three-dimensional (3D) model of an infant's head has been previously reported. The accuracy of this new system has been independently established. However, before replacing the traditional plaster casting technique, the two methods require a comparison to ensure that the models they produce are equivalent.

Methods

Ten sequential infants were digitized by the 3D imaging system and the plaster casting technique following previously reported protocols. The cast models were also digitized so they could be compared with the digitized images. The two models (3dImage and Cast) were then imported into dimensional analysis software and aligned and registered with well-established registration algorithms. Difference maps that identified the variation between the two surfaces were generated for each pair, and descriptive statistics of these differences were recorded.

Results

The mean difference between the cast and the digitized models was 0.052 mm (standard deviation = 0.988), with a root mean square (RMS) difference of 1.028 mm. Two-dimensional slices obtained from the registered 3D surfaces demonstrated excellent agreement between the cranial contours.

Conclusions

In this investigation, the 3D models created by the new imaging system were found to be within 1.0 mm RMS of the models created by the plaster casting technique. Two-dimensional cranial contours demonstrated excellent agreement between the two methods. The results of this investigation confirmed that the new cranial imaging system and the traditional plaster casting technique yield equivalent models.

Comparing Methods to Assess Intraobserver Measurement Error of 3D Craniofacial Landmarks Using Geometric Morphometrics Through a Digitizer Arm

Intraobserver error (INTRA-OE) is the difference between repeated measurements of the same variable made by the same observer. The objective of this work was to evaluate INTRA-OE from 3D landmarks registered with a Microscribe, in different datasets: (A) the 3D coordinates, (B) linear measurements calculated from A, and (C) the six-first principal component axes. INTRA-OE was analyzed by digitizing 42 landmarks from 23 skulls in three events two weeks apart from each other. Systematic error was tested through repeated measures ANOVA (ANOVA-RM), while random error through intraclass correlation coefficient. Results showed that the largest differences between the three observations were found in the first dataset. Some anatomical points like nasion, ectoconchion, temporosphenoparietal, asterion, and temporomandibular presented the highest INTRA-OE. In the second dataset, local distances had higher INTRA-OE than global distances while the third dataset showed the lowest INTRA-OE.

Evaluation of the Reproducibility of Nonverbal Facial Expressions Using a 3D Motion Capture System

Objective

To evaluate the reproducibility of three nonverbal facial expressions using a three-dimensional motion capture system.

Design

Prospective, cross-sectional, controlled study.

Setting

Glasgow Dental Hospital and School, University of Glasgow, United Kingdom.

Patients and Participants

Thirty-two subjects, 16 males and 16 females.

Methods

With a three-dimensional video passive stereophotogrammetry imaging system, maximal smile, cheek puff, and lip purse were captured for each subject. Anatomical facial landmarks were digitized on the first frame and then tracked automatically. The same facial expressions were captured 15 minutes later.

Main Outcome Measures

The magnitude of each expression and speed of landmark displacement were calculated. The landmark motion curves were spatially and temporally aligned to calculate the similarity of the dynamic movements of the same landmarks between the captures.

Results

There were no significant differences between individuals for magnitude ( P = .892) or for speed ( P = .456). There were significant differences in landmark movement similarity ( P = .011); similarity was more reproducible for maximal smile. There was no significant gender effect on the difference in magnitude. There was a significant gender effect on speed to reach maximal smile ( P = .044) and a pursed-lip expression ( P = .038). There was a significant gender effect on landmark movement similarities ( P = .031) for cheek puff expression.

Conclusions

There were no differences in magnitude and speed for maximal smile, cheek puff, and lip purse between the two captures for all participants. For individual expressions, maximal smile expression had the highest similarity value for individual landmarks.

Accuracy and reliability of 3D stereophotogrammetry: A comparison to direct anthropometry and 2D photogrammetry

OBJECTIVE

To evaluate the accuracy of three-dimensional (3D) stereophotogrammetry by comparing it with the direct anthropometry and digital photogrammetry methods. The reliability of 3D stereophotogrammetry was also examined.

