3D Optical Imaging as a New Tool for the Objective Evaluation of Body Shape Changes After Bariatric Surgery

Digital Leg Volume Quantification: Precision Assessment of a Novel Workflow Based on Single Capture Three-dimensional Whole-Body Surface Imaging

Whole-body three-dimensional surface imaging (3DSI) offers the ability to monitor morphologic changes in multiple areas without the need to individually scan every anatomical region of interest. One area of application is the digital quantification of leg volume. Certain types of morphology do not permit complete circumferential scan of the leg surface. A workflow capable of precisely estimating the missing data is therefore required. We thus aimed to describe and apply a novel workflow to collect bilateral leg volume measurements from whole-body 3D surface scans regardless of leg morphology and to assess workflow precision. For each study participant, whole-body 3DSI was conducted twice successively in a single session with subject repositioning between scans. Paired samples of bilateral leg volume were calculated from the 3D surface data, with workflow variations for complete and limited leg surface visibility. Workflow precision was assessed by calculating the relative percent differences between repeated leg volumes. A total of 82 subjects were included in this study. The mean relative differences between paired left and right leg volumes were 0.73 ± 0.62% and 0.82 ± 0.65%. The workflow variations for completely and partially visible leg surfaces yielded similarly low values. The workflow examined in this study provides a precise method to digitally monitor leg volume regardless of leg morphology. It could aid in objectively comparing medical treatment options of the leg in a clinical setting. Whole-body scans acquired using the described 3DSI routine may allow simultaneous assessment of other changes in body morphology after further validation.

Objective and Subjective Comparisons of Split Thickness Skin Graft and Full Thickness Skin Graft for Radial Forearm Flap Donor Sites Using a New Measuring Method

ABSTRACT

A split thickness skin graft (STSG) or a full thickness skin graft (FTSG) are commonly used for donor site closure after raising a radial forearm flap. The aesthetic outcome of the donor site is frequently not satisfying for the patient. This study evaluated the aesthetic outcome of the donor site of a radial forearm flap covered with an STSG or FTSG using an objective measurement method. The forearms of 30 patients (15 FTSG, 15 STSG) were scanned with an optical three-dimensional scanner. The surface of the forearm at the skin transplant was cut out and filled by an automatic hole-filling algorithm. The mean surface deviation between the original and the filled forearm was acquired. This method was validated with a control group of 15 volunteers. A questionnaire investigating aesthetical and healing satisfaction, postoperative pain and scarring was filled in by the patients. The mean surface difference in the STSG group was 0.9907 ± 0.3120 and 0.6177 ± 0.2245 mm in the FTSG group. The difference in the surface deviation between STSG and FTSG groups was significant (P = 0.0009). Correlations between the surface deviation and the subjective aesthetical satisfaction of the patient were not significant. In the questionnaires no significant differences between STSG and FTSG group were measured. Both FTSGs and STSGs resulted in good aesthetical outcomes after closure of a radial forearm flap donor site. Scanning the radial forearm flap donor site with an optical three-dimensional scanner supplied an objective, fast, and reliable measuring method of aesthetical outcomes.

Evidence-Based Efficacy of High-Intensity Focused Ultrasound (HIFU) in Aesthetic Body Contouring

Being profitable procedures with little disposable costs, a number of noninvasive technologies have gained much popularity in recent years and are permeating the aesthetic marketplace. High-intensity focused ultrasound (HIFU) when focused at a targeted depth of 1.1 to 1.6 cm within subcutaneous tissue raises local tissue temperature at the focal point resulting in almost immediate cell death without damage to the surrounding tissues. Despite having gained popularity, little information is available regarding HIFU use for the treatment of localized fat and aesthetic body sculpturing. The current literature review is intended to investigate evidence-based efficacy of HIFU in aesthetic body contouring. 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 .

A virtual environment to evaluate the arm volume for lymphedema affected patients

BACKGROUND AND OBJECTIVE

The paper presents a novel procedure based on 3D scanning and 3D modelling to automatically assess linear and volumetric measurements of an arm and to be further applied to patients affected by post breast cancer lymphedema. The aim is the creation of a virtual platform easily usable by medical personnel to get more objective evaluations during the lymphedema treatment.

METHODS

The procedure is based on the 3D scanning of the arm using the Occipital Structure Sensor and an ad-hoc developed application, named Lym 3DLab. Lym 3DLab emulates the traditional measurement methods, which consist in taking manual circumference measurements or using the water displacement method. These measurements are also used to design the compression stockings, the typical orthopaedic device used for lymphedema treatment. A validation test has been performed to compare the measurements computed by Lym 3DLab with both water displacement and manual circumference measurements. Eight volunteers have been involved who are not affected by lymphedema. Furthermore, a specific usability test has been performed to evaluate the 3D scanning procedure by involving four physiotherapists.

RESULTS

The comparison between the volumes has highlighted how all the 3D acquired models have their volumes inside a range of acceptability. This range has been defined by considering the sensitivity error of the tape measure used to measure the water displacement. The comparison between the perimeters of cross sections computed with Lym 3DLab and the circumference measurements has shown results that are very accurate with an average difference of 2 mm. The measure errors have been considered negligible by the medical personnel who have evaluated the proposed procedure more accurate than the traditional ones. The test with physiotherapists has shown a high level of usability of the whole virtual environment, but the 3D scanning procedure requires an appropriate training of the personnel to make the 3D acquisition as fast and efficient as possible.

CONCLUSIONS

The achieved results and the physiotherapists' feedback allow planning a future test with patients affected by lymphedema in collaboration with the hospital. A further test has been planned to use the computed measurements to design orthopaedic compression stockings.