Automatic Landmarks Detection in Breast Reconstruction Aesthetic Assessment

This paper addresses a fully automatic landmarks detection method for breast reconstruction aesthetic assessment. The set of landmarks detected are the supraesternal notch (SSN), armpits, nipples, and inframammary fold (IMF). These landmarks are commonly used in order to perform anthropometric measurements for aesthetic assessment. The methodological approach is based on both illumination and morphological analysis. The proposed method has been tested with 21 images. A good overall performance is observed, although several improvements must be achieved in order to refine the detection of nipples and SSNs.Junta de Andalucía PI-0223-201

Anatomical curve identification

Methods for capturing images in three dimensions are now widely available, with stereo-photogrammetry and laser scanning being two common approaches. In anatomical studies, a number of landmarks are usually identified manually from each of these images and these form the basis of subsequent statistical analysis. However, landmarks express only a very small proportion of the information available from the images. Anatomically defined curves have the advantage of providing a much richer expression of shape. This is explored in the context of identifying the boundary of breasts from an image of the female torso and the boundary of the lips from a facial image. The curves of interest are characterised by ridges or valleys. Key issues in estimation are the ability to navigate across the anatomical surface in three-dimensions, the ability to recognise the relevant boundary and the need to assess the evidence for the presence of the surface feature of interest. The first issue is addressed by the use of principal curves, as an extension of principal components, the second by suitable assessment of curvature and the third by change-point detection. P-spline smoothing is used as an integral part of the methods but adaptations are made to the specific anatomical features of interest. After estimation of the boundary curves, the intermediate surfaces of the anatomical feature of interest can be characterised by surface interpolation. This allows shape variation to be explored using standard methods such as principal components. These tools are applied to a collection of images of women where one breast has been reconstructed after mastectomy and where interest lies in shape differences between the reconstructed and unreconstructed breasts. They are also applied to a collection of lip images where possible differences in shape between males and females are of interest

3D Face Reconstruction from 2D Pictures: First Results of a Web-Based Computer Aided System for Aesthetic Procedures

The human face is a vital component of our identity and many people undergo medical aesthetics procedures in order to achieve an ideal or desired look. However, communication between physician and patient is fundamental to understand the patient's wishes and to achieve the desired results. To date, most plastic surgeons rely on either "free hand” 2D drawings on picture printouts or computerized picture morphing. Alternatively, hardware dependent solutions allow facial shapes to be created and planned in 3D, but they are usually expensive or complex to handle. To offer a simple and hardware independent solution, we propose a web-based application that uses 3 standard 2D pictures to create a 3D representation of the patient's face on which facial aesthetic procedures such as filling, skin clearing or rejuvenation, and rhinoplasty are planned in 3D. The proposed application couples a set of well-established methods together in a novel manner to optimize 3D reconstructions for clinical use. Face reconstructions performed with the application were evaluated by two plastic surgeons and also compared to ground truth data. Results showed the application can provide accurate 3D face representations to be used in clinics (within an average of 2mm error) in less than 5mi

3D reconstruction for plastic surgery simulation based on statistical shape models