MATERIALS AND METHODS

Six profile and four frontal parameters were directly measured on the faces of 80 participants. The same measurements were repeated using two-dimensional (2D) photogrammetry and 3D stereophotogrammetry (3dMDflex System, 3dMD, Atlanta, Ga) to obtain images of the subjects. Another observer made the same measurements for images obtained with 3D stereophotogrammetry, and interobserver reproducibility was evaluated for 3D images. Both observers remeasured the 3D images 1 month later, and intraobserver reproducibility was evaluated. Statistical analysis was conducted using the paired samples t-test, intraclass correlation coefficient, and Bland-Altman limits of agreement.

RESULTS

The highest mean difference was 0.30 mm between direct measurement and photogrammetry, 0.21 mm between direct measurement and 3D stereophotogrammetry, and 0.5 mm between photogrammetry and 3D stereophotogrammetry. The lowest agreement value was 0.965 in the Sn-Pro parameter between the photogrammetry and 3D stereophotogrammetry methods. Agreement between the two observers varied from 0.90 (Ch-Ch) to 0.99 (Sn-Me) in linear measurements. For intraobserver agreement, the highest difference between means was 0.33 for observer 1 and 1.42 mm for observer 2.

CONCLUSIONS

Measurements obtained using 3D stereophotogrammetry indicate that it may be an accurate and reliable imaging method for use in orthodontics.

Evaluation of precision and accuracy assessment of different 3-D surface imaging systems for biomedical purposes

Three-dimensional (3-D) surface imaging has gained clinical acceptance, especially in the field of cranio-maxillo-facial and plastic, reconstructive, and aesthetic surgery. Six scanners based on different scanning principles (Minolta Vivid 910®, Polhemus FastSCAN™, GFM PRIMOS®, GFM TopoCAM®, Steinbichler Comet® Vario Zoom 250, 3dMD DSP 400®) were used to measure five sheep skulls of different sizes. In three areas with varying anatomical complexity (areas, 1 = high; 2 = moderate; 3 = low), 56 distances between 20 landmarks are defined on each skull. Manual measurement (MM), coordinate machine measurements (CMM) and computer tomography (CT) measurements were used to define a reference method for further precision and accuracy evaluation of different 3-D scanning systems. MM showed high correlation to CMM and CT measurements (both r = 0.987; p < 0.001) and served as the reference method. TopoCAM®, Comet® and Vivid 910® showed highest measurement precision over all areas of complexity; Vivid 910®, the Comet® and the DSP 400® demonstrated highest accuracy over all areas with Vivid 910® being most accurate in areas 1 and 3, and the DSP 400® most accurate in area 2. In accordance to the measured distance length, most 3-D devices present higher measurement precision and accuracy for large distances and lower degrees of precision and accuracy for short distances. In general, higher degrees of complexity are associated with lower 3-D assessment accuracy, suggesting that for optimal results, different types of scanners should be applied to specific clinical applications and medical problems according to their special construction designs and characteristics.

Soft-tissue thickness of South Korean adults with normal facial profiles

OBJECTIVE

To standardize the facial soft-tissue characteristics of South Korean adults according to gender by measuring the soft-tissue thickness of young men and women with normal facial profiles by using three-dimensional (3D) reconstructed models.

METHODS

Computed tomographic images of 22 men aged 20 - 27 years and 18 women aged 20 - 26 years with normal facial profiles were obtained. The hard and soft tissues were three-dimensionally reconstructed by using Mimics software. The soft-tissue thickness was measured from the underlying bony surface at bilateral (frontal eminence, supraorbital, suborbital, inferior malar, lateral orbit, zygomatic arch, supraglenoid, gonion, supraM2, occlusal line, and subM2) and midline (supraglabella, glabella, nasion, rhinion, mid-philtrum, supradentale, infradentale, supramentale, mental eminence, and menton) landmarks.

