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Updated: May 12, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Three-dimensional digital capture of head size in neonates - a method evaluation
Sascha Ifflaender1, Mario Rüdiger, Arite Koch
1Department of Neonatology and Paediatric Intensive Care, University Hospital Carl Gustav Carus, Dresden, Germany.
Insights
Head circumference (HC) measurements may mislead in preterm infants; 3D laser scanning offers reproducible cranial volume (CrV) and HC data. This advanced method provides a more accurate assessment of head growth in neonates.
Area of Science:
- Neonatal care
- Neurodevelopmental outcomes
- Medical imaging technologies
Background:
- Neonatal care quality is linked to long-term neurodevelopmental outcomes.
- Preterm infant neurodevelopment depends on postnatal head growth and medical interventions.
- Head circumference (HC) is a standard 2D measure, but head deformities in preterm infants can limit its accuracy.
Purpose of the Study:
- Evaluate the reproducibility of a 3D digital capture system for newborn head scans.
- Compare manual and digital HC measurements in a neonatal cohort.
- Determine the correlation between HC and cranial volume (CrV) and assess HC's predictive value for CrV.
Main Methods:
- Analyzed head scan data from a laser shape digitizer over twelve months.
- Employed repeated measures for method evaluation and compared manual and digital HC acquisition.
- Performed regression analysis to examine the relationship between HC and CrV.
Main Results:
- The 3D laser system demonstrated excellent interobserver reliability for both HC and CrV.
- Manual and digital HC measurements were found to be interchangeable.
- HC and CrV showed a strong correlation (r²=0.859), but HC poorly predicted CrV (RSD ±24 ml).
Conclusions:
- Traditional 2D HC measurements may be misleading for assessing preterm infant head growth.
- Cranial volume (CrV) can significantly differ between infants with similar HC.
- The 3D laser scanner provides reproducible HC and CrV data, offering a promising alternative, though additional imaging is needed for cerebral structure assessment.
Introduction:
The quality of neonatal care is mainly determined by long-term neurodevelopmental outcome. The neurodevelopment of preterm infants is related to postnatal head growth and depends on medical interventions such as nutritional support. Head circumference (HC) is currently used as a two-dimensional measure of head growth. Since head deformities are frequently found in preterm infants, HC may not always adequately reflect head growth. Laser aided head shape digitizers offer semiautomatic acquisition of HC and cranial volume (CrV) and could thus be useful in describing head size more precisely.
Aims:
1) To evaluate reproducibility of a 3D digital capture system in newborns. 2) To compare manual and digital HC measurements in a neonatal cohort. 3) To determine correlation of HC and CrV and predictive value of HC.
Methods:
Within a twelve-month period data of head scans with a laser shape digitizer were analysed. Repeated measures were used for method evaluation. Manually and digitally acquired HC was compared. Regression analysis of HC and CrV was performed.
Results:
Interobserver reliability was excellent for HC (bias-0.005%, 95% Limits of Agreement (LoA) -0.39-0.39%) and CrV (bias1.5%, 95%LoA-0.8-3.6%). Method comparison data was acquired from 282 infants. It revealed interchangeability of the methods (bias-0.45%; 95%LoA-4.55-3.65%) and no significant systematic or proportional differences. HC and CrV correlated (r(2) = 0.859, p<0.001), performance of HC predicting CrV was poor (RSD ±24 ml). Correlation was worse in infants with lower postmenstrual age (r(2) = 0.745) compared to older infants (r(2) = 0.843).
Discussion:
The current practice of measuring HC for describing head growth in preterm infants could be misleading since it does not represent a 3D approach. CrV can vary substantially in infants of equal HC. The 3D laser scanner represents a new and promising method to provide reproducible data of CrV and HC. Since it does not provide data on cerebral structures, additional imaging is required.
