1
|
Zhou LC, Hong WJ, Cao MB, Zeng L, Peng T, Li XR, Zhu GS, Luo SK. Morphological Aesthetics Assessment of the Predicted 3D Simulation Results and the Actual Results of Breast Augmentation. Aesthetic Plast Surg 2024; 48:568-579. [PMID: 37608189 DOI: 10.1007/s00266-023-03597-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Although three-dimensional (3D) simulations are becoming more common in preoperative breast augmentation planning, this does not necessarily imply that the simulated results are highly accurate. OBJECTIVES We aimed to evaluate the accuracy of the 3D simulation technique by comparing the differences in breast morphology between the 3D prediction model and the actual results. METHODS The simulation and actual postoperative results of 103 patients who underwent breast augmentation were analyzed retrospectively. Therefore, a 3D model was created, and the parameters of line spacing, nipple position, breast projection, surface area, and volume were evaluated. Furthermore, consider the difference in chest circumferences and breast volume. RESULTS In comparison with the simulation results, the actual results had a mean increase in the nipple to the inframammary fold (N-IMF) of 0.3 cm (P < 0.05) and a mean increase in basal breast width (BW) of 0.3 cm (P < 0.001), a difference that was not statistically significant in patients with larger breast volumes. There was a significant difference in the mean upper and lower breast volume distribution between simulated and actual breasts (upper pole 52.9% vs. 49.2%, P < 0.05, and lower pole 47.1% vs. 50.8%, P < 0.001). However, it was not statistically significant in patients with larger chest circumferences. CONCLUSIONS Our study shows that 3D simulation has uncertainties related to the patient's chest circumference and breast volume. Therefore, these two critical factors must be considered when using simulation assessment in preoperative planning. LEVEL OF EVIDENCE III 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 .
Collapse
Affiliation(s)
- Ling-Cong Zhou
- The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Wei-Jin Hong
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong, China
| | - Mi-Bu Cao
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong, China
| | - Li Zeng
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong, China
| | - Tong Peng
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong, China
| | - Xin-Rui Li
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong, China
| | - Guo-Sheng Zhu
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong, China
| | - Sheng-Kang Luo
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou, 510317, Guangdong, China.
| |
Collapse
|
2
|
Kim MJ, Kim TW, Hahn HM, Lee IJ. Clinical use of perioperative magnetic resonance imaging-based breast volumetric analysis in final implant volume prediction for two-stage breast reconstruction. Ann Surg Treat Res 2022; 103:195-204. [PMID: 36304192 PMCID: PMC9582615 DOI: 10.4174/astr.2022.103.4.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/05/2022] [Accepted: 08/26/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Breast volume is an important factor in breast reconstruction; however, the surgeon is expected to deliver the volume expectation with his aesthetic inspiration. Therefore, objective volumetry must be developed. This study aimed to conduct an MRI-based breast volumetric analysis. With periodic analysis of 2-stage breast reconstruction, we suggest the possibility of clinical use of breast volumetry in implant volume prediction. Methods This retrospective study included 140 patients who underwent unilateral 2-stage breast reconstruction (tissue expander followed by implant insertion) between January 1, 2017 and December 31, 2019. The MRI image was converted into a 3-dimensional image with a reconstruction program (A-VIEW, Coreline Soft). MRI image was obtained before the surgery and then at 1, 3, 6, 12, and 24 months postoperatively. The volume was automatically calculated. Results Compared with the preoperative volume, maximized volume and differences were noted at 1 month and minimized at 1 year. The correlation between MRI-based preoperative breast volumetry and the mastectomy specimen volume was 0.611. Volume difference between the MRI-based preoperative state and the implant volume showed a minimal difference at 1 year. The final implant size prediction formula was calculated using the 1-year postoperative volume (P < 0.001, R2 = 0.594). Conclusion To avoid breast reconstruction based solely on the surgeon’s subjective assessment, MRI-based breast volumetry could be a useful method to develop more scientific and objective breast reconstruction planning. We suggest a volume prediction formula that describes the relationship between the postoperative breast volume and the final breast implant size.