RESULTS

The men showed significantly thicker soft tissue at the supraglabella, nasion, rhinion, mid-philtrum, supradentale, and supraglenoid points. In the women, the soft tissue was significantly thicker at the lateral orbit, inferior malar, and gonion points.

CONCLUSIONS

The soft-tissue thickness in different facial areas varies according to gender. Orthodontists should use a different therapeutic approach for each gender.

[Long-term aesthetic results of rhinoplasty in congenital nose deformities--comparison of surgeon's and patient's evaluation]

INTRODUCTION

Nose as the most projected face structure focuses the biggest people's attention. Nasal localization causes that even its small deformities are visible and subjected to different opinions. Rhinoplasty is one of the most common procedures in plastic surgery and at the same time one of the most difficult operation in facial surgery. The aim of this research is to analyze the long-term aesthetic results of rhinoplasty in congenital nose deformities in evaluation performed by surgeon and patient.

MATERIAL AND METHOD

The study was carried out in the group of 50 patients operated on in the Department of Plastic, Reconstructive and Aesthetic Surgery due to congenital nose deformity. The group consisted of 38 women and 12 men, aged from 27 to 56 years. Long-term aesthetic results' evaluation was performed on the basis of clinical examination done by doctor and questionnaire filled in by patients and surgeon.

RESULTS

Evaluation of long-term results after aesthetic rhinoplasty in patients' opinion qualified the effects as very good in 70%. In surgeon's opinion such a result was obtained in 62% of patients. Satisfactory result of performed operation was marked by 92% of patients while surgeon qualified results as a satisfactory in the group of 88%. Reoperation was considered by 12% of patients and doctor such a necessity reflected in 10%.

CONCLUSIONS

Satisfactory results of rhinoplasty in congenital nose deformities are possible to obtain while taking the degree and type of deformity into consideration and choosing proper surgical method. Surgical procedures in congenital nose deformities give good aesthetic results in patients' and as well as surgeon's opinions. Doctor evaluates surgical results in more critical way.

Testing repeatability and error of coordinate landmark data acquired from crania

This study evaluates issues of precision, repeatability, and validation in three-dimensional (3D) landmark coordinates. Two observers collected 19 homologous cranial landmarks from three skulls during three separate digitizing sessions. Statistical analysis was conducted on the 171 interlandmark distances (ILDs) derived from the original coordinate data. A mixed model ANOVA detected significant within-subject error in 54 of the 171 ILDs (i.e., 32%). A GLM procedure revealed significant between-observer variation in 14 ILDs and significant observer-by-session differences in 13 ILDs. The majority of these differences involved ILDs with type 3 landmarks as endpoints, such as euryon and alare. Unlike type 1 and 2 landmarks which are biologically informative in all directions, type 3 landmarks contain a substantial arbitrary component. Thus, it is not surprising type 3 landmarks displayed significant digitizing error. Given these results, we caution researchers to be mindful of type 3 landmarks measurement discrepancies when selecting landmarks for coordinate data evaluation.

Precision and error of three-dimensional phenotypic measures acquired from 3dMD photogrammetric images

The genetic basis for complex phenotypes is currently of great interest for both clinical investigators and basic scientists. In order to acquire a thorough understanding of the translation from genotype to phenotype, highly precise measures of phenotypic variation are required. New technologies, such as 3D photogrammetry are being implemented in phenotypic studies due to their ability to collect data rapidly and non-invasively. Before these systems can be broadly implemented, the error associated with data collected from images acquired using these technologies must be assessed. This study investigates the precision, error, and repeatability associated with anthropometric landmark coordinate data collected from 3D digital photogrammetric images acquired with the 3dMDface System. Precision, error due to the imaging system, error due to digitization of the images, and repeatability are assessed in a sample of children and adults (n = 15). Results show that data collected from images with the 3dMDface System are highly repeatable and precise. The average error associated with the placement of landmarks is sub-millimeter; both the error due to digitization and due to the imaging system are very low. The few measures showing a higher degree of error include those crossing the labial fissure, which are influenced by even subtle movement of the mandible. These results suggest that 3D anthropometric data collected using the 3dMDface System are highly reliable and, therefore, useful for evaluation of clinical dysmorphology and surgery, analyses of genotype-phenotype correlations, and inheritance of complex phenotypes.

