Automatic three-dimensional surface imaging with chest computerized alignment for preoperative breast volume evaluation

Accurate breast volume assessment is essential for preoperative planning in unilateral one-stage immediate breast reconstruction to achieve symmetry and optimal cosmetic outcomes. However, no standard method for precise breast volume estimation has been established. Three-dimensional (3D) surface imaging has gained popularity owing to its convenience. The aim of this study was to develop a novel hybrid method integrating automatic segmentation and alignment of 3D surface imaging with chest computed tomography (CT) for preoperative breast reconstruction planning. This preliminary prospective study included patients who underwent unilateral one-stage immediate breast reconstruction using direct implantation or autologous transfer after therapeutic or prophylactic mastectomy at our institution between 2020 and 2022. Breast volume was evaluated using 3D surface imaging and chest CT within 1 month before surgery. The accuracy and reliability of the hybrid method were compared with those of conventional 3D surface imaging. The results were validated using the mastectomy specimen volumes measured by water displacement. A total of 18 women and 19 breast specimens were included in the volumetric analysis. The mean estimated volumes were 486.4 ± 38.4 mL for conventional 3D surface imaging and 403.6 ± 44.2 mL for the automatic segmentation method. Conventional 3D surface imaging significantly overestimated breast volume. Meanwhile, the automatic segmentation method demonstrated higher correlation coefficients and a lower mean relative error.