Smartphone-Based 3D Surface Imaging: A New Frontier in Digital Breast Assessment? Smartphone-Based Breast Assessment

Background: Three-dimensional surface imaging is widely used in breast surgery. Recently, smartphone-based approaches have emerged. This investigation examines whether smartphone-based three-dimensional surface imaging provides clinically acceptable data in terms of accuracy when compared to a validated reference tool. Methods: Three-dimensional surface models were generated for 40 patients who underwent breast reconstruction surgery using the Vectra H2 (Canfield Scientific, Fairfield, NJ, USA) and the LiDAR sensor of an iPhone 15 Pro in conjunction with photogrammetry. The generated surface models were superimposed using CloudCompare's ICP algorithm, followed by 14 linear surface-to-surface measurements to assess agreement between the three-dimensional surface models. Statistical methods included absolute error calculation, paired t-test, Bland-Altman analysis, and Intra-Class Correlation Coefficients to evaluate intra- and inter-rater reliability. Results: The average landmark-to-landmark deviation between smartphone-based and Vectra-based surface models was M = 2.997 mm (SD = 1.897 mm). No statistical differences were found in 13 of the 14 measurements for intra-rater comparison and in 12 of the 14 for inter-rater comparison. The Intra-Class Correlation Coefficient for intra-rater reliability of the iPhone was good, ranging from 0.873 to 0.993. Intra-Class Correlation Coefficient values indicated good reliability, ranging from 0.873 to 0.993 (intra-rater) and 0.845 to 0.992 (inter-rater). Bland-Altman analyses confirmed moderate to reliable agreement in 13 of 14 measurements. Conclusions: Smartphone-based three-dimensional surface imaging presents promising possibilities for breast assessment. However, it may not yet be suitable for highly detailed breast assessments requiring accuracy below the 3 mm threshold.