Collapse
Affiliation(s)
- Min Ji Kim
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Tae Wook Kim
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hyung Min Hahn
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Il Jae Lee
- Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea
| |
Collapse
|
3
|
Nonsubjective Assessment of Shape, Volume and Symmetry during Breast Augmentation with Handheld 3D Device. J Clin Med 2022; 11:jcm11144002. [PMID: 35887767 PMCID: PMC9320179 DOI: 10.3390/jcm11144002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
Three-dimensional Surface Imaging (3DSI) has become a valuable tool for planning and documenting surgical procedures. Although surface scanners have allowed for a better understanding of breast shape, size, and asymmetry during patient consultation, its use has not been included in intraoperative assessment so far. Validation of the reliability of the intraoperative use of a portable handheld 3DSI equipment as a tool to evaluate morphological changes during breast augmentation surgery. The patients who underwent bilateral subpectoral breast augmentation through an inframammary incision were included in this study. Intraoperative 3DSI was performed with the Artec Eva device, allowing for visualization of the surgical area before incision, after use of breast sizers and implant, and after wound closure. Intraoperatively manual measurements of breast distances and volume changes due to known sizer and implant volumes were in comparison with digital measurements calculated from 3DSI of the surgical area. Bilateral breasts of 40 patients were 3D photographed before incision and after suture successfully. A further 108 implant sizer uses were digitally documented. There was no significant difference between manual tape measurement and digital breast distance measurement. Pre- to postoperative 3D volume change showed no significant difference to the known sizer and implant volume.
Collapse
|
4
|
Kim YS, Cho HG, Kim J, Park SJ, Kim HJ, Lee SE, Yang JD, Kim WH, Lee JS. ASO Author Reflections: Prediction of Implant Size Based on Breast Volumetry Using Mammography and Breast MRI in DTI Breast Reconstruction. Ann Surg Oncol 2022; 29:7855-7856. [PMID: 35717517 DOI: 10.1245/s10434-022-12025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Young Seon Kim
- Department of Radiology, Yeungnam University Hospital, Yeungnam University College of Medicine, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Hyun Geun Cho
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Jaeil Kim
- School of Computer Science and Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Sung Joon Park
- School of Computer Science and Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Hye Jung Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Seung Eun Lee
- Department of Radiology, Yeungnam University Hospital, Yeungnam University College of Medicine, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Jung Dug Yang
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea
| | - Won Hwa Kim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
| | - Joon Seok Lee
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea.
| |
Collapse
|
5
|
Wiedner M, Richter DF. Invited Discussion on: Breast Equalization Augmentation: The Use of Ultrasonic-Assisted Liposuction for Correction of Primary Breast Asymmetry with Bilateral Augmentation. Aesthetic Plast Surg 2022; 46:675-676. [PMID: 35048146 DOI: 10.1007/s00266-021-02707-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/01/2022]
|
6
|
Brébant V, Weiherer M, Noisser V, Seitz S, Prantl L, Eigenberger A. Implants Versus Lipograft: Analysis of Long-Term Results Following Congenital Breast Asymmetry Correction. Aesthetic Plast Surg 2022; 46:2228-2236. [PMID: 35296928 PMCID: PMC9592638 DOI: 10.1007/s00266-022-02843-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/12/2022] [Indexed: 11/29/2022]
Abstract
Aims Congenital breast asymmetry represents a particular challenge to the classic techniques of plastic surgery given the young age of patients at presentation. This study reviews and compares the long-term results of traditional breast augmentation using silicone implants and the more innovative technique of lipografting. Methods To achieve this, we not only captured subjective parameters such as satisfaction with outcome and symmetry, but also objective parameters including breast volume and anthropometric measurements. The objective examination was performed manually and by using the Vectra® H2 photogrammetry scanning system. Results Differences between patients undergoing either implant augmentation or lipograft were revealed not to be significant with respect to patient satisfaction with surgical outcome (p = 0.55) and symmetry (p = 0.69). Furthermore, a breast symmetry of 93 % was reported in both groups. Likewise, no statistically significant volume difference between the left and right breasts was observed in both groups (p < 0.41). However, lipograft patients needed on average 2.9 procedures to achieve the desired result, compared with 1.3 for implant augmentation. In contrast, patients treated with implant augmentation may require a number of implant changes during their lifetime. Conclusion Both methods may be considered for patients presenting with congenital breast asymmetry. Level of Evidence III 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.
