The effect of percutaneous, surgical, and medical therapies for vascular malformations (VMs) is often difficult to quantify volumetrically using cross-sectional imaging. Volumetric measurement is often estimated with serial, expensive MRI examinations which may require sedation or anesthesia. We aim to explore whether a portable 3D scanning device is capable of rapid, accurate volumetric analysis of pediatric VMs. Using an iPad-mounted infrared scanning device, 3D scans of patient faces, arms, and legs were acquired over an 8-month study period. Proprietary software was use to perform subsequent volumetric analysis. Of a total of 30 unilateral VMs involving either the face, arms, or legs, 26 (86.7%) VMs were correctly localized by discerning the larger volume of the affected side compared to the normal contralateral side. For patients with unilateral facial VMs (n = 10), volume discrepancy between normal and affected sides differed compared with normal controls (n = 19). This was true for both absolute (60 cc ± 55 vs 15 cc ± 8, p = 0.03) as well as relative (18.1% ± 13.2 vs 4.0% ± 2.1, p = 0.008) volume discrepancy. Following treatment, two patients experienced change in leg volume discrepancy ranging from − 17.3 to − 0.4%. Using a portable 3D scanning device, we were able to rapidly and noninvasively detect and quantify volume discrepancy resulting from VMs of the face, arms, and legs. Preliminary data suggests this technology can detect volume reduction of VMs in response to therapy.
Vascular malformation Volume assessment 3D Three-dimensional
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This study would not have been possible without Victoria Allen, who assisted with coordinating IRB approval and maintaining compliance with institutional research policies.
M.W. is employed by LymphaTech. He and J.D. have an equity stake in the company.
a) An unaltered 3D scan of the head and neck of a control patient rendered using MeshLab. b) The scan is manually aligned using the Manipulator tool to correct for any postural deviations from natural head position. c) A duplicate scan (purple) is imported into MeshLab. d) Six points are then manually selected on facial landmarks of the duplicate scan, each point corresponding to a point selected on the previously aligned “reference scan” (pink). e) Using the Point-based Gluing Alignment tool, the duplicate scan is aligned to the reference scan by orienting the scan such that the user-selected points on each scan are placed in closest proximity to each other. (PNG 2002 kb)
a) The region of interest (red) for the face is manually identified with boundaries defined superiorly by the level of the eye, inferiorly by the chin, anteriorly by the tip of the nose, posteriorly and laterally by the anterior crease of the earlobes. b) The region of interest is then bisected to allow for volume comparison of left and right sides. The sagittal plane is created using input from a user-defined midpoint of the nose. c) A cross-sectional view of the region of interest. (PNG 3908 kb)
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