Potential of Intraoperative 3D Photography and 3D Visualization in Breast Reconstruction

Abstract

Background: Although pre- and postoperative three-dimensional (3D) photography are well-established in breast reconstruction, intraoperative 3D photography is not. We demonstrate the process of intraoperative acquisition and visualization of 3D photographs for breast reconstruction and present clinicians’ opinions about intraoperative visualization tools. Methods: Mastectomy specimens were scanned with a handheld 3D scanner during breast surgery. The 3D photographs were processed to compute morphological measurements of the specimen. Three visualization modalities (screen-based viewing, augmented reality viewing, and 3D printed models) were created to show different representations of the 3D photographs to plastic surgeons. We interviewed seven surgeons about the usefulness of the visualization methods. Results: The average time for intraoperative acquisition of 3D photographs of the mastectomy specimen was 4 minutes, 8 seconds ± 44 seconds. The average time for image processing to compute morphological measurements of the specimen was 54.26 ± 40.39 seconds. All of the interviewed surgeons would be more inclined to use intraoperative visualization if it displayed information that they are currently missing (eg, the target shape of the reconstructed breast mound). Additionally, the surgeons preferred high-fidelity visualization tools (such as 3D printing) that are easy-to-use and have minimal disruption to their current workflow. Conclusions: This study demonstrates that 3D photographs can be collected intraoperatively within acceptable time limits, and quantitative measurements can be computed timely to be utilized within the same procedure. We also report surgeons’ comments on usability of visualization methods and of measurements of the mastectomy specimen, which can be used to guide future surgical practice.

Three-Dimensional Photography and Computer Modeling as a Reconstructive Surgical Training Tool

“…The speed at which the photographs could be taken and processed was noted as an advantage, illustrating the swiftness by which a database like ours can be compiled and grown. 11 …”

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

“…[11][12][13] Furthermore, in a series of recent interviews to gauge the utility of threedimensional photography in breast reconstruction, reconstructive surgeons at MD Anderson agreed on the value of three-dimensional imaging for providing breast volume estimates and topographic information. 14 Over the past several years, VECTRA (Canfield Scientific, Parsippany, NJ) has gained prominence as the three-dimensional imaging modality of choice in plastic surgery. 3,[15][16][17][18][19][20][21][22][23][24] However, validation studies on the ability of VECTRA to predict breast volume have varied in methodology, results, and type of VECTRA software used.…”

“…11–13 Furthermore, in a series of recent interviews to gauge the utility of three-dimensional photography in breast reconstruction, reconstructive surgeons at MD Anderson agreed on the value of three-dimensional imaging for providing breast volume estimates and topographic information. 14…”