Collapse
Affiliation(s)
- Vanessa Brébant
- University Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Maximilian Weiherer
- Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg, Germany
| | - Vivien Noisser
- University Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Stephan Seitz
- Department of Obstetrics and Gynecology, Caritas Hospital St. Josef, University of Regensburg, Regensburg, Germany
| | - Lukas Prantl
- University Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Andreas Eigenberger
- University Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
- Regensburg Center of Biomedical Engineering (RCBE), OTH Regensburg and Regensburg University, Regensburg, Germany
| |
Collapse
|
7
|
Ahmed YS, Abd El Maksoud WM, Sultan MH, El-Bakoury EA. Immediate Lipo-Filling as a Novel Technique for Volume Replacement in Oncoplastic Breast Conservative Surgery. Aesthetic Plast Surg 2022; 46:1612-1621. [PMID: 35048152 DOI: 10.1007/s00266-021-02755-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND We aimed to evaluate the feasibility of immediate lipofilling as a volume replacement technique in breast conservative surgery (BCS) in terms of the volume of fat graft resorption after radiotherapy, patient satisfaction, and oncological safety. PATIENTS AND METHODS This was a prospective study that included female patients with breast cancer, with small- or medium-sized breasts. The patients underwent BCS followed by lipofilling into the deformed areas away from the tumor site that resulted from direct closure of the tumor cavity. They were followed up for early and late postoperative complications, including recurrence. Volumetric computed tomography was performed before and after radiotherapy to determine percentage fat resorption. Postoperative patient satisfaction was assessed using the Kyungpook National University Hospital Breast Reconstruction Satisfaction Questionnaire. RESULTS The study included 54 female patients with a mean age of 47.57 ± 9.26 years. The mean follow-up period was 31.02 ± 4.47 months. Local recurrence was observed in three patients (5.56%). The volume reduction of the injected fat graft ranged from 10.15% to 55.67%, with a mean of 29.27 ± 10.06%. Fifty-two patients (96.30%) reported postoperative satisfaction, and nine of them expressed satisfaction only after a second lipofilling session. CONCLUSIONS Immediate lipofilling as a volume replacement technique in BCS is a safe and simple technique without major complications. It has a locoregional recurrence rate similar to BCS alone, with an acceptable fat resorption percentage and high postoperative patient satisfaction. 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 .
Collapse
Affiliation(s)
- Yasser S Ahmed
- Experimental Surgery Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Walid M Abd El Maksoud
- General Surgery Department, Faculty of Medicine, King Khalid University, P.O. 641, Abha, 61421, Saudi Arabia.
| | - Mohamed Hussein Sultan
- Experimental Surgery Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Eman A El-Bakoury
- Radiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| |
Collapse
|
8
|
Noisser V, Eigenberger A, Weiherer M, Seitz S, Prantl L, Brébant V. Surgery of congenital breast asymmetry-which objective parameter influences the subjective satisfaction with long-term results. Arch Gynecol Obstet 2021; 305:95-102. [PMID: 34480228 PMCID: PMC8782804 DOI: 10.1007/s00404-021-06218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/20/2021] [Indexed: 10/24/2022]
Abstract
PURPOSE Congenital breast asymmetry is a serious gynecological malformation for affected patients. The condition hits young women in puberty and is associated with socio-esthetic handicap, depression, and psychosexual problems. Surgical treatment is usually early in the patient's lifetime, so a long-term sustainable solution is important. Although postoperative outcome has been evaluated in several studies before, this study is the first to analyze which objective parameters have the greatest influence on subjective satisfaction with long-term results. METHODS Thirty-four patients diagnosed with congenital breast asymmetry that underwent either lipofilling or implant therapy between the years of 2008 to 2019 were examined. On average, our collective comprised patients seven years after surgery. Data were mainly gathered through manual measurements, patient-reported outcome measures (Breast Q™), and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific). RESULTS Among all analyzed parameters, only areolar diameter correlated significantly negatively with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of postoperative satisfaction with similarity of the breasts, again the mean areolar diameter, but also the difference in areolar diameter and breast volume between the right and left breasts correlated significantly negatively. CONCLUSION Areolar diameter was revealed as being a significant factor influencing subjective long-term satisfaction in breast asymmetry patients. Moreover, 3D volumetry proves to be an effective tool to substantiate subjective patient assessments. Our findings may lead to further improvements to surgical planning and will be expanded in further studies.
Collapse
Affiliation(s)
- Vivien Noisser
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Andreas Eigenberger
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.,Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg, Germany
| | - Maximilian Weiherer
- Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg, Germany
| | - Stephan Seitz
- Department of Obstetrics and Gynecology, Caritas Hospital St. Josef, University of Regensburg, Regensburg, Germany
| | - Lukas Prantl
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Vanessa Brébant
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| |
Collapse
|
9
|
Malter W, Bachmann BJ, Krug B, Hellmich M, Zinser M, Mallmann P, Eichler C, Puppe J. Correlation analysis of resected breast tissue and implant volume after mastectomy and its association with breast density. Arch Gynecol Obstet 2021; 305:169-177. [PMID: 34189629 PMCID: PMC8782773 DOI: 10.1007/s00404-021-06128-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 06/15/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The current methods for calculating the ideal implant volume for breast reconstruction are based on pre- or intraoperative volume measurements of the existing breast volume and do not take into account the individual breast density of the woman. This study aims is to identify objective parameters that can help to improve the optimal implant selection. MATERIALS AND METHODS This retrospective analysis includes 198 breast cancer patients who underwent mastectomy. Breast densities (ACR) measured in mammography and MRI were compared with the removed breast tissue weight and volume of the implants used. In addition, the resected weight was compared directly with the implant volume to calculate a mathematical function. RESULTS There was no significant correlation between the ACR values and the resected weights [correlation coefficient: mammography:- 0.117 (p = 0.176), MRI - 0.033 (p = 0.756)]. A negative correlation between the implant volumes and both imaging methods could be demonstrated [correlation coefficient: mammography - 0.268; p = 0.002; MRI was - 0.200 (p = 0.055)]. A highly significant correlation between the resected weights and the implant volumes (correlation coefficient 0.744; p < 0.001) was observed. This correlation corresponds to a power function (y = 34.71 x0.39), in which any resected weight can be used for the variable x to calculate the implant volume. CONCLUSION We were able to show that there is a significant correlation between the resected breast tissue and the implant volume. With our novel potency function, the appropriate implant volume can be calculated for any resected weight making it easier for the surgeon to choose a fitting implant in a simple and more objective manner.