This thesis has been accomplished in Crisalix in collaboration with the Universitat Pompeu Fabra within the program of Doctorats Industrials. Crisalix has the mission of enhancing the communication between professionals of plastic surgery and patients by providing a solution to the most common question during the surgery planning process of ``How will I look after the surgery?''. The solution proposed by Crisalix is based in 3D imaging technology. This technology generates the 3D reconstruction that accurately represents the area of the patient that is going to be operated. This is followed by the possibility of creating multiple simulations of the plastic procedure, which results in the representation of the possible outcomes of the surgery. This thesis presents a framework capable to reconstruct 3D shapes of faces and breasts of plastic surgery patients from 2D images and 3D scans. The 3D reconstruction of an object is a challenging problem with many inherent ambiguities. Statistical model based methods are a powerful approach to overcome some of these ambiguities. We follow the intuition of maximizing the use of available prior information by introducing it into statistical model based methods to enhance their properties. First, we explore Active Shape Models (ASM) which are a well known method to perform 2D shapes alignment. However, it is challenging to maintain prior information (e.g. small set of given landmarks) unchanged once the statistical model constraints are applied. We propose a new weighted regularized projection into the parameter space which allows us to obtain shapes that at the same time fulfill the imposed shape constraints and are plausible according to the statistical model. Second, we extend this methodology to be applied to 3D Morphable Models (3DMM), which are a widespread method to perform 3D reconstruction. However, existing methods present some limitations. Some of them are based in non-linear optimizations computationally expensive that can get stuck in local minima. Another limitation is that not all the methods provide enough resolution to represent accurately the anatomy details needed for this application. Given the medical use of the application, the accuracy and robustness of the method, are important factors to take into consideration. We show how 3DMM initialization and 3DMM fitting can be improved using our weighted regularized projection. Finally, we present a framework capable to reconstruct 3D shapes of plastic surgery patients from two possible inputs: 2D images and 3D scans. Our method is used in different stages of the 3D reconstruction pipeline: shape alignment; 3DMM initialization and 3DMM fitting. The developed methods have been integrated in the production environment of Crisalix, proving their validity.Aquesta tesi ha estat realitzada a Crisalix amb la col·laboració de la Universitat Pompeu Fabra sota el pla de Doctorats Industrials. Crisalix té com a objectiu la millora de la comunicació entre els professionals de la cirurgia plàstica i els pacients, proporcionant una solució a la pregunta que sorgeix més freqüentment durant el procés de planificació d'una operació quirúrgica ``Com em veuré després de la cirurgia?''. La solució proposada per Crisalix està basada en la tecnologia d'imatge 3D. Aquesta tecnologia genera la reconstrucció 3D de la zona del pacient operada, seguit de la possibilitat de crear múltiples simulacions obtenint la representació dels possibles resultats de la cirurgia. Aquesta tesi presenta un sistema capaç de reconstruir cares i pits de pacients de cirurgia plàstica a partir de fotos 2D i escanegis. La reconstrucció en 3D d'un objecte és un problema complicat degut a la presència d'ambigüitats. Els mètodes basats en models estadístics son adequats per mitigar-les. En aquest treball, hem seguit la intuïció de maximitzar l'ús d'informació prèvia, introduint-la al model estadístic per millorar les seves propietats. En primer lloc, explorem els Active Shape Models (ASM) que són un conegut mètode fet servir per alinear contorns d'objectes 2D. No obstant, un cop aplicades les correccions de forma del model estadístic, es difícil de mantenir informació de la que es disposava a priori (per exemple, un petit conjunt de punts donat) inalterada. Proposem una nova projecció ponderada amb un terme de regularització, que permet obtenir formes que compleixen les restriccions de forma imposades i alhora són plausibles en concordança amb el model estadístic. En segon lloc, ampliem la metodologia per aplicar-la als anomenats 3D Morphable Models (3DMM) que són un mètode extensivament utilitzat per fer reconstrucció 3D. No obstant, els mètodes de 3DMM existents presenten algunes limitacions. Alguns estan basats en optimitzacions no lineals, computacionalment costoses i que poden quedar atrapades en mínims locals. Una altra limitació, és que no tots el mètodes proporcionen la resolució adequada per representar amb precisió els detalls de l'anatomia. Donat l'ús mèdic de l'aplicació, la precisió i la robustesa són factors molt importants a tenir en compte. Mostrem com la inicialització i l'ajustament de 3DMM poden ser millorats fent servir la projecció ponderada amb regularització proposada. Finalment, es presenta un sistema capaç de reconstruir models 3D de pacients de cirurgia plàstica a partir de dos possibles tipus de dades: imatges 2D i escaneigs en 3D. El nostre mètode es fa servir en diverses etapes del procés de reconstrucció: alineament de formes en imatge, la inicialització i l'ajustament de 3DMM. Els mètodes desenvolupats han estat integrats a l'entorn de producció de Crisalix provant la seva validesa