Comparison of three methods of facial measurement

The aims of this study were to assess the accuracy of measurements recorded by 3D stereophotogrammetry and to compare three methods of facial measurement: manual anthropometry, 3D stereophotogrammetry and 2D photography. Measurements were taken from 14 landmarks on each of six volunteers and compared. In addition, the variability of the methods was assessed. Three-dimensional measurements were shown to compare well with manual measurements on volunteers as well as test objects for which the mean difference was 0.23 mm (shortest distance) and 0.13 mm (surface). All the three methods of measurement were found to have good levels of repeatability. Two-dimensional measurements were more variable than manual measurements (P=0.021). Three-dimensional stereophotogrammetric measurements were shown to compare well with manual measurements although the values obtained were mostly slightly larger. Stereophotogrammetry allows images to be taken in a Medical Photography Department, facilitating the accurate measurement of facial morphology from digitized data, including changes associated with treatment or growth. There are clear potential benefits of using 3D measurements in the assessment of facial deformity.

Anthropometric precision and accuracy of digital three-dimensional photogrammetry: comparing the Genex and 3dMD imaging systems with one another and with direct anthropometry

A variety of commercially available three-dimensional (3D) surface imaging systems are currently in use by craniofacial specialists. Little is known, however, about how measurement data generated from alternative 3D systems compare, specifically in terms of accuracy and precision. The purpose of this study was to compare anthropometric measurements obtained by way of two different digital 3D photogrammetry systems (Genex and 3dMD) as well as direct anthropometry and to evaluate intraobserver precision across these three methods. On a sample of 18 mannequin heads, 12 linear distances were measured twice by each method. A two-factor repeated measures analysis of variance was used to test simultaneously for mean differences in precision across methods. Additional descriptive statistics (e.g., technical error of measurement [TEM]) were used to quantify measurement error magnitude. Statistically significant (P < 0.05) mean differences were observed across methods for nine anthropometric variables; however, the magnitude of these differences was consistently at the submillimeter level. No significant differences were noted for precision. Moreover, the magnitude of imprecision was determined to be very small, with TEM scores well under 1 mm, and intraclass correlation coefficients ranging from 0.98 to 1. Results indicate that overall mean differences across these three methods were small enough to be of little practical importance. In terms of intraobserver precision, all methods fared equally well. This study is the first attempt to simultaneously compare 3D surface imaging systems directly with one another and with traditional anthropometry. Results suggest that craniofacial surface data obtained by way of alternative 3D photogrammetric systems can be combined or compared statistically.

Bewertung von Präzision und Genauigkeit der digitalen Oberflächenphotogrammetrie mit dem DSP 400 System / Assessment of Precision and Accuracy of Digital Surface Photogrammetry with the DSP 400 System

The objective of the present study was to evaluate the precision and accuracy of facial anthropometric measurements obtained through digital 3-D surface photogrammetry with the DSP 400 system in comparison to traditional 2-D photogrammetry. Fifty plaster casts of cleft infants were imaged and 21 standard anthropometric measurements were obtained. For precision assessment the measurements were performed twice in a subsample. Accuracy was determined by comparison of direct measurements and indirect 2-D and 3-D image measurements. Precision of digital surface photogrammetry was almost as good as direct anthropometry and clearly better than 2-D photogrammetry. Measurements derived from 3-D images showed better congruence to direct measurements than from 2-D photos. Digital surface photogrammetry with the DSP 400 system is sufficiently precise and accurate for craniofacial anthropometric examinations.

Digital three-dimensional photogrammetry: evaluation of anthropometric precision and accuracy using a Genex 3D camera system

OBJECTIVE

To determine the precision and accuracy of facial anthropometric measurements obtained through digital three-dimensional (3D) photogrammetry.