Collapse
Affiliation(s)
- Wolfram Malter
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Cologne, Germany.
| | - Bo Jan Bachmann
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Barbara Krug
- Department for Diagnostic and Interventional Radiology¸ Medical Faculty, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany
| | - Max Zinser
- Department for Plastic and Reconstructive Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Peter Mallmann
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Christian Eichler
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Julian Puppe
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Cologne, Germany
| |
Collapse
|
10
|
Kim JS, Bae K, Lee EJ, Bang M. Mammography with a fully automated breast volumetric software as a novel method for estimating the preoperative breast volume prior to mastectomy. Ann Surg Treat Res 2021; 100:313-319. [PMID: 34136427 PMCID: PMC8176198 DOI: 10.4174/astr.2021.100.6.313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/22/2021] [Accepted: 04/09/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Increasing interest in maintaining a positive body image following breast cancer surgery has become an important aspect of reconstruction surgery. Volume matching of the reconstructed breast to natural breasts is the most important consideration. This study aimed to explore the feasibility of using mammography with a fully automated breast volumetric software to measure the preoperative breast volume in patients with breast cancer. Methods We evaluated patients who underwent a total mastectomy between July 2016 and February 2021. The specimen volume following total mastectomy was compared with breast volume estimates using a fully automated volumetric software (Quantra ver. 2.1.1) and 4 other previously described mammography-based prediction methods. The association between the estimates and mastectomy specimen volume was assessed using Pearson correlation and Bland-Altman analysis. Results Sixty-six patients were included. Compared with previously described mammography-based methods, Quantra estimates were more strongly correlated with mastectomy specimen volume in the entire, fatty, and dense breast groups (r = 0.920, 0.921, and 0.915, respectively; P < 0.001). In applying Quantra estimates for measuring preoperative breast volume, we adjusted a simple equation: mastectomy specimen volume = Quantra estimate × 0.8. Conclusion Mammography with a fully automated breast volumetric software can be useful for measuring preoperative breast volume in patients with breast cancer who undergo reconstruction surgery.
Collapse
Affiliation(s)
- Jin Sung Kim
- Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kyoungkyg Bae
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Eun Ji Lee
- Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Minseo Bang
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| |
Collapse
|
11
|
Alshehri SA, Singh SK, Mosahebi A, Kalaskar DM. The current progress and critical analysis of three-dimensional scanning and three-dimensional printing applications in breast surgery. BJS Open 2021; 5:6272168. [PMID: 33963367 PMCID: PMC8105620 DOI: 10.1093/bjsopen/zrab025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Several attempts have been made to develop a tool capable of evaluating breast shape and volume to aid surgical planning and outcome assessment. More recently, newer technologies such as three-dimensional (3D) scanning and 3D printing have been applied in breast assessment. The aim of this study was to review the literature to assess the applicability of 3D scanning and 3D printing in breast surgery. Methods A literature search was carried on PubMed, Google Scholar and OVID from January 2000 to December 2019 using the keywords ‘3D’, ‘Three-dimensional’, ‘Three/four dimensions’ and ‘Breast’. Results A total of 6564 articles were identified initially; the abstracts of 1846 articles were scanned, and 81 articles met the inclusion criteria and were included in this review. Articles were reviewed and classified according to their aims, study subjects, the software and hardware used, main outcomes and major limitations. Conclusions These technologies are fast and easy to use, however, high costs, long processing times and the need for training might limit their application. To incorporate these technologies into standard healthcare, their efficacy and effectiveness must be demonstrated through multiple and rigorous clinical trials.
Collapse
Affiliation(s)
- S A Alshehri
- UCL Division of Surgery & Interventional Science, Royal Free Hospital, London, UK.,Department of Surgery, King Faisal University, Al-Hofuf, Saudi Arabia
| | - S K Singh
- UCL Division of Surgery & Interventional Science, Royal Free Hospital, London, UK.,Department of Burns & Plastic Surgery, Nottingham University Hospitals, Nottingham, UK
| | - A Mosahebi
- UCL Division of Surgery & Interventional Science, Royal Free Hospital, London, UK.,Department of Plastic Surgery, Royal Free Hospitals NHS Trust, London, UK
| | - D M Kalaskar
- UCL Division of Surgery & Interventional Science, Royal Free Hospital, London, UK
| |
Collapse
|
12
|
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.
