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Three-dimensional head shape quantification for infants with and without deformational plagiocephaly
I Atmosukarto1, L G Shapiro, J R Starr
1Department of Computer Science and Engineering, University of Washington, Seattle, USA.
Insights
New 3D indices accurately measure deformational plagiocephaly (DP) severity in infants. These advanced measurements offer improved classification of head shapes compared to 2D methods, aiding future research and clinical care.
Area of Science:
- Craniofacial development and pediatric orthopedics.
- Medical imaging and quantitative analysis.
- Infant health and developmental pediatrics.
Background:
- Deformational plagiocephaly (DP) is a common condition in infants.
- Accurate quantification of DP severity is crucial for diagnosis and treatment.
- Existing 2D methods may lack precision in assessing DP.
Purpose of the Study:
- To develop and validate novel three-dimensional (3D) indices for quantifying DP severity.
- To compare the diagnostic accuracy of 3D indices against 2D measures.
- To enhance the precision of DP phenotyping in research and clinical practice.
Main Methods:
- Development of 3D indices including LPFS, RPFS, AS, AAS, and aOCLR from 3D mesh data.
- Classification of infants with and without DP using expert ratings.
- Evaluation of classification accuracy using receiver operating characteristic curves and AUC statistics.
Main Results:
- The 3D asymmetry score (AS) achieved the highest classification accuracy (99% AUC).
- Other 3D indices (LPFS, RPFS, AAS) also demonstrated high accuracy (91-97% AUC).
- The 2D approximation (aOCLR) showed lower accuracy (79% AUC).
Conclusions:
- Novel 3D posterior severity scores offer superior sensitivity and specificity for discriminating DP from typical head shapes.
- These 3D indices enable more precise quantification of the DP phenotype.
- Improved quantification may lead to better understanding of DP prevalence and enhanced clinical management.
Objective:
The authors developed and tested three-dimensional (3D) indices for quantifying the severity of deformational plagiocephaly (DP).
Design:
The authors evaluated the extent to which infants with and without DP (as determined by clinic referral and two experts' ratings) could be correctly classified.
Participants:
Infants aged 4 to 11 months, including 154 with diagnosed DP and 100 infants without a history of DP or other craniofacial condition. After excluding participants with discrepant expert ratings, data from 90 infants with DP and 50 infants without DP were retained.
Measurements:
Two-dimensional (2D) histograms of surface normal vector angles were extracted from 3D mesh data and used to compute the severity scores.
Outcome Measures:
Left posterior flattening score (LPFS), right posterior flattening score (RPFS), asymmetry score (AS), absolute asymmetry score (AAS), and an approximation of a previously described 2D measure, the oblique cranial length ratio (aOCLR). Two-dimensional histograms localized the posterior flatness for each participant.
Analysis:
The authors fit receiver operating characteristic curves and calculated the area under the curves (AUC) to evaluate the relative accuracy of DP classification using the above measures.
Results:
The AUC statistics were AAS = 91%, LPFS = 97%, RPFS = 91%, AS = 99%, and aOCLR = 79%.
Conclusion:
Novel 3D-based plagiocephaly posterior severity scores provided better sensitivity and specificity in the discrimination of plagiocephalic and typical head shapes than the 2D measurements provided by a close approximation of OCLR. These indices will allow for more precise quantification of the DP phenotype in future studies on the prevalence of this condition, which may lead to improved clinical care.