A Research Agenda for Appearance Changes Due to Breast Cancer Treatment

Breast cancer is one of the most prevalent forms of cancer in the US. It is estimated that more than 180,000 American women will be diagnosed with invasive breast cancer in 2008. Fortunately, the survival rate is relatively high and continually increasing due to improved detection techniques and treatment methods. However, maintaining quality of life is a factor often under emphasized for breast cancer survivors. Breast cancer treatments are invasive and can lead to deformation of the breast. Breast reconstruction is important for restoring the survivor’s appearance. However, more work is needed to develop technologies for quantifying surgical outcomes and understanding women’s perceptions of changes in their appearance. A method for objectively measuring breast anatomy is needed in order to help both the breast cancer survivors and their surgeons take expected changes to the survivor’s appearance into account when considering various treatment options. In the future, augmented reality tools could help surgeons reconstruct a survivor’s breasts to match her preferences as much as possible

Evaluation of Intraoperative Volumetric Assessment of Breast Volume Using 3D Handheld Stereo Photogrammetric Device.

Methods for assessing three-dimensional (3D) breast volume are becoming increasingly popular in breast surgery. However, the precision of intraoperative volumetric assessment is still unclear. Until now, only non-validated scanning systems have been used for intraoperative volumetric analyses. This study aimed to assess the feasibility, handling, and accuracy of a commercially available, validated, and portable device for intraoperative 3D volumetric evaluation. All patients who underwent breast surgery from 2020 to 2022 were identified from our institutional database. Intraoperative 3D volumetric assessments of 103 patients were included in this study. Standardized 3D volumetric measurements were obtained 3 months postoperatively to compare the intraoperatively generated volumetric assessment. All of the study participants were women with a mean age of 48.3 ± 14.7 years (range: 20-89). The mean time for intraoperative volumetric assessment was 8.7 ± 2.6 min. The postoperative 3D volumetric assessment, with a mean volume of 507.11 ± 206.29 cc, showed no significant difference from the intraoperative volumetric measurements of 504.24 ± 276.61 cc (p = 0.68). The mean absolute volume difference between the intraoperative simulations and postoperative results was 27.1 cc. Intraoperative 3D volumetric assessment using the VECTRA H2 imaging system seems to be a feasible, reliable, and accurate method for measuring breast volume. Based on this finding, we plan to investigate whether volumetric objective evaluations will help to improve breast symmetry in the future

A Novel Method of Outcome Assessment in Breast Reconstruction Surgery: Comparison of Autologous and Alloplastic Techniques Using Three-Dimensional Surface Imaging

Background Breast reconstruction is an important coping tool for patients undergoing a mastectomy. There are numerous surgical techniques in breast reconstruction surgery (BRS). Regardless of the technique used, creating a symmetric outcome is crucial for patients and plastic surgeons. Three-dimensional surface imaging enables surgeons and patients to assess the outcome's symmetry in BRS. To discriminate between autologous and alloplastic techniques, we analyzed both techniques using objective optical computerized symmetry analysis. Software was developed that enables clinicians to assess optical breast symmetry using three-dimensional surface imaging. Methods Twenty-seven patients who had undergone autologous (n = 12) or alloplastic (n = 15) BRS received three-dimensional surface imaging. Anthropomorphic data were collected digitally using semiautomatic measurements and automatic measurements. Automatic measurements were taken using the newly developed software. To quantify symmetry, a Symmetry Index is proposed. Results Statistical analysis revealed that there is no difference in the outcome symmetry between the two groups (t test for independent samples; p = 0.48, two-tailed). Conclusion This study's findings provide a foundation for qualitative symmetry assessment in BRS using automatized digital anthropometry. In the present trial, no difference in the outcomes' optical symmetry was detected between autologous and alloplastic approaches. Level of evidence Level 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

Kinect based system applied to breast cancer conservative treatment

Tese de Mestrado Integrado. Engenharia Electrotécnica e de Computadores. Faculdade de Engenharia. Universidade do Porto. 201