Collapse
|
13
|
Tong OLH, Chamson-Reig A, Yip LCM, Brackstone M, Diop M, Carson JJL. Structured-light surface scanning system to evaluate breast morphology in standing and supine positions. Sci Rep 2020; 10:14087. [PMID: 32839488 PMCID: PMC7445296 DOI: 10.1038/s41598-020-70476-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/05/2020] [Indexed: 11/09/2022] Open
Abstract
Breast shapes are affected by gravitational loads and deformities. Measurements obtained in the standing position may not correlate well with measurements in the supine position, which is more representative of patient position during breast surgery. A dual color 3D surface imaging system capable of scanning patients in both supine and standing positions was developed to evaluate the effect of changes in body posture on breast morphology. The system was evaluated with breast phantoms to assess accuracy, then tested on ten subjects in three body postures to assess its effectiveness as a clinical tool. The accuracy of the system was within 0.4 mm on average across the model. For the human study, there was no effect of body posture on breast volumes (p value > 0.05), but we observed an effect of completeness of breast scans on body posture (p value < 0.05). Post-hoc tests showed that the supine position and the standing position with hands at the waist differed significantly (p value < 0.05). This study shows that the system can quantitatively evaluate the effect of subject postures, and thereby has the potential to be used to investigate peri-operative changes in breast morphology.
Collapse
Affiliation(s)
- Olivia L H Tong
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, ON, N6A 4V2, Canada.,School of Biomedical Engineering, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
| | - Astrid Chamson-Reig
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, ON, N6A 4V2, Canada
| | - Lawrence C M Yip
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, ON, N6A 4V2, Canada.,Department of Medical Biophysics, Western University, London, Canada
| | - Muriel Brackstone
- London Regional Cancer Program, London Health Sciences Centre, 800 Commissioners Road East, London, N6A 5W9, Canada.,Department of Surgery, Western University, London, Canada
| | - Mamadou Diop
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, ON, N6A 4V2, Canada.,School of Biomedical Engineering, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada.,Department of Medical Biophysics, Western University, London, Canada
| | - Jeffrey J L Carson
- Imaging Program, Lawson Health Research Institute, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. .,School of Biomedical Engineering, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada. .,Department of Medical Biophysics, Western University, London, Canada. .,Department of Surgery, Western University, London, Canada.
| |
Collapse
|
14
|
马 建, 夏 有, 李 比, 赵 红, 雷 玉. [Techniques enhancement for tissue expander/implant two-stage breast reconstruction]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:169-176. [PMID: 32071482 PMCID: PMC7439067 DOI: 10.19723/j.issn.1671-167x.2020.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the outcomes of breast reconstruction with employing improved techniques throughout the tissue expander/implant two-stage breast reconstructed process, which involved the tissue expander placement, the saline filling intraoperatively and postoperatively, the implant selection, and the permanent implant replacement. METHODS In this study, 68 patients who had been provided immediate or delayed tissue expander/implant two-stage breast reconstruction with autologous fat injection post-mastectomy in Peking University Third Hospital from April 2014 to September 2018 were involved, and the relevant information was analyzed retrospectively. The enhancements of the techniques, involving the incision selection, the expander placement, the principle of expansion, the management of capsule, the prosthesis selection, and the assisted reconstruction method were summarized, and the reconstruction outcomes were evaluated objectively through three-dimensional surface imaging. RESULTS Among the 68 patients in this study, immediate reconstruction was conducted in 25 patients and 43 patients underwent delayed reconstruction. The median time of tissue expansion was 7.0 (3.0, 20.0) months, and the average volume of expansion was (372.8±87.2) mL. The median size of breast implant was 215 (100, 395) mL. The median number of injections for fat grafting was 1 (1, 3), and the average volume of fat grafting was (119.3±34.1) mL. The median follow-up time was 7.0 (4.0, 24.0) months. During the process of breast reconstruction, the tissue expander leakage was observed in two patients, and one of them underwent expander replacement due to the secondary infection. In the immediate reconstruction cases, the volume symmetry of bilateral breasts after reconstruction got even better than that before mastectomy (t=4.465, P<0.01). And in the delayed reconstruction cases, the volume between bilateral breasts also achieved good symmetry after reconstruction (t=0.867, P>0.1). CONCLUSION Good results of tissue expander/implant two-stage breast reconstruction could be achieved through the techniques enhancement, which involved the preferred transverse incision, the downward placement of expander, the rapid expansion of chest soft tissue, the release of capsule tension, the application of sizer in prosthesis selection, and the assisted autologous fat grafting.
