Preoperative implant selection for unilateral breast reconstruction using 3D imaging with the Microsoft Kinect sensor

Publication date: Available online 23 April 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Stefanie T.L. Pöhlmann, Elaine Harkness, Christopher J. Taylor, Ashu Gandhi, Susan M. Astley
AimsThis study aimed to investigate whether breast volume measured preoperatively with a Kinect 3D sensor could be used to determine the most appropriate implant size for reconstruction.MethodsTen patients underwent 3D imaging before and after unilateral implant-based reconstruction. Imaging used seven configurations, varying patient pose and Kinect location, which were compared regarding suitability for volume measurement. Four methods of defining the breast boundary for automated volume calculation were compared, and repeatability assessed over five repetitions.ResultsThe most repeatable breast boundary annotation used an ellipse to track the inframammary fold and a plane describing the chest wall (coefficient of repeatability: 70 ml). The most reproducible imaging position comparing pre- and postoperative volume measurement of the healthy breast was achieved for the sitting patient with elevated arms and Kinect centrally positioned (coefficient of repeatability: 141 ml). Optimal implant volume was calculated by correcting used implant volume by the observed postoperative asymmetry. It was possible to predict implant size using a linear model derived from preoperative volume measurement of the healthy breast (coefficient of determination R²=0.78, standard error of prediction 120 ml). Mastectomy specimen weight and experienced surgeons' choice showed similar predictive ability (both: R²=0.74, standard error: 141/142 ml). A leave one-out validation showed that in 61% of cases 3D imaging could predict implant volume to within 10%, however for 17% of cases it was >30%.ConclusionThis technology has the potential to aid reconstruction surgery planning and implant procurement in order to maximize symmetry after unilateral reconstruction.



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