DESIGN

Nineteen standard craniofacial measurements were repeatedly obtained on 20 subjects by two independent observers, using calipers and 3D photos (obtained with a Genex 3D camera system), both with and without facial landmarks labeled. Four different precision estimates were then calculated and compared statistically across techniques. In addition, mean measurements from 3D photos were compared statistically with those from direct anthropometry.

RESULTS

In terms of measurement precision, the 3D photos were clearly better than direct anthropometry. In almost all cases, the 3D photo with landmarks labeled had the highest overall precision. In addition, labeling landmarks prior to taking measurements improved precision, regardless of method. Good congruence was observed between means derived from the 3D photos and direct anthropometry. Statistically significant differences were noted for seven measurements; however, the magnitude of these differences was often clinically insignificant (< 2 mm).

CONCLUSIONS

Digital 3D photogrammetry with the Genex camera system is sufficiently precise and accurate for the anthropometric needs of most medical and craniofacial research designs.

Development of a new three-dimensional cranial imaging system

The development of a new three-dimensional (3D) imaging system designed to obtain a digital image of an infant's cranium is described. This system is intended to replace the manual plaster-casting technique currently used during the process of fabricating cranial remodeling bands. The system uses 18 triangulated digital cameras and the projection of random infrared patterns to capture a 360 degrees image of an infant's cranium instantaneously, including the face and top of the head. Accuracy was calculated by comparing models digitized with this system with the same models digitized with high-precision inspection equipment. Safety was documented under guidelines established by the American Council of Governmental Industrial Hygienists. Images were acquired in 0.008 seconds and processed for viewing in software within 2.5 minutes. Accuracy was calculated to be +/-0.236 mm. Hazard analysis confirmed the system to be safe for direct continuous exposure. The data acquired may be viewed as a point cloud, wire frame, or surface on which a digital photograph (ie, texture) is automatically overlaid. Physical models are created by exporting the digital data to a multiaxis milling machine or stereolithography machine. Quantitative data (linear and surface measurements, curvature, and volumes) can be obtained directly from the digital data. The cranial imaging system is a safe and accurate method of obtaining digital 3D images of an infant's cranium. Along with the obvious clinical and manufacturing benefits, it also has significant potential as a research tool for documenting the natural history and evaluating the treatment of plagiocephaly.

Three-dimensional video-analysis of facial movements in healthy volunteers

The aim of this study was to determine the mean distances of facial movements in 24 healthy individuals aged between 22 and 70 years, using the digitised three-dimensional video-analysis system developed by Frey et al. The subjects were divided into three groups of eight. The first group consisted of individuals aged between 20 and 30 years (mean+/-s.d.=25.0+/-2.33 years). Subjects in the second group were aged between 40 and 50 years (mean+/-s.d.=46.8+/-2.53 years), and the third group consisted of subjects aged between 60 and 70 years (mean+/-s.d.=63.6+/-3.07 years). In all groups the sexes were equally represented. No subject had had treatment to the face, nor did they have paralysis, scars or diseases of the skin. Males showed larger movements of the face than females, on average by 1.40+/-0.73 mm (15.08%). Subjects aged between 60 and 70 years demonstrated the largest movements of the face. The evaluation of facial movements in 24 healthy volunteers showed that sex and age affect facial dynamics. Thus study generated three-dimensional standard values for healthy facial movements.

Precision and accuracy of computed tomography foot measurements

OBJECTIVE

To test the accuracy and precision of computed tomography (CT) imaging for describing the 3-dimensional structure of the foot in patients with diabetes mellitus and peripheral neuropathy.

DESIGN

Experimental, test-retest.

SETTING

Clinical CT scanner at a local hospital.

SPECIMENS

Two tissue-equivalent phantoms and 6 cadaver feet.

MAIN OUTCOME MEASURES

Measurements taken from CT data of phantoms and cadaver feet were compared with physical (caliper) measurements. The feasibility of creating a computer-aided design/rapid prototyping 3-dimensional model from CT data was assessed by using 1 cadaver foot.