Collapse
Affiliation(s)
- 建勋 马
- 北京大学第三医院 成形外科, 北京 100191Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - 有辰 夏
- 北京大学第三医院 成形外科, 北京 100191Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - 比 李
- 北京大学第三医院 成形外科, 北京 100191Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - 红梅 赵
- 北京大学第三医院 普通外科,北京 100191Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
| | - 玉涛 雷
- 北京大学第三医院 普通外科,北京 100191Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
| |
Collapse
|
15
|
Wavelia Breast Imaging: The Optical Breast Contour Detection Subsystem. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10041234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Wavelia is a low-power electromagnetic wave breast imaging device for breast cancer diagnosis, which consists of two subsystems, both performing non-invasive examinations: the Microwave Breast Imaging (MBI) subsystem and the Optical Breast Contour Detection (OBCD) subsystem. The Wavelia OBCD subsystem is a 3D scanning device using an infrared 3D stereoscopic camera, which performs an azimuthal scan to acquire 3D point clouds of the external surface of the breast. The OBCD subsystem aims at reconstructing fully the external envelope of the breast, with high precision, to provide the total volume of the breast and morphological data as a priori information to the MBI subsystem. This paper presents a new shape-based calibration procedure for turntable-based 3D scanning devices, a new 3D breast surface reconstruction method based on a linear stretching function, as well as the breast volume computation method that have been developed and integrated with the Wavelia OBCD subsystem, before its installation at the Clinical Research Facility of Galway (CRFG), in Ireland, for first-in-human clinical testing. Indicative results of the Wavelia OBCD subsystem both from scans of experimental breast phantoms and from patient scans are thoroughly presented and discussed in the paper.
Collapse
|
16
|
Oranges CM, Madduri S, Brantner P, Msallem B, Giordano S, Benitez B, Kalbermatten DF, Schaefer DJ, Thieringer FM. Three-dimensional Assessment of the Breast: Validation of a Novel, Simple and Inexpensive Scanning Process. In Vivo 2019; 33:839-842. [PMID: 31028206 PMCID: PMC6559897 DOI: 10.21873/invivo.11548] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIM Methods to assess three-dimensionally the breast surface are increasingly used in plastic and reconstructive surgery. The aim of this study was to validate the use of the Structure Sensor 3D scanner (Occipital, Inc., Boulder, CO, USA) connected to an iPad Pro (Apple, Inc., Cupertino, CA, USA) as a novel, inexpensive and handheld three-dimensional scanning process. MATERIALS AND METHODS Surface images of a medical human female anatomy torso model of rigid plastic were repeatedly acquired with Structure Sensor 3D scanner and compared with those obtained using two clinically established 3D imaging systems. Digital measurements of vector and surface breast distances were analyzed using Mimics® Innovation Suite 20 medical imaging software (Materialise, Leuven, Belgium). RESULTS The analysis of variance (ANOVA) revealed no statistically significant difference among measurements obtained using different scanning processes for all the variables examined (p>0.05). CONCLUSION The study demonstrates analogous practicability and reliability for surface image acquisition using the newly introduced Structure Sensor 3D scanner and other clinically established scanners.
Collapse
Affiliation(s)
- Carlo M Oranges
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, University of Basel, Basel, Switzerland
| | - Srinivas Madduri
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, University of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Philipp Brantner
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Bilal Msallem
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Department of Oral and Cranio-Maxillofacial Surgery, Basel University Hospital, Basel, Switzerland
| | - Salvatore Giordano
- Department of Plastic and General Surgery, Turku University Hospital, University of Turku, Turku, Finland
| | - Benito Benitez
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Department of Oral and Cranio-Maxillofacial Surgery, Basel University Hospital, Basel, Switzerland
| | - Daniel F Kalbermatten
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, University of Basel, Basel, Switzerland
| | - Dirk J Schaefer
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, University of Basel, Basel, Switzerland
| | - Florian M Thieringer
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Department of Oral and Cranio-Maxillofacial Surgery, Basel University Hospital, Basel, Switzerland
| |
Collapse
|
17
|
Lacher RM, Vasconcelos F, Williams NR, Rindermann G, Hipwell J, Hawkes D, Stoyanov D. Nonrigid reconstruction of 3D breast surfaces with a low-cost RGBD camera for surgical planning and aesthetic evaluation. Med Image Anal 2019; 53:11-25. [PMID: 30660103 PMCID: PMC6854464 DOI: 10.1016/j.media.2019.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 01/06/2019] [Accepted: 01/10/2019] [Indexed: 12/18/2022]
Abstract
A nonrigid 3D breast surface reconstruction pipeline running on a standard PC taking a noisy RGBD input video from a Kinect-style camera is proposed. Pairwise nonrigid ICP is extended to the multi-view case incorporating soft mobility constraints in areas of non-overlap. Shortest distance correspondences as a new technique for data association are shown to lead to consistently better alignment. The method is able to reconstruct clinical-quality surface models in spite of varying degrees of postural sway during data capture. Landmark and volumetric quantitative validation in metric units demonstrate improved reconstruction quality on par with the gold standard and superior to a competing method.
Accounting for 26% of all new cancer cases worldwide, breast cancer remains the most common form of cancer in women. Although early breast cancer has a favourable long-term prognosis, roughly a third of patients suffer from a suboptimal aesthetic outcome despite breast conserving cancer treatment. Clinical-quality 3D modelling of the breast surface therefore assumes an increasingly important role in advancing treatment planning, prediction and evaluation of breast cosmesis. Yet, existing 3D torso scanners are expensive and either infrastructure-heavy or subject to motion artefacts. In this paper we employ a single consumer-grade RGBD camera with an ICP-based registration approach to jointly align all points from a sequence of depth images non-rigidly. Subtle body deformation due to postural sway and respiration is successfully mitigated leading to a higher geometric accuracy through regularised locally affine transformations. We present results from 6 clinical cases where our method compares well with the gold standard and outperforms a previous approach. We show that our method produces better reconstructions qualitatively by visual assessment and quantitatively by consistently obtaining lower landmark error scores and yielding more accurate breast volume estimates.
Collapse
Affiliation(s)
- R M Lacher
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK.
| | - F Vasconcelos
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK.
| | - N R Williams
- Surgical & Interventional Trials Unit, University College London, London, United Kingdom.
| | | | - J Hipwell
- Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom.
| | - D Hawkes
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK.
| | - D Stoyanov
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK.
| |
Collapse
|
18
|
A Review of Objective Measurement of Flap Volume in Reconstructive Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1752. [PMID: 29922550 PMCID: PMC5999430 DOI: 10.1097/gox.0000000000001752] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/20/2018] [Indexed: 11/03/2022]
Abstract
Background The utility and efficacy of 3-dimensional representation have been proven in bony reconstruction; however, its role in soft-tissue reconstruction remains limited. There is currently no reliable gold standard to objectively measure flap volume. This systematic review aims to summarize the available techniques used to objectively measure flap volume in reconstructive surgery. Methods A systematic literature search was performed to identify all relevant articles describing objective techniques to quantify flap volume. The search included published articles in 3 electronic databases-Ovid MEDLINE, EMBASE, and PubMed. Results A total of 16 studies were included. Flap volume was calculated using the following techniques: magnetic resonance imaging, computed tomography, 3-dimensional imaging and modeling, material templates, ultrasound, and weighing scales. Techniques and results of the included studies are summarized. Conclusions This systematic review provides a summary of various published techniques for objective pre- or intraoperative quantification of flap volume in reconstructive surgery. The preliminary results from this review are promising, and we believe that 3-dimensional representation and objective quantification is the future of reconstructive flap surgery. More studies are needed to study the clinical relevancy and impact of the various imaging modalities reviewed and to develop automated volumetric measurement technology with improved accuracy, efficacy, and reproducibility.
Collapse
|
19
|
Chae MP, Rozen WM, Patel NG, Hunter-Smith DJ, Ramakrishnan V. Enhancing breast projection in autologous reconstruction using the St Andrew's coning technique and 3D volumetric analysis. Gland Surg 2017; 6:706-714. [PMID: 29302489 DOI: 10.21037/gs.2017.06.01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background An increasing number of women undergo mastectomy for breast cancer and post-mastectomy autologous breast reconstruction has been shown to significantly improve the psychosexual wellbeing of the patients. A goal of treatment is to achieve symmetry and projection to match the native breast, and/or the contralateral breast in the case of a unilateral reconstruction. Autologous reconstruction, particularly with the deep inferior epigastric artery perforator (DIEP) flap, is particularly advantageous as it can be manipulated to mimic the shape and turgor of the native breast. However, very few techniques of shaping the breast conus when insetting the DIEP flap to enhance aesthetic outcome have been reported to date. With the aide of three-dimension (3D) photography and 3D-printed mirrored image of the contralateral breast as a guide intraoperatively, we describe our St Andrew's coning technique to create a personalized flap projection. Method We report a prospective case series of 3 delayed unilateral breast reconstructions where symmetrization procedure to the contralateral breast was not indicated. Using a commercial 3D scanner (VECTRA XR, Canfield Scientific), the breast region was imaged. The mirrored image was 3D-printed in-house using a desktop 3D printer. Results In all cases, projection of the breast mound was able to be safely achieved, with a demonstrated central volume (or 'cone') able to be highlighted on imaging and a 3D printed breast. A 3D print of the contralateral breast was able to be used intraoperatively to guide the operative approach. Conclusions The St Andrew's coning technique is a useful aesthetic maneuver for achieving breast projection during DIEP flap breast reconstruction, with 3D imaging techniques able to assist in perioperative assessment of breast volume.