RESULTS

No bias was found for phantom or cadaver CT measurements compared with caliper measurements. The mean difference between repeat scans of cadaver feet (1 observer) was 0.1 +/- 0.8 mm and between observers, 0.4 +/- 0.8 mm. Comparing caliper measurements of the rapid prototype model and actual foot measurements revealed an error of 0.3 +/- 0.4 mm.

CONCLUSION

CT-based 3-dimensional imaging produced accurate and precise foot measurements, enabling description of internal and external structures. This capability will be coupled with plantar pressure measurements to improve our understanding and treatment of foot ulcers in people with diabetes.

Digital two-dimensional photogrammetry: a comparison of three techniques of obtaining digital photographs

Three methods of obtaining digital photographs in a clinical setting were compared using direct anthropometry as a reference standard. The methods included a digital camera, scanning negatives from a 35-mm single-lens reflex camera, and scanning Polaroid photographs taken with a Polaroid camera designed for medical documentation. A total of 11 angular and linear anthropometric measurements obtained from 30 healthy volunteers were used for the comparison. The data were analyzed using a variance covariance approach to repeated measures. The analysis revealed that the three cameras were not statistically different from each other. Other advantages and disadvantages, such as cost and ease of use, are discussed.

Comparison of linear measurements made from storage phosphor and dental radiographs

OBJECTIVES

To compare linear measurements made from storage phosphor and dental radiographs.

METHODS

Five dry hemimandibles were imaged with an 8 x 10-inch (20.3/25.4 cm) high-resolution storage phosphor plate and Ektaspeed Plus occlusal-size dental film. Optimal exposure was empirically determined for the dental films. Reductions in exposure of 50 and 75% were used for the storage phosphor. Three observers made linear measurements between end-points of lines and center-points of fiducials on clinical specimens, dental radiographs, digitized dental radiographs and storage phosphor images. Data were analysed with repeated-measures and nested analysis of variance.

RESULTS

Measurements obtained from optimally exposed dental films and reduced-exposure storage phosphor images were equivalent to clinical measurements recorded from dry hemimandibles. Less than 2% of variation among measurements was attributable to the five modalities.

CONCLUSION

No substantive difference was detected between linear measurements obtained from the storage phosphor or dental radiographis. Because storage phosphor images require no chemical processing, can be used at reduced exposure and are inherently digital, they are a viable alternative to dental film for making linear measurements.

Precision of surface measurements for below-knee residua

OBJECTIVE

To determine the absolute and relative precision of geometric measurements made of below knee (BK) residua and their BK plaster positive casts using calipers, electromagnetic digitizer, optical surface scanner (OSS), and spiral x-ray computed tomography (SXCT).

DESIGN

The experimental measurement protocol for a single measurement session was as follows: Dot markers were placed on the residuum, and volume and distances were measured using water displacement and calipers; residuum was measured using electromagnetic digitizer; residuum was scanned using three-dimensional (3D) OSS; a negative plaster cast of subject's residuum was made; the residuum was scanned using SXCT scanner. These steps were repeated at a second measurement session. Plaster positive casts were constructed and subsequently measured using the same protocol.

PARTICIPANTS

Thirteen adult below-knee amputee volunteers (subjects) participated in the study, and nine subjects returned for a second measurement session. The study group consisted of 9 men and 4 women; 10 Caucasians and 3 African Americans.

RESULTS

Distance measurements for all measurement devices were repeatable within 1% in vivo and within 0.5% on plaster casts; and volumes were within 1% in vivo and within 0.1% on plaster casts. Distance measurements for each device were precise within 3% in vivo and within 1% on plaster casts; and volumes were within 5% in vivo and within 6% on plaster casts when compared with caliper and water displacement measures.

CONCLUSION

These measurement systems were found to be substantially equivalent in terms of repeatability and precision for measurement of lower extremity residua.