Collapse
Affiliation(s)
- Michael P Chae
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash Medical Centre, Clayton, Victoria, Australia.,Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria, Australia
| | - Warren Matthew Rozen
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash Medical Centre, Clayton, Victoria, Australia.,Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria, Australia.,St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Chelmsford, UK
| | - Nakul Gamanlal Patel
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Chelmsford, UK
| | - David J Hunter-Smith
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash Medical Centre, Clayton, Victoria, Australia.,Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria, Australia
| | - Venkat Ramakrishnan
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Chelmsford, UK
| |
Collapse
|
20
|
Rodríguez-Ruiz A, Agasthya GA, Sechopoulos I. The compressed breast during mammography and breast tomosynthesis: in vivo shape characterization and modeling. Phys Med Biol 2017; 62:6920-6937. [PMID: 28665291 DOI: 10.1088/1361-6560/aa7cd0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To characterize and develop a patient-based 3D model of the compressed breast undergoing mammography and breast tomosynthesis. During this IRB-approved, HIPAA-compliant study, 50 women were recruited to undergo 3D breast surface imaging with structured light (SL) during breast compression, along with simultaneous acquisition of a tomosynthesis image. A pair of SL systems were used to acquire 3D surface images by projecting 24 different patterns onto the compressed breast and capturing their reflection off the breast surface in approximately 12-16 s. The 3D surface was characterized and modeled via principal component analysis. The resulting surface model was combined with a previously developed 2D model of projected compressed breast shapes to generate a full 3D model. Data from ten patients were discarded due to technical problems during image acquisition. The maximum breast thickness (found at the chest-wall) had an average value of 56 mm, and decreased 13% towards the nipple (breast tilt angle of 5.2°). The portion of the breast not in contact with the compression paddle or the support table extended on average 17 mm, 18% of the chest-wall to nipple distance. The outermost point along the breast surface lies below the midline of the total thickness. A complete 3D model of compressed breast shapes was created and implemented as a software application available for download, capable of generating new random realistic 3D shapes of breasts undergoing compression. Accurate characterization and modeling of the breast curvature and shape was achieved and will be used for various image processing and clinical tasks.
Collapse
Affiliation(s)
- Alejandro Rodríguez-Ruiz
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, Netherlands
| | | | | |
Collapse
|
21
|
Riggio E, Ardoino I, Richardson CE, Biganzoli E. Predictability of anthropomorphic measurements in implant selection for breast reconstruction: a retrospective cohort study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017; 40:203-212. [PMID: 28603385 PMCID: PMC5440532 DOI: 10.1007/s00238-016-1261-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/20/2016] [Indexed: 11/26/2022]
Abstract
Background Preoperative implant planning for breast reconstruction is often at risk of being changed perioperatively. This study examined which factors are associated with a change of implant selection. Methods Women who had unilateral two-stage breast reconstruction between 2002 and 2007 were studied. Inclusion criteria were photographic evidence of preoperative skin markings indicating breast dimensions and a selected implant model. Multivariable logistic regression was used to identify variables associated with a changed selection. Results Among the 496 women studied, 308 preoperative implant choices (62.1%) were changed during surgery. A change in plan was significantly associated with symmetrization surgery involving contralateral reduction mammaplasty (OR = 1.92; 95% CI, 1.12 to 3.29) and contralateral mastopexy (OR = 2.26; 95% CI, 1.29 to 3.96), but not with BMI. The required implant width changed more than 0.5 cm in 70 cases (14.1%) while height changed more than 0.5 cm in 215 cases (43.2%). The likelihood of a change was high for large preoperative widths (OR = 9.66 for 15.5 cm) and small preoperative heights (OR = 2.97 for 10.5 cm). At a mean follow-up of 16.6 months, patient satisfaction was good or average in 92.1% of cases and 5.9% of implants had been replaced with another model, indicating that the perioperative implant selection was usually appropriate. Conclusions This study documents the frequency with which implant choices, despite accurate preoperative planning, are changed perioperatively as a result of relatively small differences in anthropomorphic measurements. Perioperative recalculation of breast dimensions may have an advantage in terms of patient reoperation rates. Changes in width were less frequent than changes in height and projection. Contralateral surgery, large width, and small height were the most influential factors. Level of Evidence: Level IV, risk / prognostic study.
Collapse
Affiliation(s)
- Egidio Riggio
- Unit of Plastic and Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Ilaria Ardoino
- G.A. Maccacaro Unit of Medical Statistics, Biometry and Bioinformatics, Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Caroline E. Richardson
- Unit of Plastic and Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Elia Biganzoli
- G.A. Maccacaro Unit of Medical Statistics, Biometry and Bioinformatics, Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| |
Collapse
|